1
|
Alemany M. The Metabolic Syndrome, a Human Disease. Int J Mol Sci 2024; 25:2251. [PMID: 38396928 PMCID: PMC10888680 DOI: 10.3390/ijms25042251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
This review focuses on the question of metabolic syndrome (MS) being a complex, but essentially monophyletic, galaxy of associated diseases/disorders, or just a syndrome of related but rather independent pathologies. The human nature of MS (its exceptionality in Nature and its close interdependence with human action and evolution) is presented and discussed. The text also describes the close interdependence of its components, with special emphasis on the description of their interrelations (including their syndromic development and recruitment), as well as their consequences upon energy handling and partition. The main theories on MS's origin and development are presented in relation to hepatic steatosis, type 2 diabetes, and obesity, but encompass most of the MS components described so far. The differential effects of sex and its biological consequences are considered under the light of human social needs and evolution, which are also directly related to MS epidemiology, severity, and relations with senescence. The triggering and maintenance factors of MS are discussed, with especial emphasis on inflammation, a complex process affecting different levels of organization and which is a critical element for MS development. Inflammation is also related to the operation of connective tissue (including the adipose organ) and the widely studied and acknowledged influence of diet. The role of diet composition, including the transcendence of the anaplerotic maintenance of the Krebs cycle from dietary amino acid supply (and its timing), is developed in the context of testosterone and β-estradiol control of the insulin-glycaemia hepatic core system of carbohydrate-triacylglycerol energy handling. The high probability of MS acting as a unique complex biological control system (essentially monophyletic) is presented, together with additional perspectives/considerations on the treatment of this 'very' human disease.
Collapse
Affiliation(s)
- Marià Alemany
- Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Catalonia, Spain
| |
Collapse
|
2
|
Yin L, Dong X, Liao W, Liu X, Zheng Z, Liu D, Wang C, Liu Z. Relationships of beans intake with chronic kidney disease in rural adults: A large-scale cross-sectional study. Front Nutr 2023; 10:1117517. [PMID: 37081921 PMCID: PMC10111024 DOI: 10.3389/fnut.2023.1117517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/14/2023] [Indexed: 04/07/2023] Open
Abstract
Background and aimsDietary factors play an important role in the development of chronic kidney disease (CKD). However, evidence on the relationship of beans consumption with CKD remains limited and inconclusive, especially in the middle-and low-income populations. The current study aimed to investigate the relationships of beans intake with indicators of kidney injury and CKD prevalence in rural adults.MethodsA total of 20,733 rural adults from the Henan Rural Cohort Study in 2018–2022 were included. The total beans intake was collected using a validated food frequency questionnaire. Indicators of kidney injury and CKD was determined by the estimated glomerular filtration rate and the urinary albumin to creatinine ratio. Generalized linear regression and logistic regression models were applied to estimate the relationship of beans intake with continuous and dichotomized indicators of renal function, respectively.ResultsOf the 20,733 participants, 2,676 (12.91%) subjects were identified as CKD patients. After adjusting for potential confounders, participants in the higher quartiles of beans intake had a lower prevalence of CKD (odds ratio and 95% confidence interval, OR (95%CI); Q2: 0.968(0.866–1.082); Q3: 0.836(0.744–0.939); Q4: 0.854(0.751–0.970)) and albuminuria (Q2: 0.982(0.875–1.102); Q3: 0.846(0.750–0.954); Q4: 0.852 (0.746–0.973)), compared with the Q1. Per 50 g/day increment in beans intake was significantly associated with a 5 and 4% decreased prevalence of albuminuria and CKD, respectively. These inverse relationships were also significant in the subgroups of men, elder, and high-income participants (p < 0.05).ConclusionDietary beans intake was inversely associated with the prevalence of albuminuria and CKD in rural adults, suggesting that promoting soy food intake might help reduce the occurrence of CKD in rural adults.
Collapse
Affiliation(s)
- Lei Yin
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhaohui Zheng
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongwei Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- *Correspondence: Chongjian Wang,
| | - Zhangsuo Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- Zhangsuo Liu,
| |
Collapse
|
3
|
Shi Y, Hu L, Li M, Zhou W, Wang T, Zhu L, Bao H, Cheng X, Li P. Association Between the Surrogate Markers of Insulin Resistance and Chronic Kidney Disease in Chinese Hypertensive Patients. Front Med (Lausanne) 2022; 9:831648. [PMID: 35198578 PMCID: PMC8859105 DOI: 10.3389/fmed.2022.831648] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 01/05/2022] [Indexed: 12/21/2022] Open
Abstract
BackgroundWe aim to evaluate the four surrogate markers of insulin resistance (IR), including triglyceride-glucose index (TyG), lipid accumulation product index (LAP), visceral adiposity index (VAI), triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL), on prevalence of chronic kidney disease (CKD) and to examine any possible effect modifiers in Chinese hypertensive patients.MethodsA total of 13,055 hypertensive participants were included in this cross-sectional study. In addition, average age of the study population was 63.81 ± 9.46 years, and 47.66% of them are men. The primary outcome was CKD, defined as eGFR <60 ml/min/1.73 m2. Multivariate logistic regression analysis and the generalized additive model and a fitted smoothing curve (penalized spline method) were used to examine the association between the surrogate markers of IR and CKD.ResultsFour surrogate markers of IR were independently and positively associated with CKD in a dose-response fashion. The association between four surrogate markers of IR and the prevalence of CKD was examined as a continuous variable per one unit increment and also as a categorical variable using tertiles with the tertiles (T1) as the reference group. In the fully adjusted model, multivariate logistic analyses showed that the per one unit increments of the TyG, LAP, VAI, and TG/HDL ratios were all significantly associated with 42, 31, 67, and 78% higher risk for CKD, respectively. Consistently, the adjusted ORs (95% CI) for CKD were 1.48 (1.21, 1.81), 1.34 (1.06, 1.69), 1.26 (1.03, 1.53), 1.35 (1.12, 1.63) when comparing the highest tertile to the lowest tertile of the TyG, LAP, VAI, and TG/HDL ratios, respectively. The stratification analysis showed that a significant positive correlation between TyG, VAI, and TG/HDL and CKD in patients over 65 years old.ConclusionFour surrogate markers of IR were independently and positively correlated with CKD, and LAP was better than the other surrogate markers of IR for predicting CKD. Only among participants aged over 65 years were higher levels of TyG, VAI and TG/HDL found to be closely related to the increased prevalence of CKD.
Collapse
Affiliation(s)
- Yumeng Shi
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
| | - Lihua Hu
- Department of Cardiovascular Medicine, Peking University First Hospital, Beijing, China
| | - Minghui Li
- Department of Cardiovascular Medicine, Inner Mongolia People's Hospital, Hohhot, China
| | - Wei Zhou
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Wang
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lingjuan Zhu
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Huihui Bao
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Xiaoshu Cheng
| | - Ping Li
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China
- Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
- Ping Li
| |
Collapse
|
4
|
Xiao H, Shao X, Gao P, Zou H, Zhang X. Metabolic Syndrome Components and Chronic Kidney Disease in a Community Population Aged 40 Years and Older in Southern China: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:839-848. [PMID: 35321352 PMCID: PMC8935083 DOI: 10.2147/dmso.s353305] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/08/2022] [Indexed: 04/09/2023] Open
Abstract
PURPOSE To investigate the correlation between metabolic syndrome components and chronic kidney disease (CKD) among a community population aged 40 years and older in Southern China. PATIENTS AND METHODS From December 2017 to March 2018, 1969 participants (male n = 715, female n = 1254) aged 40 years and older were recruited in Southern China for a cross-sectional survey. A logistic regression model was established to analyze the correlation between metabolic syndrome components and CKD. RESULTS Among the 1969 subjects, 407 (20.7%) were CKD patients, including 152 males (prevalence rate 21.3%) and 255 females (prevalence rate 20.3%). Anthropometric data (waist circumference, age, systolic and diastolic blood pressure), serum/plasma data (serum creatinine, serum uric acid, fasting plasma glucose, C-reactive protein, serum triglyceride), urinary and other findings (body mass index, waist-to-hip and waist-to-height ratios, urinary albumin to creatinine ratio, homeostasis model assessment of insulin resistance) were significantly higher in patients with than without CKD (P < 0.05). Metabolic syndrome and at least some of its components were statistically significant risk factors for CKD in models with and without adjustment for diabetes, obesity and hypertension. CONCLUSION Metabolic syndrome and its single or combined components are independently associated with CKD in community populations aged 40 years and older. The correlation between some components and CKD remained significant in both non-diabetic and non-obese subjects. Correlations between components of metabolic syndrome and CKD show that it is feasible and necessary to carry out targeted screening and intervention tests in people aged 40 and over.
