Sarcopenic Obesity Linked to Higher Risk of Kidney Stones

Dr Sanjay Kalra, Treasurer, International Society of Endocrinology (ISE); Vice President, South Asian Obesity Forum (SOF); Bharti Hospital, Karnal, India

In a UK Biobank cohort of over 157,000 adults, sarcopenic obesity was associated with an 83% higher risk of developing kidney stone disease.

Kidney stone disease (KSD) has become increasingly common over the past few decades. In the United States, prevalence rose from 3.2% in 1976–1980 to 9.4% in 2017–2018, and annual spending on KSD runs into tens of billions of dollars. Stone formation is linked to both genetic and environmental factors, including climate, water hardness, diet, basal metabolic rate, and obesity. Most patients also show disturbances in calcium or other metabolic processes.

High body mass index (BMI) is certainly a risk factor for KSD, but the role of certain body composition factors such as muscle mass and fat distribution has received little attention. A normal BMI does not necessarily mean a lower risk, since individuals with sarcopenia may still be predisposed to stones despite a normal BMI.

KSD is closely associated with metabolic disturbances, and sarcopenic obesity (SO) is a recognized risk factor for several diseases. To understand how the two may be connected, researchers assessed the prospective association between SO and KSD along with its potential mediators.

This prospective cohort study included 157,505 UK Biobank participants. Sarcopenic obesity (SO) was defined using BMI, handgrip strength, and muscle mass. Participants were classified into four groups: control, obesity alone, sarcopenia alone, and SO. The researchers examined the incidence and timing of KSD and assessed whether insulin resistance-related indexes and inflammatory markers mediated the association. The analyses were adjusted for social characteristics, lifestyle, diet, blood biochemistry, and baseline disease history.

Of the participants, 7,501 (4.76%) had sarcopenia alone, and 1,407 (0.89%) had SO. During follow-up, 1,592 participants (1.01%) developed KSD. Compared with the control group, the risk of incident KSD was 48% higher with obesity alone, 33% higher with sarcopenia alone, and 83% higher with SO. These findings were consistent across four sensitivity analyses.

The authors conclude that sarcopenia and SO are linked with a higher risk of developing KSD, with insulin resistance and inflammation playing a partial mediating role. They suggest that individuals with SO should pay attention to preventing kidney stones.

(Reference: Zhang J, Jiang S, Huang L, Ling K, Tang Z, Wang J, Cong H, Wu H, Qian Y, He Z, Tang F. Association between sarcopenic obesity and kidney stones: evidence from a prospective cohort study on the UK Biobank. BMC Public Health. 2026 Feb 17;26(1):971.)