Individual and joint associations of modifiable metabolic status and lifestyle with kidney stones among sedentary population: insights from a nationally representative dataset

Background: Kidney stone is one of the most common urological conditions in sedentary individuals. Although specific behaviors such as diet and prolonged sitting are known risk factors, the individual and joint effects of metabolic status and lifestyle on kidney stone risk remain understudied. Materials and Methods: This cross-sectional study analyzed data from 10,801 sedentary individuals aged over 20 from the U.S. National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018. Metabolic status indicators included central obesity, hyperglycemia, hypertension, and dyslipidemia, assessed using anthropometric and laboratory data and self-reported disease history. Lifestyle factors including physical inactivity, addictive behaviors and unhealthy diet, as well as kidney stone history were also estimated from self-reported questionnaire. We estimated the risk of kidney stone associated with individual and joint factors using weighted multivariable logistic regression, presenting odds ratios (ORs) and 95% confidence intervals (CIs). Results: Among the participants, 9.1% reported kidney stone. Individual poor metabolic status and unhealthy lifestyle were associated with higher prevalence of kidney stones. Higher cumulative scores in poor metabolic status or unhealthy lifestyle corresponded with an increased prevalence of kidney stones, rising from 4.37% to 15.59% and 8.01% to 15.39%, respectively. Additionally, participants with “worst metabolic status” or “worst lifestyle” separately had a 1.32-fold and 77% increase for risk of kidney stone, respectively (OR = 2.321, 95% CI: 1.479-3.645; OR = 1.774, 95% CI: 1.260-2.499). Furthermore, when metabolic status was not optimal, the worst lifestyle significantly increased the risk of kidney stone. The risk nearly increased by threefold in participants with both worst metabolic and lifestyle (OR = 3.918, 95% CI: 1.659-9.256). Conclusions: Worsening metabolic health combined with an unhealthy lifestyle significantly elevates kidney stone risk in sedentary populations, emphasizing the need to address both factors simultaneously for effective prevention.