Collapse
Affiliation(s)
- Hua Xiao
- Department of Nephrology, Shenzhen People’s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, 518020, People’s Republic of China
- Shenzhen Key Laboratory of Kidney Diseases, Shenzhen People’s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, 518055, People’s Republic of China
| | - Xiaofei Shao
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, 510630, People’s Republic of China
| | - Peichun Gao
- Zhujiang Hospital of Southern Medical University, Guangzhou, 510282, People’s Republic of China
| | - Hequn Zou
- Department of Nephrology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, 518116, People’s Republic of China
- Hequn Zou, Department of Nephrology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, 518116, People’s Republic of China, Tel +860755-21583803, Email
| | - Xinzhou Zhang
- Department of Nephrology, Shenzhen People’s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, 518020, People’s Republic of China
- Correspondence: Xinzhou Zhang, Department of Nephrology, Shenzhen People’s Hospital (The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology), Shenzhen, 518020, People’s Republic of China, Tel +86 0755-25533018-3500, Fax +86 0755-25533497, Email
| |
Collapse
|
5
|
Nagayama D, Fujishiro K, Tsuda S, Watanabe Y, Yamaguchi T, Suzuki K, Saiki A, Shirai K. Enhanced prediction of renal function decline by replacing waist circumference with "A Body Shape Index (ABSI)" in diagnosing metabolic syndrome: a retrospective cohort study in Japan. Int J Obes (Lond) 2021; 46:564-573. [PMID: 34824353 PMCID: PMC8872991 DOI: 10.1038/s41366-021-01026-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 11/09/2022]
Abstract
Background Abdominal obesity as a risk factor for diagnosing metabolic syndrome (MetS) is conventionally evaluated using waist circumference (WC), although WC does not necessarily reflect visceral adiposity. Objective To examine whether replacing WC with “A Body Shape Index (ABSI)”, an abdominal obesity index calculated by dividing WC by an allometric regression of weight and height, in MetS diagnosis is useful for predicting renal function decline. Subjects/Methods In total, 5438 Japanese urban residents (median age 48 years) who participated in a public health screening program for 4 consecutive years were enrolled. Systemic arterial stiffness was assessed by cardio-ankle vascular index (CAVI). The predictability of the new-onset renal function decline (eGFR < 60 mL/min/1.73 m2) by replacing high WC with high ABSI (ABSI ≥ 0.080) was examined using three sets of MetS diagnostic criteria: Japanese, IDF and NCEP-ATPIII. Results In Japanese and NCEP-ATPIII criteria, MetS diagnosed using ABSI (ABSI-MetS) was associated with significantly higher age-adjusted CAVI compared to non-MetS, whereas MetS diagnosed using WC (WC-MetS) showed no association. Kaplan–Meier analysis of the rate of new-onset renal function decline over 4 years (total 8.7%) showed remarkable higher rate in subjects with ABSI-MetS than in those without (log-rank test p < 0.001), but almost no difference between subjects with and without WC-MetS (p = 0.014–0.617). In gender-specific Cox-proportional hazards analyses including age, proteinuria, and treatments of metabolic disorders as confounders, ABSI-MetS (Japanese criteria for both sexes, IDF criteria for men) contributed independently to the new-onset renal function decline. Of these, the contribution of IDF ABSI-MetS disappeared after adjustment by high CAVI in the subsequent analysis. Conclusion In this study, replacing WC with ABSI in MetS diagnostic criteria more efficiently predicted subjects at risk of renal function decline and arterial stiffening.
Collapse
Affiliation(s)
- Daiji Nagayama
- Department of Internal Medicine, Nagayama Clinic, 2-12-22, Tenjin-cho, Oyama-city, Tochigi, 3230032, Japan. .,Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.
| | - Kentaro Fujishiro
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Shinichi Tsuda
- Fukuda Denshi Co., Ltd., 3-39-4, Hongo, Bunkyo-ku, Tokyo, 1130033, Japan
| | - Yasuhiro Watanabe
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kenji Suzuki
- Japan Health Promotion Foundation, 1-24-4, Ebisu, Shibuya-ku, Tokyo, 1500013, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan
| | - Kohji Shirai
- Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center, 564-1, Shimoshizu, Sakura-city, Chiba, 2850841, Japan.,Department of Internal Medicine, Mihama Hospital, 1-1-5, Uchise, Mihama-ku, Chiba, 2610013, Japan
| |
Collapse
|
6
|
Duan JY, Duan GC, Wang CJ, Liu DW, Qiao YJ, Pan SK, Jiang DK, Liu Y, Zhao ZH, Liang LL, Tian F, Liu ZS. Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in a central Chinese urban population: a cross-sectional survey. BMC Nephrol 2020; 21:115. [PMID: 32245423 PMCID: PMC7118942 DOI: 10.1186/s12882-020-01761-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 03/11/2020] [Indexed: 12/11/2022] Open
Abstract
Background This study was conducted to evaluate and update the current prevalence of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in a central Chinese urban population. Methods From December 2017 to June 2018, a total of 5231 subjects were randomly enrolled from 3 communities in 3 districts of Zhengzhou. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min.1.73m2 or urinary albumin to creatinine ratio ≥ 30 mg/g (albuminuria). Diabetic subjects with systolic blood pressure > 140 mmHg, albuminuria or an eGFR less than 60 mL/min/1.73 m2 were classified as having DKD. Participants completed a questionnaire assessing lifestyle and relevant medical history, and blood and urine specimens were taken. Serum creatinine, uric acid, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and urinary albumin were assessed. The age- and sex-adjusted prevalences of CKD and DKD were calculated, and risk factors associated with the presence of reduced eGFR, albuminuria, DKD, severity of albuminuria and progression of reduced renal function were analyzed by binary and ordinal logistic regression. Results The overall adjusted prevalence of CKD was 16.8% (15.8–17.8%) and that of DKD was 3.5% (3.0–4.0%). Decreased renal function was detected in 132 participants (2.9, 95% confidence interval [CI]: 2.5–3.2%), whereas albuminuria was found in 858 participants (14.9, 95% CI: 13.9–15.9%). In all participants with diabetes, the prevalence of reduced eGFR was 6.3% (95% CI = 3.9–8.6%) and that of albuminuria was 45.3% (95% CI = 40.4–50.1%). The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1–52.9%). The results of the binary and ordinal logistic regression indicated that the factors independently associated with a higher risk of reduced eGFR and albuminuria were older age, sex, smoking, alcohol consumption, overweight, obesity, diabetes, hypertension, dyslipidemia and hyperuricemia. Conclusions Our study shows the current prevalence of CKD and DKD in residents of Central China. The high prevalence suggests an urgent need to implement interventions to relieve the high burden of CKD and DKD in China.
Collapse
Affiliation(s)
- Jia-Yu Duan
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Guang-Cai Duan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Chong-Jian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Dong-Wei Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Ying-Jin Qiao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Shao-Kang Pan
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Deng-Ke Jiang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Yong Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Zi-Hao Zhao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Lu-Lu Liang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Fei Tian
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China
| | - Zhang-Suo Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Jianshe Road No.1, Zhengzhou, 450052, Henan, People's Republic of China.
| |
Collapse
|
7
|
Xie K, Bao L, Jiang X, Ye Z, Bing J, Dong Y, Gao D, Ji X, Jiang T, Li J, Li Y, Luo S, Mao W, Peng D, Qu P, Song S, Wang H, Wang Z, Xu B, Yin X, Yu Z, Zhang X, Zhang Z, Zhu Z, Gao X, Li Y. The association of metabolic syndrome components and chronic kidney disease in patients with hypertension. Lipids Health Dis 2019; 18:229. [PMID: 31881889 PMCID: PMC6935087 DOI: 10.1186/s12944-019-1121-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/30/2019] [Indexed: 02/05/2023] Open
Abstract
Background Hypertension is a highly prevalent disease and the leading cause of chronic kidney disease (CKD). Metabolic syndrome could also be the risk factor for CKD. We sought to study the association between metabolic syndrome components and the prevalence of CKD in patients with hypertension. Methods We carried out a multi-center cross-sectional study from Apr. 2017- Apr. 2018 in 15 cities in China. Results A total of 2484 patients with hypertension were enrolled. Among them, 56% were male and the average age was 65.12 ± 12.71 years. The systolic BP/diastolic BP was 142 ± 18/83 ± 12 mmHg. Metabolic syndrome components turned out to be highly prevalent in patients with hypertension, ranging from 40 to 58%. The prevalence of chronic kidney disease reached 22.0%. Multi-variate logistic analysis revealed that elevated triglyceride (TG) (OR = 1.81, 95% CI 1.28–2.57, p < 0.01), elevated fasting blood glucose (FBG) (OR = 1.43, 95% CI 1.00–2.07, p = 0.05) and hypertension grades (OR = 1.20, 95% CI 1.00–1.44, p = 0.05) were associated with the prevalence of CKD. In sub-group analysis, elevated TG remained strongly associated with CKD in both diabetes (OR = 2.10, 95%CI 1.22–3.61, p < 0.01) and non-diabetes (OR = 1.53, 95% CI 1.09–2.16, p = 0.01). In sub-group analysis of hypertension grades, there was also a graded trend between elevated TG and CKD from controlled blood pressure (BP) to hypertension grade 2 (OR = 1.81, 95%CI 1.06–3.11, p = 0.03; OR = 1.85, 95%CI 1.00–3.43, p = 0.05; OR = 2.81, 95% CI 1.09–7.28, p = 0.03, respectively). Conclusion Elevated TG, elevated FBG and hypertension grades were significantly associated with the prevalence of CKD in patients with hypertension. Particularly, elevated TG was strongly associated with CKD, independent of diabetes and hypertension grades.
