Background
Phase angle (PhA), derived from bioelectrical impedance analysis, reflects cellular health and membrane integrity and is reduced in chronic diseases. Albuminuria is an early marker of endothelial and microvascular injury and predicts renal and cardiovascular diseases. This study aimed to investigate the association between PhA and albuminuria in Korean adults aged 40 years or older.
Methods
We conducted a cross-sectional analysis of data from the 9th Korea National Health and Nutrition Examination Survey (2022–2023). After excluding participants younger than 40 years of age, those with diabetes, elevated serum creatinine levels, and those with missing data, 3,283 adults (1,495 men and 1,788 women) were included. Whole-body PhA at 50 kHz was used as the independent variable. Albuminuria was defined as a urine albumin-to-creatinine ratio of ≥30 mg/g. Survey-weighted, sex-stratified multivariate logistic regression models were adjusted for age, lifetime smoking, drinking frequency in the previous year, hypertension status, body mass index, glycated hemoglobin, low- and high-density lipoprotein cholesterol, triglycerides, serum creatinine, blood urea nitrogen, high sensitivity C-reactive protein, and skeletal muscle mass index.
Results
Albuminuria was identified in 7.0% of the participants (7.2% of men and 6.9% of women). In women, each 1° increase in PhA was associated with substantially lower odds of albuminuria (adjusted odds ratio, 0.47; 95% confidence interval, 0.26–0.86). In men, the relationship showed a J-shaped pattern, with the lowest risk at mid-range PhA values and a marked increase at higher values; both linear and quadratic PhA terms were significant.
Conclusion
In Korean adults, PhA showed sex-specific associations with albuminuria, with an inverse association in women and a J-shaped association in men. As a noninvasive and widely available measure, PhA could potentially serve as a supplementary tool for identifying individuals at risk for early renal microvascular injury.

Background
Studies have shown that incident albuminuria is associated with insulin resistance (IR); however, an IR marker that best predicts the prevalence of albuminuria has not yet been established. This study explored the association between IR and incident albuminuria using various IR indices, including the homeostasis model assessment of IR (HOMA-IR), metabolic score for IR (METS-IR), and triglyceride-glucose (TyG) index, and compared their predictive abilities for the prevalence of albuminuria.
Methods
A total of 4,982 Korean adults from the 2019 Korea National Health and Nutritional Examination Survey were analyzed. The odds of albuminuria were determined using the quartiles of the IR indices. Receiver operating characteristic (ROC) curves were used to calculate the area under the ROC curve and predictability. The cutoff values for albuminuria detection were also computed.
Results
An increase in the quartiles of all three IR indices was associated with incident albuminuria, even after full adjustment for covariates (HOMA-IR: odds ratio [OR], 1.906; 95% confidence interval [CI], 1.311–2.772; P=0.006; METS-IR: OR, 2.236; 95% CI, 1.353–3.694; P=0.002; TyG index: OR, 1.757; 95% CI, 1.213–2.544; P=0.003). The area under the ROC curve for incident albuminuria based on the HOMA-IR, METS-IR, and TyG indices was 0.594 (95% CI, 0.568–0.619), 0.633 (95% CI, 0.607–0.659), and 0.631 (95% CI, 0.606–0.656), respectively. The optimal cutoff values for predicting albuminuria were 2.38, 35.38, and 8.72 for the HOMA-IR, METS-IR, and TyG indices, respectively.
Conclusion
The METS-IR and TyG indices outperformed HOMA-IR in predicting incident albuminuria.

Citations

• Propensity score analysis of triglyceride-glucose index in newly diagnosed patients with essential hypertension as a predictor of microalbuminuria
  Nuoni Wang, Shihao Liu, Wei Wang, Yicheng Zou, Liangqing Ge, Sulan Huang
  Frontiers in Endocrinology.2026;[Epub]     CrossRef
• Metabolic syndrome and kidney dysfunction: emerging molecular and cellular mechanisms at the metabolic–renal interface
  William R. Marshall, Darren Green, Smeeta Sinha, Philip A. Kalra
  Frontiers in Endocrinology.2026;[Epub]     CrossRef
• Inverse Association Between METS-IR and Lung Cancer Risk: The Role of BMI in a Nationwide Korean Cohort
  Bo-Kyung Shine, In Hwa Jeong, Minkook Son, Bongjo Kim, Sang Yi Moon, Jong Yoon Lee, Hye Ryeon Kim, Seok Jae Huh
  Cancers.2025; 17(23): 3727.     CrossRef
• The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007–2016
  Ruihua Shen, Ling Lin, Zexuan Bin, Xi Qiao
  Diabetology & Metabolic Syndrome.2024;[Epub]     CrossRef

