{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:50:31Z","timestamp":1753890631907,"version":"3.41.2"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T00:00:00Z","timestamp":1697500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The renal effect of metabolic syndrome components is unclear in patients with atrial fibrillation. This study aimed to investigate the association between metabolic syndrome components and incident end-stage renal disease among patients with atrial fibrillation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 202,434 atrial fibrillation patients without prevalent end-stage renal disease were identified from the National Health Insurance Service database between 2009 and 2016. We defined the metabolic score range from 0 to 5 points such that a patient received every 1 point if the patient met each component listed in the diagnostic criteria of metabolic syndrome. The population was divided into 6 groups: MS<jats:sub>0<\/jats:sub>\u2013MS<jats:sub>5<\/jats:sub> for a metabolic score of 0\u20135, respectively. Multivariate Cox regression analysis was used to estimate the risks of end-stage renal disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 12,747, 31,059, 40,361, 48,068, 46,630, and 23,569 patients for MS<jats:sub>0<\/jats:sub>\u2013MS<jats:sub>5<\/jats:sub>, respectively. Compared with MS<jats:sub>0<\/jats:sub>, MS<jats:sub>5<\/jats:sub> had a higher CHA<jats:sub>2<\/jats:sub>DS<jats:sub>2<\/jats:sub>-VASc score (3.8 vs. 1.0) (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u2009.001). During a median follow-up of 3.5 years, compared with MS<jats:sub>0<\/jats:sub>, MS<jats:sub>1<\/jats:sub>\u2013MS<jats:sub>5<\/jats:sub> were associated with a gradually increasing incidence of end-stage renal disease, in relation to an increase in the metabolic score, (log-rank <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u2009.001). After multivariate adjustment, a higher metabolic score was associated with a greater risk of incident end-stage renal disease: adjusted hazard ratio [95% confidence interval]\u2009=\u20091.60 [0.78\u20133.48], 2.08 [1.01\u20134.31], 2.94 [1.43\u20136.06], 3.71 [1.80\u20137.66], and 4.82 [2.29\u201310.15], for MS<jats:sub>1<\/jats:sub>\u2013MS<jats:sub>5<\/jats:sub>, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Metabolic syndrome components additively impacts the risk of incident end-stage renal disease among patients with atrial fibrillation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1208979","type":"journal-article","created":{"date-parts":[[2023,10,17]],"date-time":"2023-10-17T07:22:40Z","timestamp":1697527360000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of components of metabolic syndrome on the risk of adverse renal outcomes in patients with atrial fibrillation: a nationwide cohort study"],"prefix":"10.3389","volume":"10","author":[{"given":"Soonil","family":"Kwon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"So-Ryoung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eue-Keun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Woo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Hyung","family":"Jung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung-Do","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyo-Jeong","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seil","family":"Oh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory Y. 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