Collapse
Affiliation(s)
- Kun Xie
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
| | - Liwen Bao
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
| | - Xiaofei Jiang
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
| | - Zi Ye
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China.,Department of cardiovascular medicine Mayo Clinic, Rochester, USA
| | | | - Yugang Dong
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Danchen Gao
- The First Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Xiaoping Ji
- Qilu Hospital of Shandong University, Jinan, China
| | - Tingbo Jiang
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jiehua Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yan Li
- Rui Jin Hospital Shanghai Jiao Tong University School of Medical, Shanghai, China
| | - Suxin Luo
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wei Mao
- Zhejiang Provincial Hospital of TCM, Zhejiang, China
| | - Daoquan Peng
- The Second Xiangya Hospital of Central South University, Furong, China
| | - Peng Qu
- The second hospital of Dalian Medical University, Zunyi, China
| | | | - Hui Wang
- Jiangsu Province Hospital, Nanjing, China
| | | | - Biao Xu
- Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xinhua Yin
- First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Zaixin Yu
- Xiangya Hospital, Central South University, Changsha, China
| | - Xinjun Zhang
- West China Hospital, Sichuan University, Lesha, China
| | - Zixin Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhiming Zhu
- Grand ping hospital, third military medical university, Chongqing, China
| | - Xiufang Gao
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China.
| | - Yong Li
- Cardiology Department, Huashan Hospital, Fudan University, No. 12 Mid Wulumuqi Road, Shanghai, 200040, China
| |
Collapse
|
8
|
Duan J, Wang C, Liu D, Qiao Y, Pan S, Jiang D, Zhao Z, Liang L, Tian F, Yu P, Zhang Y, Zhao H, Liu Z. Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in Chinese rural residents: a cross-sectional survey. Sci Rep 2019; 9:10408. [PMID: 31320683 PMCID: PMC6639314 DOI: 10.1038/s41598-019-46857-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/05/2019] [Indexed: 01/20/2023] Open
Abstract
We conducted a cross-sectional survey including 23869 participants and aimed to measure the prevalences of and risk factors for chronic kidney disease (CKD) and diabetic kidney disease (DKD) in a Chinese rural population. CKD and DKD status was defined according to the combination of estimated glomerular filtration rate (eGFR) and presence of albuminuria Participant completed a questionnaire involving life-style and relevant medical history, and the blood and urinary specimen were taken. The age- and gender- adjusted prevalences of CKD and DKD were calculated and risk factors associated with the presence of CKD and DKD were analyzed by logistic regression. The overall prevalence of CKD was 16.4% (15.9–16.8%) and of DKD was 2.9% (2.7–3.1%). In participants with diabetes, the overall prevalence of CKD was 35.5% (95% CI = 33.7–37.3%). Factors independently associated with renal damage were age, gender, education, personal income, alcohol consumption, overweight, obesity, diabetes, hypertension and dyslipidemia. Our study shows current prevalences of CKD and DKD in Chinese rural residents. Further researches could identify potential factors explaining the observed differences and implement the interventions to relieve the high burden of CKD and DKD in rural population.
Collapse
Affiliation(s)
- Jiayu Duan
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, P.R. China
| | - Dongwei Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Yingjin Qiao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Shaokang Pan
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Dengke Jiang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Zihao Zhao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Lulu Liang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Fei Tian
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Pei Yu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Yu Zhang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Huanhuan Zhao
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China
| | - Zhangsuo Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Research Institute of Nephrology, Zhengzhou University, Zhengzhou, 450052, China.
| |
Collapse
|
9
|
Alizadeh S, Ahmadi M, Ghorbani Nejad B, Djazayeri A, Shab-Bidar S. Metabolic syndrome and its components are associated with increased chronic kidney disease risk: Evidence from a meta-analysis on 11 109 003 participants from 66 studies. Int J Clin Pract 2018; 72:e13201. [PMID: 29790628 DOI: 10.1111/ijcp.13201] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 04/06/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND & AIMS Observational studies examining the relationship between metabolic syndrome and the risk of chronic kidney disease (CKD) have reported inconclusive results. This meta-analysis was performed to resolve these controversies. METHODS The MEDLINE, EMBASE, and PubMed databases were systematically searched from their inception until March 2016 to identify all relevant studies. Risk estimates and their corresponding 95% confidence intervals (CIs) for the associations of MetS and its components with CKD risk were extracted and pooled using a random-effects model. RESULTS A total of 66 studies, including 18 prospective cohorts and 48 cross-sectional studies, with 699 065 CKD patients and 11 109 003 participants were included in the meta-analysis. When all definitions were pooled, the presence of MetS was associated with a significant 50% increase of CKD risk (OR = 1.50, 95% CI = 1.43-1.56), with evidence of moderate heterogeneity (I2 = 72.3%, P < .001). The risk of CKD associated with MetS was higher in studies using the American Heart Association/National Heart, Lung, and Blood Institute criteria (OR = 1.68, 95% CI = 1.25-2.10) compared with those using the Adult Treatment Panel III (OR = 1.49, 95% CI = 1.42-1.56) and the International Diabetes Federation (OR = 1.32, 95% CI = 1.22-1.41) definitions. This relationship was independent of diabetes status. Moreover, all individual components of the MetS were significantly associated with CKD, and their coexistence resulted in an escalating dose-response relationship. The sensitivity and subgroup analyses established the stability of the findings. CONCLUSIONS This meta-analysis strongly suggests that the metabolic syndrome and its components are independently associated with the increased risk of CKD.
Collapse
Affiliation(s)
- Shahab Alizadeh
- Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mahsa Ahmadi
- Department of Microbiology, Faculty of Basic Sciences, Karaj Branch, Islamic Azad University, Alborz, Iran
| | - Behnam Ghorbani Nejad
- Department of pharmacology, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Abolghassem Djazayeri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
10
|
Wen J, Chen Y, Huang Y, Lu Y, Liu X, Zhou H, Yuan H. Association of the TG/HDL-C and Non-HDL-C/HDL-C Ratios with Chronic Kidney Disease in an Adult Chinese Population. Kidney Blood Press Res 2017; 42:1141-1154. [PMID: 29224024 DOI: 10.1159/000485861] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Evidence indicates a role for dyslipidemia in the development of chronic kidney disease (CKD). However, the association of lipid abnormalities and their ratios with kidney disease using the new CKD Epidemiology Collaboration (CKD-EPI) equation is not well understood. METHODS This cross-sectional study included 48,054 adult subjects. CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 or dipstick-positive proteinuria. Logistic regression models were used to examine the relationship between lipid variables and CKD. RESULTS The prevalence of CKD in this study was 3.7%. When the participants exhibited higher serum triglyceride (TG), a higher TG/high-density lipoprotein cholesterol (TG/HDL-c) ratio or a higher non-HDL-c/HDL-c ratio or HDL-c in a lower quartile, the prevalence of CKD tended to be higher. The multivariate adjusted odds ratios for CKD per 1 standard deviation increase in lipid level were 1.17 (1.10-1.23) for TG, 0.86 (0.79-0.93) for HDL-c, 1.21 (1.13-1.31) for the TG/HDL-c ratio, and 1.14 (1.06-1.22) for the non-HDL-c/HDL-c ratio. No significant association was detected between CKD and total cholesterol (TC), non-HDL-c or the low-density lipoprotein cholesterol/HDL-c (LDL-c/HDL-c) ratio. CONCLUSION In this relatively healthy adult Chinese population, the CKD-EPI equation determined that the TG/HDL-c and non-HDL-c/HDL-c ratios as well as TG and HDL-c correlate with the prevalence of CKD.
Collapse
Affiliation(s)
- Jia Wen
- Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.,Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yiyin Chen
- Department of Geriatrics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yun Huang
- Pharmacy Department of Ningbo City Medical Treatment Center, Lihuili Hospital, Ningbo, China
| | - Yao Lu
- Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Xing Liu
- Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.,Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Honghao Zhou
- Institute of Clinical Pharmacology of Central South University, Changsha, China
| | - Hong Yuan
- Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China.,Center of Clinical Pharmacology, The Third Xiangya Hospital of Central South University, Changsha, China
| |
Collapse
|
11
|
Chen J, Kong X, Jia X, Li W, Wang Z, Cui M, Xu D. Association between metabolic syndrome and chronic kidney disease in a Chinese urban population. Clin Chim Acta 2017; 470:103-108. [PMID: 28501388 DOI: 10.1016/j.cca.2017.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/07/2017] [Accepted: 05/09/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Few studies have examined the relationships between the prevalence of chronic kidney disease (CKD) and the metabolic risk factors in a developing country such as China, where genetic and environmental backgrounds differ from those in Western countries. METHODS The subjects of this cross-sectional study were the individuals from 18 to 92y. The metabolic syndrome (MetS) was defined based on the criteria of Adult Treatment Panel Third Report (ATP III), but using body mass index (BMI) instead of waist circumference. CKD was defined as decreased estimated glomerular filtration rate (eGFR<60mL/min/1.73m2) or presence of proteinuria (urine protein≥1+) assessed using dipstick method. RESULTS A total of 26,601 subjects (average age of 48.7y) were analyzed. Among them, the prevalence of the MetS and CKD was 36.4% and 3.0%, respectively. After adjustment for age, gender, cigarette smoking and alcohol drinking, the prevalence of CKD was significantly greater in subjects with than without MetS (OR 1.99, 95% CI 1.57-2.53, p<0.001). Multivariate-adjusted odd ratios for CKD in subjects with 3, 4 or 5 MetS components were 1.82 (95% CI 1.31-2.52, p<0.001), 2.92 (95% CI 2.09-4.09, p<0.001), and 3.07 (95% CI 1.67-5.67, p<0.001), respectively. After further adjustments were made for the other components of MetS, only high fasting glucose (OR 1.52, 95% CI 1.12-2.05) were significant risk factors for reduced renal function(eGFR<60mL/min/1.73m2). High blood pressure (OR 1.81, 95% CI 1,42-2.29), high triglycerides (OR 1.34, 95% CI 1.11-1.67) and high fasting glucose (OR 2.07, 95% CI 1.62-2.66) were significant risk factors for proteinuria. CONCLUSIONS MetS was highly prevalent in the middle-aged and elderly Chinese population in the city of Jinan. There was a graded relationship between the number of MetS components and risk of CKD. High fasting blood glucose levels were the main risk factor of reduced renal function. High blood pressure, high fasting blood glucose levels and high triglycerides were main risk factors for proteinuria.