Citations

• Incidence and Influencing Factors of Depression in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis
  田田 李
  Advances in Clinical Medicine.2026; 16(02): 464.     CrossRef
• Prediction of depression risk in chronic kidney disease using PSO-optimized random forest: a web-based application based on CHARLS data
  Siyu Li, Xianhua Wang, Jiangli Hu
  Frontiers in Psychology.2026;[Epub]     CrossRef
• The Paradox of Care: Family Support and Its Complex Role in the Depression and Anxiety Comorbidity Among Older Adults With Chronic Kidney Disease
  Shujian Wang, Meiling Gu, Xinyuan Zou, Xiangping Liu, Yanqiang Tao
  Psychogeriatrics.2025;[Epub]     CrossRef
• Sex and Gender Characteristics of Adults on Hemodialysis Experiencing Depression and Depressive Symptoms: A Scoping Review
  Primrose Mharapara, Sofia B. Ahmed, Joanne Olson, Kara Schick-Makaroff
  Canadian Journal of Kidney Health and Disease.2025;[Epub]     CrossRef
• Prevalence of anxiety and depression among end-stage kidney disease patients on dialysis: A cross-sectional multiple-centre study in Riyadh, Saudi Arabia
  Omar A. AlShammari, Sara O. AlFadil, Abdulaziz AlShabibi, Hussein Mohamed, Mohammd Alomi, Khalid Almatham
  Journal of Family Medicine and Primary Care.2024; 13(10): 4406.     CrossRef
• Combined influence of depression and low-grade inflammation on mortality in peritoneal dialysis patients
  Yanxia Zhang, Jiexin Chen, Ruiying Tang, Jihong Deng, Huankai Guo, Xianfeng Wu, Qingdong Xu
  BMC Nephrology.2023;[Epub]     CrossRef
• Depression in maintenance hemodialysis patients: What do we need to know?
  Yulu Li, Bin Zhu, Jianqin Shen, Liying Miao
  Heliyon.2023; 9(9): e19383.     CrossRef
• Depression of caregivers is significantly associated with depression and hospitalization of hemodialysis patients
  Lili Fu, Yanfen Wu, Aiguo Zhu, Zhihong Wang, Hualin Qi
  Hemodialysis International.2022; 26(1): 108.     CrossRef
• Low levels of serum urate are associated with a higher prevalence of depression in older adults: a nationwide cross-sectional study in Korea
  Woo-Joong Kim, Hye Ri Kim, Jung Soo Song, Sang Tae Choi
  Arthritis Research & Therapy.2020;[Epub]     CrossRef
• Cross-sectional study of association between psychosocial stressors with chronic kidney disease among migrant and non-migrant Ghanaians living in Europe and Ghana: the RODAM study
  David Nana Adjei, Karien Stronks, Dwomoa Adu, Erik Beune, Karlijn Meeks, Liam Smeeth, Juliet Addo, Ellis Owusu-Dabo, Kerstin Klipstein-Grobusch, Frank Mockenhaupt, Matthias Schulze, Ina Danquah, Joachim Spranger, Silver Karaireho Bahendeka, Charles Agyema
  BMJ Open.2019; 9(8): e027931.     CrossRef
• Factors influencing integrated wellbeing in older Chinese outpatients with chronic diseases
  Fei Huang, Hongyu Li
  Australian Journal of Primary Health.2018; 24(2): 189.     CrossRef

Background
Metabolic syndrome (MetS), characterized by abdominal obesity, hypertriglyceridemia, low high-density lipoprotein (HDL) cholesterol, high blood pressure, and high fasting glucose level, is a common risk factor for cardiovascular disease and associated complication. We examined the relationshipbetween the metabolic syndrome and risk of chronic kidney disease (CKD) in Korean women. Methods: We used data from 10,170 women, aged 30-89 years, who had visited the health examination center at a tertiary care hospital in 2006. The data were studied cross-sectionally. MetS was identified using the modified criteria of the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATPⅢ). CKD was defined as an estimated GFR< 60 ml/min per 1.73 m². The multivariable-adjusted(adjustment for age, a high school education, body mass index (BMI),alcohol drinking, current and former smoking, previous coronary heart disease, menopause and physical inactivity) odds ratio of CKD (95% CI) associated with each component of the metabolic syndrome, was calculated using logistic regression models. Result: 1,039 participants developed MetS. The multivariable-adjusted odds ratios (OR) of CKD in participants with MetS, hypertriglyceridemia and high blood pressure compared with participants without those factors were 2.68 (95% CI, 1.77-4.06), 1.96 (95% CI, 1.34-2.88), 2.00(95% CI, 1.38-2.89). Compared with participants with no MetS traits, those with one, two, equal to or more than three traits of MetShad OR of CKD of 1.24 (95% CI, 0.75-2.06), 1.56 (95% CI, 0.89-2.75), 2.18 (95% CI, 1.21-3.93), respectively. Conclusion: We found that Korean women with MetS had an increased risk for developing CKD. Finally, earlier identification and management of MetS might improve patient health and prevent the progression of CKD.