Table 2.

Association between all-cause mortality and kidney or liver biomarker ratio with or without MetS (referent)

Biomarkers	Groups		Unadjusteda		Adjustedb		Adjustedc
	MetS status	High biomarker ratio	Hazard ratiosa	95% confidence interval	Hazard ratiosb	95% confidence interval	Hazard ratiosc	95% confidence interval
UACR	No	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	Yes	4.12	3.16 to 5.37	2.12	1.65 to 2.72	2.07	1.53 to 2.79
	Yes	No	1.93	1.64 to 2.26	1.05	0.89 to 1.24	1.04	0.86 to 1.24
	Yes	Yes	6.11	4.78 to 7.80	2.57	1.99 to 3.33	2.40	1.76 to 3.26
BUN-CR	No	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	Yes	1.63	1.23 to 2.16	1.05	0.79 to 1.39	0.99	0.71 to 1.38
	Yes	No	2.02	1.71 to 2.39	1.10	0.93 to 1.31	1.09	0.90 to 1.31
	Yes	Yes	3.38	2.66 to 4.28	1.26	0.96 to 1.64	1.12	0.82 to 1.54
GGT-ALP	No	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	Yes	1.45	1.06 to 1.99	1.24	0.92 to 1.67	1.21	0.88 to 1.65
	Yes	No	2.17	1.87 to 2.53	1.12	0.96 to 1.32	1.07	0.90 to 1.28
	Yes	Yes	2.07	1.54 to 2.77	1.26	0.95 to 1.67	1.39	1.02 to 1.90
AST-ALT	No	No	1.00 (REF)	–	1.00 (REF)	–	1.00 (REF)	–
	No	Yes	2.25	1.78 to 2.85	1.71	1.35 to 2.18	1.69	1.30 to 2.21
	Yes	No	2.19	1.88 to 2.55	1.17	1.00 to 1.38	1.15	0.97 to 1.37
	Yes	Yes	6.71	4.83 to 9.34	2.22	1.61 to 3.07	2.09	1.46 to 3.00

Data derived from NHANES 1999–2015; referent group has neither elevated biomarker ratio nor 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 = 10,604); n = 1215 deaths

^bFully adjusted model of the analytic subsample (n = 10,604); n = 1215 deaths

^cFully adjusted model of a subsample without self-reported CVD, diabetes, or hypertension (n = 9909); n = 970 deaths