Collapse
Affiliation(s)
- Juan Chen
- Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China
| | - Xianglei Kong
- Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China
| | - Xiaoyan Jia
- Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China
| | - Wenbin Li
- Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China
| | - Zunsong Wang
- Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China
| | - Meiyu Cui
- Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China
| | - Dongmei Xu
- Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China.
| |
Collapse
|
12
|
Gender-specific association between metabolic syndrome and decreased glomerular filtration rate in elderly population. Int Urol Nephrol 2016; 48:389-97. [DOI: 10.1007/s11255-015-1172-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/21/2015] [Indexed: 10/22/2022]
|
13
|
Maleki A, Montazeri M, Rashidi N, Montazeri M, Yousefi-Abdolmaleki E. Metabolic syndrome and its components associated with chronic kidney disease. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2015; 20:465-9. [PMID: 26487875 PMCID: PMC4590201 DOI: 10.4103/1735-1995.163969] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background: There is limited information on the relationship between metabolic syndrome (MetS) and chronic kidney disease (CKD) in the Iranian population, a group that has a high prevalence of CKD and obesity. The aim of present study was to determine the relationship between MetS and CKD in West of Iran. Materials and Methods: A total of 800 subjects aged more than 35 years admitted from 2011 to 2013 were enrolled in the study. MetS was defined based on the Adult Treatment Panel III criteria, and CKD was defined from the Kidney Disease Outcomes Quality Initiative practice guidelines. Waist circumference and body mass index were calculated, as well, blood samples were taken and lipid profile, plasma glucose levels, and serum creatinine were measured. Data were analyzed with SPSS version 17 (SPSS Inc., Chicago, IL, USA). Results: CKD was seen in 14.8% patients with MetS and 8.3% individuals without MetS. MetS was associated with an increased odds ratio (OR) for a glomerular filtration rate <60 ml/min/1.73 m2 (OR: 1.91; 95% confidence interval [CI]: 1.22-2.99; P = 0.004). Individuals with 2, 3, 4, and 5 components of the MetS had an increased OR for CKD: 2.19 (95% CI: 0.95-3.62), 2.65 (95% CI: 1.03-4.71), 2.86 (95% CI: 1.08-5.53), and 5.03 (95% CI: 1.80-8.57), respectively, compared with individuals with none of the components. Conclusion: We found a high prevalence of CKD in patients with MetS compared with the subject without MetS. Our observations raised major clinical and public health concerns in Iran, where both the MetS and kidney diseases are becoming common.
Collapse
Affiliation(s)
- Ali Maleki
- Department of Cardiology, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mahdi Montazeri
- Department of Cardiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Rashidi
- Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Montazeri
- Young Researchers Club, Islamic Azad University, Babol Branch, Babol, Iran
| | | |
Collapse
|
14
|
Suzuki T, Voeks J, Zakai NA, Jenny NS, Brown TM, Safford MM, LeWinter M, Howard G, Cushman M. Metabolic syndrome, C-reactive protein, and mortality in U.S. Blacks and Whites: the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. Diabetes Care 2014; 37:2284-90. [PMID: 24879838 PMCID: PMC4113170 DOI: 10.2337/dc13-2059] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2013] [Accepted: 04/18/2014] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We evaluate associations of metabolic syndrome (MetS), C-reactive protein (CRP), and a CRP-incorporated definition of MetS (CRPMetS) with risk of all-cause mortality in a biracial population. RESEARCH DESIGN AND METHODS We studied 23,998 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, an observational study of black and white adults ≥45 years old across the U.S. Elevated CRP was defined as ≥3 mg/L and MetS by the revised Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III; ATP III) criteria (three of five components). CRPMetS was defined as presence of three out of six components, with elevated CRP added to ATP III criteria as a sixth component. Cox models were used to calculate hazard ratios (HRs) for all-cause mortality, and population attributable risk (PAR) was calculated. Stratified analyses based on race and diabetes status were performed. RESULTS There were 9,741 participants (41%) with MetS and 12,179 (51%) with CRPMetS at baseline. Over 4.8 years of follow-up, 2,050 participants died. After adjustment for multiple confounders, MetS, elevated CRP, and CRPMetS were each significantly associated with increased mortality risk (HRs 1.26 [95% CI 1.15-1.38], 1.55 [1.41-1.70], and 1.34 [1.22-1.48], respectively). The PAR was 9.5% for MetS, 18.1% for CRP, and 14.7% for CRPMetS. Associations of elevated CRP and of CRPMetS with mortality were significantly greater in whites than blacks, while no differences in associations were observed based on diabetes status. CONCLUSIONS By definition, CRPMetS identifies more people at risk than MetS but still maintains a similar mortality risk. Incorporating CRP into the definition for MetS may be useful in identifying additional high-risk populations to target for prevention.
Collapse
Affiliation(s)
- Takeki Suzuki
- Department of Medicine, Johns Hopkins Hospital, Baltimore, MD
| | - Jenifer Voeks
- Department of Medicine, Medical University of South Carolina, Charleston, SC
| | - Neil A Zakai
- Department of Medicine, University of Vermont College of Medicine, Burlington, VTDepartment of Pathology, University of Vermont College of Medicine, Burlington, VT
| | - Nancy Swords Jenny
- Department of Pathology, University of Vermont College of Medicine, Burlington, VT
| | - Todd M Brown
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Monika M Safford
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Martin LeWinter
- Department of Medicine, University of Vermont College of Medicine, Burlington, VT
| | - George Howard
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Mary Cushman
- Department of Medicine, University of Vermont College of Medicine, Burlington, VTDepartment of Pathology, University of Vermont College of Medicine, Burlington, VT
| |
Collapse
|
15
|
Li Y, Chen Y, Liu X, Liang Y, Shao X, Zhang Y, Wang H, Wang X, Li B, Deng K, Liu Q, Holthöfer H, Liu H, Zou H. Metabolic syndrome and chronic kidney disease in a Southern Chinese population. Nephrology (Carlton) 2014; 19:325-31. [PMID: 24548104 DOI: 10.1111/nep.12219] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Yongqiang Li
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Youming Chen
- Clinical Laboratory; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Xinyu Liu
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Yan Liang
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Xiaofei Shao
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Ying Zhang
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Honglei Wang
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Xiaohong Wang
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Bin Li
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Kangping Deng
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Qin Liu
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Harry Holthöfer
- National Centre for Sensor Research/BioAnalytical Sciences; Dublin City University; Dublin Ireland
| | - Hongmei Liu
- Department of Ultrasound; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| | - Hequn Zou
- Department of Nephronology; Institute of Nephronology and Urology; The Third Affiliated Hospital of Southern Medical University; Guangzhou China
| |
Collapse
|
16
|
Ming J, Xu S, Yang C, Gao B, Wan Y, Xing Y, Zhang L, Yang W, Ji Q. Metabolic syndrome and chronic kidney disease in general Chinese adults: Results from the 2007–08 China National Diabetes and Metabolic Disorders Study. Clin Chim Acta 2014; 430:115-20. [PMID: 24412317 DOI: 10.1016/j.cca.2014.01.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 12/27/2013] [Accepted: 01/03/2014] [Indexed: 12/31/2022]
|
17
|
Annaloro C, Airaghi L, Saporiti G, Onida F, Cortelezzi A, Deliliers GL. Metabolic syndrome in patients with hematological diseases. Expert Rev Hematol 2014; 5:439-58. [DOI: 10.1586/ehm.12.35] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
18
|
Association between metabolic syndrome and chronic kidney disease in perimenopausal women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3987-97. [PMID: 23999547 PMCID: PMC3799514 DOI: 10.3390/ijerph10093987] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 08/20/2013] [Accepted: 08/22/2013] [Indexed: 11/17/2022]
Abstract
The purpose of the study was to explore the association between metabolic syndrome (MetS) and chronic kidney disease (CKD) in perimenopausal women. A cross-sectional study was conducted in Zhuhai from June to October 2012. Perimenopausal women (n = 685) were included in the study. All participants were divided into three subgroups: Group 1, 40 years old ≤ Age < 50 years old; Group 2, 50 years old ≤ Age < 60 years old; Group 3, 60 years old ≤ Age ≤ 65 years old. MetS was associated with CKD (p < 0.01) in the unadjusted analyses in total subjects. After adjusting the potential confounders, the odd ratios of CKD for MetS was 2.66 (95% CI 1.56 to 4.49, p < 0.001). There was no relationship between MetS and CKD in both Group 1 and Group 3. MetS was associated with CKD (p < 0.001) in the unadjusted analyses in Group 2. After adjusting for potential confounders, MetS was significantly associated with CKD. The odd ratios for MetS was 6.79 (95% CI 2.30 to 20.09, p < 0.001). There was no relationship between elevated blood pressure, elevated fasting glucose, abdominal obesity, Low HDL cholesterol, elevated triglycerides and CKD in both Group 1 and Group 3. Elevated blood pressure was associated with CKD in Group 2 (unadjusted Odds ratio: 4.52 (1.28-16.02), p = 0.02). After adjusting for potential confounders, there was no relationship between elevated blood pressure and CKD (p = 0.78). Elevated fasting glucose was associated with CKD in Group 2 (unadjusted Odds ratio: 3.69 (1.10-12.38), p = 0.03). After adjusting for potential confounders, there was no relationship between elevated fasting glucose and CKD (p = 0.15). There was no relationship between abdominal obesity, Low HDL cholesterol, elevated triglycerides and CKD in Group 2. These findings suggest that in perimenopausal women aged from 50 or older to 60 MetS was associated with CKD. There is no relationship between MetS and CKD in perimenopausal women aged from 40 or older to 50 and aged from 60 or older to 65.
