Associations between elevated kidney and liver biomarker ratios, metabolic syndrome and all-cause and coronary heart disease (CHD) mortality: analysis of the U.S. National Health and Nutrition Examination Survey (NHANES)

Table 5 Association between CHD mortality and kidney or liver biomarker ratio without or with MetS (referent)

Biomarkers	Groups		Unadjusted^a		Adjusted^b		Adjusted^c
	MetS status	High biomarker ratio	Hazard ratios^a	95% confidence interval	Hazard ratios^b	95% confidence interval	Hazard ratios^c	95% confidence interval
UACR	Yes	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	No	1.03	0.68 to 1.56	1.21	0.79 to 1.85	1.30	0.77 to 2.19
	No	Yes	1.98	1.14 to 3.44	1.48	0.81 to 2.69	0.87	0.41 to 1.87
	Yes	Yes	1.81	1.11 to 2.96	2.03	1.28 to 3.22	2.22	1.24 to 3.97
BUN-CR	Yes	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	No	0.84	0.55 to 1.28	0.86	0.57 to 1.29	0.79	0.48 to 1.31
	No	Yes	1.20	0.63 to 2.27	1.82	1.00 to 3.29	1.50	0.67 to 3.35
	Yes	Yes	0.66	0.32 to 1.36	0.69	0.32 to 1.49	0.47	0.17 to 1.28
GGT-ALP	Yes	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	No	0.87	0.60 to 1.26	0.90	0.62 to 1.31	0.84	0.52 to 1.35
	No	Yes	1.62	0.79 to 3.34	1.45	0.78 to 2.68	1.19	0.51 to 2.78
	Yes	Yes	0.96	0.49 to 1.87	0.73	0.42 to 1.29	0.58	0.31 to 1.11
AST-ALT	Yes	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	No	1.07	0.74 to 1.54	1.40	0.76 to 2.58	1.09	0.69 to 1.71
	No	Yes	1.33	0.73 to 2.45	0.88	0.62 to 1.24	1.65	0.75 to 3.62
	Yes	Yes	3.06	1.73 to 5.42	3.20	1.86 to 5.51	3.38	1.64 to 6.98

Data derived from NHANES 1999–2015; referent group has prevalent MetS. Covariates include age, sex, ethnicity, education, income ratio, alcohol use, smoking, hospital visits, insurance coverage, self-rated health, and physical activity
^aUnadjusted model of the analytic subsample (n = 1212); n = 201 deaths
^bFully adjusted model of the analytic subsample (n = 1212); n = 201 deaths
^cFully adjusted model of a subsample without self-reported CVD, diabetes, or hypertension (n = 968); n = 134 deaths

ISSN: 1471-2261