Collapse
|
19
|
Carbone F, Montecucco F, Mach F, Pontremoli R, Viazzi F. The liver and the kidney: two critical organs influencing the atherothrombotic risk in metabolic syndrome. Thromb Haemost 2013; 110:940-58. [PMID: 23966104 DOI: 10.1160/th13-06-0499] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 07/12/2013] [Indexed: 02/07/2023]
Abstract
The increased atherothrombotic risk in patients with metabolic syndrome (MetS) has been classically explained by the multiplicative effect of systemic concomitant pro-atherosclerotic factors. In particular, centripetal obesity, dyslipidaemia, glucose intolerance, hypertension (differently combined in the diagnosis of the disease) would be expected to act as classical cardiovascular risk conditions underlying accelerated atherogenesis. In order to better understand specific atherosclerotic pathophysiology in MetS, emerging evidence focused on the alterations in different organs that could serve as both pathophysiological targets and active players in the disease. Abnormalities in adipose tissue, heart and arteries have been widely investigated in a variety of basic research and clinical studies in MetS. In this narrative review, we focus on pathophysiological activities of the liver and kidney. Considering its key role in metabolism and production of soluble inflammatory mediators (such as C-reactive protein [CRP]), the liver in MetS has been shown to be altered both in its structure and function. In particular, a relevant amount of the fat accumulated within this organ has been shown to be associated with different degrees of inflammation and potential insulin resistance. In humans, non-alcoholic fatty liver disease (NAFLD) has been described as the hepatic manifestation of MetS. In an analogous manner, epidemiological evidence strongly suggested a "guilty" association between MetS and chronic kidney disease (CKD). Some biomarkers of hepatic (such as C-reactive protein, TNF-alpha or other cytokines) and renal diseases (such as uric acid) associated with MetS might be particularly useful to better manage and prevent the atherothrombotic risk.
Collapse
Affiliation(s)
- F Carbone
- Dr. Fabrizio Montecucco, MD, PhD, Cardiology Division, Foundation for Medical Researches, Department of Internal Medicine, University of Geneva, 64 Avenue Roseraie, 1211 Geneva, Switzerland, Tel: +41 22 382 72 38, Fax: +41 22 382 72 45, E-mail:
| | | | | | | | | |
Collapse
|
20
|
Jiang L, Huang W, Liang Y, Wang F, Duan X, Yang X, Wen J, Wang N. Metabolic syndrome, C-reactive protein and microalbuminuria in a rural Chinese population: a cross-sectional study. BMC Nephrol 2013; 14:118. [PMID: 23725496 PMCID: PMC3674949 DOI: 10.1186/1471-2369-14-118] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 05/30/2013] [Indexed: 01/18/2023] Open
Abstract
Background Microalbuminuria is an early marker of chronic kidney disease (CKD). Previous studies have shown that either metabolic syndrome (MetS) or chronic inflammation is related to renal impairment. The aim of this study was to investigate the association between MetS, C-reactive protein (CRP) and microalbuminuria in a rural Chinese population. Methods This was a cross-sectional study using data from the Handan Eye Study. MetS was defined according to the Chinese Diabetes Society (CDS) criteria. CRP levels ≥ 3 mg/L were classified as high CRP. Microalbuminuria was defined as a urinary albumin/creatinine ratio (ACR) of 30–300 mg/g. Results We included 4191 subjects aged ≥ 30 years in this analysis. The prevalence of MetS and microalbuminuria in the group was 25.7% and 15.6%, respectively. The odds ratio (OR) of microalbuminuria in subjects with MetS was 1.25 (95% confidence interval (CI): 1.03 − 1.51) compared with those without microalbuminuria. In multivariate logistic regression analysis, high blood pressure (OR 1.36, 95% CI: 1.10 − 1.67) and high fasting blood glucose (OR 1.44, 95% CI: 1.17 − 1.76) were independently associated with microalbuminuria. Subjects with high CRP and MetS had a 1.46-fold greater risk of having microalbuminuria compared with those with low CRP without MetS (95% CI: 1.06 − 2.01). Conclusions In this rural Chinese population aged ≥30 years, MetS and microalbuminuria were independently related and the combination of high CRP and MetS was associated with an increased risk of microalbuminuria.
Collapse
|
21
|
Interaction Effects of the Leu162Val PPAR α and Pro12Ala PPAR γ 2 Gene Variants with Renal Function in Metabolic Syndrome Population. PPAR Res 2013; 2013:329862. [PMID: 23690758 PMCID: PMC3649708 DOI: 10.1155/2013/329862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 02/04/2013] [Accepted: 03/08/2013] [Indexed: 02/03/2023] Open
Abstract
Leu162Val PPARα and Pro12Ala PPARγ2 were investigated for their individual and their interactive impact on MS and renal functionality (RF). 522 subjects were investigated for biochemical and anthropometric measurements. The diagnosis of MS was based on the IDF definition (2009). The HOMA 2 was used to determine HOMA-β, HOMA-S and HOMA-IR from FPG and FPI concentrations. RF was assessed by estimating the GFR. PCR-RFLP was performed for DNA genotyping. Allele frequencies were 0.845 for Pro and 0.155 for Ala, and were 0.915 for Leu and 0.085 for Val. We showed that carriers of the PPARα Val 162 allele had lower urea, UA and higher GFR compared to those homozygous for the Leu162 allele. Subjects carried by PPARγ2Ala allele had similar results. They also had reduced FPG, FPI and HOMA-IR, and elevated HOMA-β and HOMA-S compared to those homozygous for the Pro allele. Subjects were divided into 4 groups according to the combinations of genetic alleles of the 2 polymorphisms. Subjects carrying the Leu/Val with an Ala allele had lower FPG, PPI, HOMA-IR, urea, UA levels, higher HOMA-β, HOMA-S and GFR than different genotype combinations. Leu162Val PPARα and Pro12Ala PPARγ2 can interact with each other to modulate glucose and insulin homeostasis and expand their association with overall better RF.
Collapse
|
22
|
Gluba A, Mikhailidis DP, Lip GY, Hannam S, Rysz J, Banach M. Metabolic syndrome and renal disease. Int J Cardiol 2013; 164:141-50. [DOI: 10.1016/j.ijcard.2012.01.013] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 10/31/2011] [Accepted: 01/06/2012] [Indexed: 02/07/2023]
|
23
|
Ethnic variation in the impact of metabolic syndrome components and chronic kidney disease. Maturitas 2013; 74:369-74. [PMID: 23395404 DOI: 10.1016/j.maturitas.2013.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 12/27/2012] [Accepted: 01/08/2013] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the ethnic differences in the association between metabolic syndrome components and CKD in Asian populations. METHODS We analyzed data from three independent populations in Singapore representing the three major Asian ethnic groups (n=3167 Chinese, 3082 Malays and 3228 Indians) aged 40-80 years. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m(2). Factor analysis of metabolic syndrome components was conducted and factor scores were used as independent variables in multivariable logistic regression models. RESULTS The prevalence of CKD was highest among Malays (21.0% vs. 7.4%, 5.9% in Indians and Chinese). Factor analysis identified three factors among Chinese (glycemia, blood pressure [BP], and obesity/lipid) and Malays (glycemia, BP, and lipids) accounting for 70% of the variance and four factors (glycemia, BP, lipids, and obesity) among Indians accounting for 82% of the variance. Glycemia was positively associated with CKD in all three ethnic groups. BP was positively associated with CKD among Malays (OR [95% CI] of 1.16 [1.06-1.28]), whereas it showed an inverse association among Chinese (0.84 [0.71-0.99]) and Indians (0.84 [0.73-0.97]). However, this inverse association lost significance after adjusting for antihypertensive medication use in Chinese and Indians. Obesity/lipids among Chinese and obesity among Indians showed a positive association; lipids showed an inverse association among Malays. CONCLUSIONS These data suggest that while hyperglycemia was associated with CKD in all three ethnic groups, the impact of BP, lipids, obesity on CKD varies across ethnic groups. Understanding the specific associations may allow greater understanding of how CKD develops in different racial/ethnic groups.
Collapse
|
24
|
Ziaee A, Oveisi S, Ghorbani A, Hashemipour S, Mirenayat M. Association between metabolic syndrome and premicroalbuminuria among Iranian women with Polycystic Ovary Syndrome: a case control study. Glob J Health Sci 2012; 5:187-92. [PMID: 23283052 PMCID: PMC4776989 DOI: 10.5539/gjhs.v5n1p187] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 11/12/2012] [Accepted: 11/29/2012] [Indexed: 12/03/2022] Open
Abstract
Objective: The aim of this study was to assess the association between premicroalbuminuria and metabolic syndrome in women with Polycystic Ovary Syndrome (PCOS). Methods: In this case – control study, we analyzed the medical records of 78 women from an endocrinology outpatient center of Booali hospital in Qazvin city in Iran during 2008 to 2010. Anthropometric characteristics, Albumin/Creatinine Ratio (ACR), Lipid profile, Liver enzyme concentration, and occurrence of metabolic syndrome were compared between the two groups. Premicroalbuminuria was defined as ACR>7mg/g. Results: Mean age of patients with PCOS was 27.2± 2.5 years and mean age of 63 controls was 26.9±2.4 years. Premicroalbuminuria was found in 53.8% of PCOS and 33.3% of control group (p value=0.015). Again, patients with PCOS divided in two groups: ACR>7mg/g and ACR<7mg/g. Higher serum levels of fasting insulin and glucose, blood pressure and more waist circumference were seen in PCOS patients with ACR>7mg/g. Fifty percent of patients with PCOS and ACR>7mg/g fulfilled criteria of metabolic syndrome; whereas no case of metabolic syndrome was found in PCOS patients with ACR<7mg/g. Conclusions: Premicroalbuminuria is more prevalent in patients with PCOS compared to normal individuals. Metabolic syndrome is more frequently seen in patients with PCOS and premicroalbuminuria against patients with ACR<7mg/g.
Collapse
Affiliation(s)
- Amir Ziaee
- Department of Community Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | | | | | | |
Collapse
|
25
|
Kovács T, Vas T, Kovesdy CP, Késõi I, Sági B, Wittmann I, Nagy J. Metabolic syndrome and other cardiovascular risk factors associated with the progression of IgA nephropathy. Clin Kidney J 2012; 6:395-401. [PMID: 27293567 PMCID: PMC4898329 DOI: 10.1093/ckj/sfs131] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 08/18/2012] [Indexed: 01/21/2023] Open
Abstract
Background The metabolic syndrome is associated with modest but independent and additive risk of new onset chronic kidney disease (CKD) in several studies. The purpose of our study was to determine whether metabolic syndrome and other cardiovascular risk factors (hyperuricaemia and smoking) are associated with the progression of IgA nephropathy (IgAN). Methods Two hundred and twenty three IgAN patients (107 with and 116 without metabolic syndrome) were examined. The primary renal end point was doubling of serum creatinine; secondary end points were reaching eGFR of ≤ 60 ml/min/1,73m2 or eGFR of ≤30 ml/min/1.73 m2, and end-stage renal disease, ESRD (the composite of serum creatinine ≥500 μmol/l, initiation of dialysis treatment or transplantation). The association of metabolic syndrome with renal end points was examined using the Kaplan-Meier method and Cox models. Results Metabolic syndrome established at the diagnosis or during follow-up of IgAN patients was significantly associated with the primary renal end point (unadjusted hazard ratio of doubling of serum creatinine, 95% confidence interval: 1.96 (1.17–1.33, p = 0.011). The association remained significant after adjustment for confounders: 1.70 (1.02–3.83, p = 0.040). Results were similar for secondary end points except ESRD which was not associated with the presence of metabolic syndrome. Hyperuricaemia and smoking were independent risk factors of progression. Survival curves stratified on metabolic syndrome status showed significant differences for the end points (p = 0.017–0.001) except for ESRD. Conclusions Early diagnosis and treatment of metabolic syndrome, hyperuricaemia and smoking may be an additional cost-effective strategy for preventing the progression of IgAN.
Collapse
Affiliation(s)
- Tibor Kovács
- Second Department of Medicine and Nephrological Center, Faculty of Medicine , University of Pécs, Pécs , Hungary
| | - Tibor Vas
- Second Department of Medicine and Nephrological Center, Faculty of Medicine , University of Pécs, Pécs , Hungary
| | - Csaba P Kovesdy
- Health Science Center , University of Tennessee , Memphis, TN , USA
| | - István Késõi
- Second Department of Medicine and Nephrological Center, Faculty of Medicine , University of Pécs, Pécs , Hungary
| | - Balázs Sági
- Second Department of Medicine and Nephrological Center, Faculty of Medicine , University of Pécs, Pécs , Hungary
| | - István Wittmann
- Second Department of Medicine and Nephrological Center, Faculty of Medicine , University of Pécs, Pécs , Hungary
| | - Judit Nagy
- Second Department of Medicine and Nephrological Center, Faculty of Medicine , University of Pécs, Pécs , Hungary
| |
Collapse
|
26
|
Wang Y, Zhao D, Xing Y, Li J, Hu D, Xu Y, Merriam PA, Ma Y. Clinical features of Chinese coronary heart disease patients with chronic kidney disease. Ren Fail 2012; 34:985-90. [PMID: 22880803 DOI: 10.3109/0886022x.2012.706879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of chronic kidney disease (CKD) by stage in Chinese patients with coronary heart disease (CHD) and to identify the clinical features and examine control of cardiovascular risk factors. METHODS AND RESULTS Clinical data of hospitalized patients were collected by investigators in China. CKD stages were classified according to estimated glomerular filtration rate (eGFR). A total of 2509 participants with CHD were included in the final statistical analysis. The overall prevalence of CKD stage 3 and greater (eGFR of less than 60 mL/min/1.73 m(2)) in the CHD patients was 32.5%. As the CKD stage increased, fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), and high-sensitivity C-reactive protein (HS-CRP) levels all worsened. As the CKD stage became more severe, CHD patients had comorbidities such as diabetes mellitus, periphery arterial disease, and ischemic stroke, and more CHD patients had triple vessel disease increased. Even when patients received treatment of CHD and risk factors, control of cardiovascular risk factors such as SBP, DBP, FBG, and low-density lipoprotein was worsened as CKD stage became more severe over a 6-week follow-up. CONCLUSIONS The data suggested a high prevalence of CKD in Chinese patients with CHD. Many conventional risk factors and comorbidities were correlated with high prevalence of CKD in CHD patients. Control of cardiovascular risk factors in those patients was poor.
Collapse
Affiliation(s)
- Yong Wang
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Jiang L, Liang Y, Qiu B, Wang F, Duan X, Yang X, Yang J, Huang W, Wang N. Metabolic syndrome and chronic kidney disease in a rural Chinese population. Clin Chim Acta 2011; 412:1983-8. [DOI: 10.1016/j.cca.2011.07.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 07/08/2011] [Accepted: 07/16/2011] [Indexed: 11/26/2022]
|
28
|
Ferraro PM, Lupo A, Yabarek T, Graziani MS, Bonfante L, Abaterusso C, Gambaro G. Metabolic syndrome, cardiovascular disease, and risk for chronic kidney disease in an Italian cohort: analysis of the INCIPE study. Metab Syndr Relat Disord 2011; 9:381-8. [PMID: 21711121 DOI: 10.1089/met.2011.0040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Metabolic syndrome is a frequent condition that has been linked to cardiovascular disease (CVD) and mortality. Metabolic syndrome has been extensively shown to increase the risk of chronic nephropathies in Americans and Asians, but not in European populations. Renal disease increases the risk of CVD and mortality. However, the chronic nephropathy-CVD liaison has not been analyzed in the framework of the possible role of metabolic syndrome in both. METHODS We analyzed data from 3,757 subjects participating in the INCIPE survey (Initiative on Nephropathy, of relevance to public health, which is Chronic, possibly in its Initial stages, and carries a Potential risk of major clinical End-points), a cross-sectional study enrolling subjects from the general population in the Veneto region in Italy, and calculated the odds ratio (OR) and 95% confidence interval (CI) of the association between metabolic syndrome, and/or chronic kidney disease (CKD) and albuminuria, and/or previous CVD after adjustment for confounding factors. RESULTS Metabolic syndrome is associated with CKD (OR 2.17; P<0.001) and albuminuria (OR 2.28; P<0.001) and CVD (OR 1.58; P=0.002). There is a direct correlation between number of metabolic syndrome traits and nephropathy and CVD. CVD and nephropathies are associated even after adjustment for metabolic syndrome (OR 2.30; P<0.001). CONCLUSIONS In a homogeneous Caucasian European population, metabolic syndrome is associated with CKD and albuminuria, and CVD. Although metabolic syndrome is a risk factor for both CVD and nephropathy, it does not entirely explain the dangerous CVD-nephropathy liaison.
Collapse
Affiliation(s)
- Pietro Manuel Ferraro
- Division of Nephrology and Dialysis, Institute of Internal Medicine and Medical Specialties, Columbus-Gemelli University Hospital, Renal Program, Catholic University, Rome, Italy
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Sheen YJ, Sheu WHH. Metabolic syndrome and renal injury. Cardiol Res Pract 2011; 2011:567389. [PMID: 21461396 PMCID: PMC3065010 DOI: 10.4061/2011/567389] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2010] [Revised: 12/12/2010] [Accepted: 12/22/2010] [Indexed: 12/24/2022] Open
Abstract
Both metabolic syndrome (MetS) and chronic kidney disease (CKD) are major global health issues. Current clinical markers used to reflect renal injury include albuminuria and estimated glomerular filtration rate (eGFR). Given the same eGFR level, urine albumin might be a better risk marker to predict progression of CKD and future development of cardiovascular diseases (CVDs). Serum Cystatin C is emerging as a new biomarker for early detection of renal injury associated with MetS and cardiovascular risk. In addition to each component, MetS per se influences the incidence and prognosis of renal injury and the odds ratios increased with the increase in the number of metabolic abnormalities. Hyperinsulinemia, activation of rennin-angiotensin-aldosterone system, increase of oxidative stress, and inflammatory cytokines are proposed to be the plausible biological link between MetS and CKD. Weight control, stick control of blood pressure, glucose, and lipids disorders may lead to lessening renal injury and even the subsequent CVD.
Collapse
Affiliation(s)
- Yi-Jing Sheen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital Department of Health, Executive Yuan, No. 199, Sec. 1, Sanmin Road, Taichung 403, Taiwan
| | - Wayne Huey-Herng Sheu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, No. 160, Sec. 3, Taichung-Kang Road, Taichung 407, Taiwan
| |
Collapse
|
30
|
Raimundo M, Lopes JA. Metabolic syndrome, chronic kidney disease, and cardiovascular disease: a dynamic and life-threatening triad. Cardiol Res Pract 2011; 2011:747861. [PMID: 21403897 PMCID: PMC3043294 DOI: 10.4061/2011/747861] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 12/06/2010] [Accepted: 12/24/2010] [Indexed: 01/19/2023] Open
Abstract
The metabolic syndrome (MS) and chronic kidney disease (CKD) have both become global public health problems, with increasing social and economic impact due to their high prevalence and remarkable impact on morbidity and mortality. The causality between MS and CKD, and its clinical implications, still does remain not completely understood. Moreover, prophylactic and therapeutic interventions do need to be properly investigated in this field. Herein, we critically review the existing clinical evidence that associates MS with renal disease and cardiovascular disease, as well as the associated pathophysiologic mechanisms and actual treatment options.
Collapse
Affiliation(s)
- Mário Raimundo
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, EPE, Hospital de Santa Maria, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal
| | - José António Lopes
- Department of Nephrology and Renal Transplantation, Centro Hospitalar Lisboa Norte, EPE, Hospital de Santa Maria, Avenida Professor Egas Moniz, 1649-035 Lisboa, Portugal
| |
Collapse
|
31
|
Shan Y, Zhang Q, Liu Z, Hu X, Liu D. Prevalence and risk factors associated with chronic kidney disease in adults over 40 years: a population study from Central China. Nephrology (Carlton) 2010; 15:354-61. [PMID: 20470307 DOI: 10.1111/j.1440-1797.2009.01249.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Chronic kidney disease (CKD) poses a serious public health problem worldwide. Population-based studies determining the prevalence of this disease in China have been limited in several large developed cities. In the present study, a population-based screening study in Henan, a representative province in Central China, was conducted in order to quantify the prevalence of CKD and identify the associated risk factors for this disease in a population of developing areas of China. METHODS Residents (n = 4156) over 40 years old in four major cities of Henan Province were interviewed and their albuminuria, reduced renal function, haematuria and blood pressure were measured. Associations between age, components of metabolism syndrome and indicators of CKD were examined. RESULTS Among these subjects, the prevalence rates of albuminuria, haematuria and reduced renal function were 4.51%, 6.28% and 1.53%, respectively. Approximately 10.49% of the subjects had at least one indicator of kidney damage. The awareness rate of this disease in subjects with CKD was only 9.50%. Hypertension, diabetes and hyperuricaemia were three independent risk factors for CKD. CONCLUSION The high prevalence and low awareness of CKD in the studied population suggest that CKD is a severe public health problem in Central China. Effectively preventive and therapeutic interventions are needed.
Collapse
Affiliation(s)
- Yan Shan
- Department of Clinical Medicine, Nursing College of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
| | | | | | | | | |
Collapse
|
32
|
|
33
|
Liu H, Yu J, Chen F, Wang J, Chen S, Wang F, Hu D. Does Obesity Attenuate the Effect of Metabolic Syndrome on Chronic Kidney Disease in Patients With Coronary Artery Disease? Report From China Heart Survey. Circ J 2010; 74:462-7. [DOI: 10.1253/circj.cj-09-0771] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hao Liu
- Institute of Clinical Epidemiology, School of Public Health, Fudan University
| | - Jinming Yu
- Institute of Clinical Epidemiology, School of Public Health, Fudan University
| | - Fang Chen
- Department of Preventive Medicine, Medical College, Tongji University
| | - Jinsong Wang
- Department of Preventive Medicine, Medical College, Tongji University
| | - Shengbao Chen
- Department of Preventive Medicine, Medical College, Tongji University
| | - Fang Wang
- Department of Preventive Medicine, Medical College, Tongji University
| | - Dayi Hu
- Department of Cardiology, People's Hospital, Peking University
| |
Collapse
|
34
|
Yoon YS, Park HS, Yun KE, Kim SB. Obesity and metabolic syndrome-related chronic kidney disease in nondiabetic, nonhypertensive adults. Metabolism 2009; 58:1737-42. [PMID: 19615700 DOI: 10.1016/j.metabol.2009.05.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2008] [Accepted: 05/29/2009] [Indexed: 10/20/2022]
Abstract
Metabolic syndrome (MS) is associated with chronic kidney disease (CKD). The objective of this study is to examine the association between obesity and MS-related CKD in nondiabetic, nonhypertensive Korean adults. Korea National Health and Nutrition Examination Survey III data from 3771 nondiabetic, nonhypertensive Koreans were analyzed. Metabolic syndrome was defined according to the National Cholesterol Education Program-Adult Treatment Panel III, and CKD was diagnosed at an estimated glomerular filtration rate less than 60 mL/(min 1.73 m(2)). The crude and multivariate-adjusted odds ratios (ORs) of CKD associated with MS and its individual components were calculated using logistic regression models in a study population stratified by obesity. The prevalence of MS and CKD was 13.4% and 3.2%, respectively. The association between MS and CKD was significant in obese (OR, 2.91; 95% confidence interval [CI] = 1.34-6.34), but not nonobese (OR, 1.38; 95% CI = 0.60-3.17), subjects. In obese subjects, impaired fasting glucose (OR, 2.47; 95% CI = 1.10-5.57) and high triglyceride levels (OR, 2.42; 95% CI = 1.01-5.83) were risk factors for CKD, whereas no components were significantly associated with CKD in nonobese subjects. Our findings suggest that even in nondiabetic, nonhypertensive Korean adults, early detection and prevention of CKD in obese subjects with MS are critical.
Collapse
Affiliation(s)
- Yeong Sook Yoon
- Department of Family Medicine, Ilsan Paik Hospital, University of Inje College of Medicine. Gyeonggi-do 410-706, South Korea
| | | | | | | |
Collapse
|
35
|
Chang IH, Han JH, Myung SC, Kwak KW, Kim TH, Park SW, Choi NY, Chung WH, Ahn SH. Association between metabolic syndrome and chronic kidney disease in the Korean population. Nephrology (Carlton) 2009; 14:321-6. [PMID: 19444966 DOI: 10.1111/j.1440-1797.2009.01091.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM We performed a retrospective study to examine the association between the metabolic syndrome (MS)and risk for the development of chronic kidney disease (CKD). METHODS This cohort study included 60 921 healthy adults recruited from two health promotion centres.Anthropometric measures, blood pressure, fasting glucose, lipid profile and serum creatinine were evaluated. The glomerular filtration rate was estimated (eGFR) using the abbreviated equation developed by the Modification of Diet in Renal Disease (MDRD) formula. CKD was defined as an eGFR of <60 mL/min per 1.73 m2 or the presence of proteinuria. RESULTS The prevalence of MS and CKD was 19.0% and 7.2% respectively. Those with MS had a higher prevalence of CKD (11.0% vs 6.3%, P < 0.001) than those without MS. As the number of MS components increased, the prevalence of CKD increased and the eGFR decreased. The multiple linear analyses showed that each of the components of the MS was negatively correlated with the eGFR. Unadjusted and multivariate adjusted associations were identified between MS and CKD. Individuals with MS had a multivariate adjusted odds ratio of 1.680 (95% confidence interval, 0.566-1.801) for CKD compared with those without MS. CONCLUSION Our findings, which were obtained from a large Korean cohort, suggest that MS was associated with CKD.
Collapse
Affiliation(s)
- In Ho Chang
- Department of Urology, Chung-Ang University, College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Tsukamoto Y, Wang H, Becker G, Chen HC, Han DS, Harris D, Imai E, Jha V, Li PKT, Lee EJC, Matsuo S, Tomino Y, Tungsanga K, Yamagata K, Hishida A. Report of the Asian Forum of Chronic Kidney Disease Initiative (AFCKDI) 2007. "Current status and perspective of CKD in Asia": diversity and specificity among Asian countries. Clin Exp Nephrol 2009; 13:249-56. [PMID: 19288169 DOI: 10.1007/s10157-009-0156-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Accepted: 12/18/2008] [Indexed: 01/07/2023]
Abstract
The Japanese Society of Nephrology (JSN) sponsored the Asian Forum of CKD Initiative (AFCKDI) 2007 with the support of the International Society of Nephrology-Commission for Global Advancement in Nephrology (ISN-COMGAN), Asian Pacific Society of Nephrology (APSN), the Kidney Disease: Improving Global Outcome (KDIGO) and other national societies of nephrology in the Asian Pacific region on 27-28 May 2007 in Hamamatsu City, Japan. An international organising committee was established by leading experts of the CKD initiative. The main objective of this forum was to clarify the current status and perspectives of CKD and to promote coordination, collaboration and integration of initiatives in the Asian Pacific region. The forum received 56 papers from 16 countries; it began with the symposium "A Challenge to CKD in the world" and was followed by the ISN-COMGAN affiliated workshop "Current status and perspective of CKD in Asia". The second day was dedicated to discussion on the evaluation, surveillance and intervention in CKD in this area. At the end of the forum, we decided on the future plan as follows: (1) The AFCKDI will provide opportunities annually or biannually for every person who promotes CKD initiatives in the Asian Pacific region to join together and build consensus for action; (2) the second forum will be held in Kuala Lumpur on 4 May 2008 at the time of the 11th Asian Pacific Congress of Nephrology (APCN). Zaki Morad, President of the 11th APCN, will host the second forum; (3) the International Organising Committee (IOC) of the 1st AFCKDI will continue its function by adding other experts, including the organisers of the APCN; (4) the AFCKDI is not an organisation by itself, nor does it belong to any society, but is organised by each host national society of nephrology. The IOC will assist the domestic committee for the success of the forum and will assure the continuation of the mission; (5) in order to organise the forum and promote CKD initiatives in the Asia Pacific region, the AFCKDI will look for support by both national and international societies. The AFCKDI will keep an intimate and mutual relation with the ISN, APSN and KDIGO.
Collapse
Affiliation(s)
- Yusuke Tsukamoto
- Department of Nephrology, Shuwa General Hospital, Saitama, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Cystatin C is associated with the metabolic syndrome and other cardiovascular risk factors in a hypertensive population. ACTA ACUST UNITED AC 2009; 3:201-9. [PMID: 20409960 DOI: 10.1016/j.jash.2009.01.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Revised: 01/02/2009] [Accepted: 01/05/2009] [Indexed: 11/24/2022]
Abstract
Serum cystatin C has been associated with cardiovascular disease. We investigated whether cystatin C concentration is associated with the metabolic syndrome and with other cardiovascular risk factors in a hypertensive population. In this cross-sectional study, we prospectively included 611 essential hypertensive patients during a 12-month period. Cystatin C concentration was measured by nephelometry. The metabolic syndrome was present in 46% of the patients. Cystatin C was significantly higher in patients with the metabolic syndrome (0.94 +/- 0.27 mg/L) than in those without (0.87 +/- 0.23 mg/L) (P < .0001). Pearson partial correlation analysis showed a significant correlation between cystatin C and body mass index (r = 0.240; P = .001); waist circumference (r = 0.173; P = .012); microalbuminuria (r = 0.273; P < .0001); triglycerides (r = 0.138; P = .047); C-reactive protein (r = 0.190; P = .006); uric acid (r = 0.284; P < .0001); age (r = 0.409; P < .0001); and glomerular filtration rate (GFR) (r = -0.638; P < .0001). Multivariate analysis showed that GFR (B = -0.0061; 95% confidence interval [CI], -0.0073 to -0.0049; P < .0001), age (B = 0.0023; 95% CI, 0.0005-0.0041; P = .009), microalbuminuria (B = 0.0005; 95% CI, 0.0002-0.0007; P < .0001), uric acid (B = 0.0252; 95% CI, 0.0085-0.0418; P = .003), body mass index (B = 0.0051, 95% CI, 0.0012-0.0089; P = .011), and C-reactive protein (B = 0.0048; 95% CI, 0.0015-0.0082; P = .005) were independent determinants of cystatin C concentration. Measuring cystatin C concentration in hypertensive patients may be useful for evaluating their cardiovascular risk profile.
Collapse
|
38
|
Xu R, Zhang L, Zhang P, Wang F, Zuo L, Wang H. Comparison of the prevalence of chronic kidney disease among different ethnicities: Beijing CKD survey and American NHANES. Nephrol Dial Transplant 2008; 24:1220-6. [PMID: 18987261 DOI: 10.1093/ndt/gfn609] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND It is unclear whether ethnic disparity of the prevalence of chronic kidney disease (CKD) exists among native Chinese and American ethnicities. METHODS A stratified multistage clustered screening for CKD performed in Beijing in 2006 was compared with data from the National Health and Nutrition Examination Survey (NHANES) between 1999-2006 (participants aged > or =20 years, 13 626 Chinese, 9006 whites, 3447 African Americans, 4626 Hispanics). Serum creatinine from Beijing and NHANES were calibrated at the Cleveland Clinic Laboratory. The re-expressed abbreviated MDRD equation for Americans and its modified form for Chinese were used to estimate glomerular filtration rate (eGFR). Subjects with eGFR <60 mL/min/1.73 m(2) were diagnosed as having chronic renal insufficiency (CRI). Albuminuria was diagnosed if the urine albumin-creatinine ratio was >17 mg/g for males or >25 mg/g for females. CKD was diagnosed if CRI or albuminuria was present. RESULTS Compared with American whites, African Americans and Hispanics, Chinese had a lower prevalence of adjusted albuminuria (12.10%, 16.33% and 14.16% versus 9.27%), CRI (9.46%, 5.18% and 3.11% versus 1.38%) and CKD (19.03%, 19.00% and 15.99% versus 10.25%). Moreover, Chinese hold the lowest risk of albuminuria when exposed to diabetes; the risk of CRI among Chinese when exposed to diabetes or hypertension was lower than that among African Americans, but similar to that among whites and Hispanics. CONCLUSIONS The CKD prevalence was significantly different among native Chinese and American ethnicities.
Collapse
Affiliation(s)
- Rong Xu
- Institute of Nephrology Peking University First Hospital, 8 XiShiKu Street, XiCheng District, Beijing 100034, China
| | | | | | | | | | | |
Collapse
|
39
|
Affiliation(s)
- Thomas C Gerber
- Division of Cardiovascular Diseases, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL, USA.
| | | | | | | |
Collapse
|
40
|
Chang Y, Ryu S, Sung E, Woo HY, Oh E, Cha K, Jung E, Kim WS. Nonalcoholic fatty liver disease predicts chronic kidney disease in nonhypertensive and nondiabetic Korean men. Metabolism 2008; 57:569-76. [PMID: 18328362 DOI: 10.1016/j.metabol.2007.11.022] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Accepted: 11/28/2007] [Indexed: 01/12/2023]
Abstract
In the absence of significant research, we performed a prospective study to examine the association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). The study cohort comprised a total of 8329 healthy men, with normal baseline kidney functions and no proteinuria, working in a semiconductor manufacturing company and its 13 affiliates. Alcohol intake was assessed with a self-reported questionnaire. Biochemical tests for liver and metabolic function and abdominal ultrasonography were done. Chronic kidney disease was defined as either the presence of proteinuria or a glomerular filtration rate (GFR) of <60 mL/min per 1.73 m(2). Cox proportional hazards model was used to estimate hazard ratios in the model for CKD. During 26717.1 person-years of follow-up, 324 men developed CKD. Nonalcoholic fatty liver disease was associated with the development of CKD (crude relative risk, 2.18; 95% confidence interval [CI], 1.75-2.71); and this relationship remained significant even after adjustment for age, GFR, triglyceride, and high-density lipoprotein cholesterol (adjusted relative risk [aRR], 1.55; 95% CI, 1.23-1.95). The association between NAFLD and incident CKD was evident in the NAFLD group with elevated serum gamma-glutamyltransferase (GGT) (aRR, 2.31; 95% CI, 1.53-3.50), even after adjustment for age, GFR, triglyceride, and high-density lipoprotein cholesterol, but not in the NAFLD group without elevated GGT (aRR, 1.09; 95% CI, 0.79-1.50) (P = .008 for interaction). To summarize, NAFLD with elevated GGT concentration was associated with an increased CKD risk among nondiabetic, nonhypertensive Korean men, irrespective of metabolic syndrome.
Collapse
Affiliation(s)
- Yoosoo Chang
- Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul 110-746, South Korea
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Kawamoto R, Kohara K, Tabara Y, Miki T. An association between metabolic syndrome and the estimated glomerular filtration rate. Intern Med 2008; 47:1399-406. [PMID: 18670145 DOI: 10.2169/internalmedicine.47.1202] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Metabolic syndrome (MetS) is a major public health problem. However, few studies have examined the significance of MetS as a risk factor for the development of chronic kidney disease (CKD) in the general Japanese population. METHODS Study participants without a clinical history of stroke, transient ischemic attack, myocardial infarction, angina, or renal failure (1,158 men, aged 61+/-15 years and 1,606 women, aged 63+/-12 years) were recruited from a single community. We examined the cross-sectional relationship between MetS and renal function as evaluated by estimated glomerular filtration rate (eGFR). RESULTS The presence of MetS was consistently associated with reduced eGFR, with the level of reduction proportional to the number of MetS components present. Multiple linear regression analysis using eGFR as an objective variable showed that BMI, DBP, antihypertensive drug use, high-density lipoprotein cholesterol, antilipidemic drug use and fasting blood glucose, which were components of MetS, were significantly and independently associated with eGFR, in addition to age and low-density lipoprotein cholesterol. Individuals with MetS showed a multivariate-adjusted odds ratio of 1.53 (95% confidence interval, 1.10-2.13) for CKD compared to those without MetS. CONCLUSIONS MetS was significantly associated with decreased eGFR in the general population.
Collapse
Affiliation(s)
- Ryuichi Kawamoto
- Department of Internal Medicine, Nomura Municipal Hospital, Seiyo.
| | | | | | | |
Collapse
|