Relationships Between Various Components of Metabolic Syndrome and Chronic Kidney Disease in Shiraz, Iran

Prediction of metabolic syndrome and its associated risk factors in patients with chronic kidney disease using machine learning techniques

INTRODUCTION

Chronic kidney disease (CKD) and metabolic syndrome (MS) are recognized as public health problems which are related to overweight and cardiometabolic factors. The aim of this study was to develop a model to predict MS in people with CKD.

METHODS

This was a prospective cross-sectional study of patients from a reference center in São Luís, MA, Brazil. The sample included adult volunteers classified according to the presence of mild or severe CKD. For MS tracking, the k-nearest neighbors (KNN) classifier algorithm was used with the following inputs: gender, smoking, neck circumference, and waist-to-hip ratio. Results were considered significant at p < 0.05.

RESULTS

A total of 196 adult patients were evaluated with a mean age of 44.73 years, 71.9% female, 69.4% overweight, and 12.24% with CKD. Of the latter, 45.8% had MS, the majority had up to 3 altered metabolic components, and the group with CKD showed statistical significance in: waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood glucose. The KNN algorithm proved to be a good predictor for MS screening with 79% accuracy and sensitivity and 80% specificity (area under the ROC curve - AUC = 0.79).

CONCLUSION

The KNN algorithm can be used as a low-cost screening method to evaluate the presence of MS in people with CKD.

Association of Metabolic Syndrome and Chronic Kidney Disease in Moroccan Adult Population

Background: Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that may promote the development of chronic kidney disease (CKD). The aim of this research was to determine the prevalence of MetS and its components and, to study their association with CKD among Moroccan adult population living in an agricultural province. Materials and Methods: The study involved 210 adult participants of 18 and over years, of both sexes, sampled from urban and rural areas of Sidi Bennour province in Morocco. Systolic and diastolic blood pressure, weight, height, and waist circumference were measured and body mass index (BMI) was calculated. Blood total cholesterol, triglycerides, glucose, and serum creatinine were determined. Subsequent glomerular filtration rate (GFR) was estimated by the modification of diet in renal disease formula and the CKD was defined by an estimated GFR (eGFR) <60 mL/min/1.73 m². The diagnosis of MetS was based on the National Cholesterol Education Program/Adult Treatment Panel (NCEP ATP III) report. Results: The mean age of the participants was 54.18 ± 13.45 years, the prevalence of MetS and CKD were 38% and 4.4%, respectively. Abdominal obesity was the strongest risk factor of MetS among the studied population (71%), followed by increased fasting plasma glucose (40.5%), high blood pressure (35.2%), hypercholesterolemia (31.0%), and hypertriglyceridemia (23.8%). The prevalence of these comorbid factors increased with age (P = 0.000), BMI (P = 0.000), and decreased with education level (P = 0.012). The presence of MetS was significantly associated with decreased eGFR (P = 0.022), hence the prevalence of CKD was markedly greater in subjects with MetS than those without. Conclusions: Our finding indicates that MetS is a serious public health problem in the study population and that its individual components are involved in decreasing the eGFR and the progression of renal dysfunction. The study results support the need of the development of a strategy to control and prevent worsening of the MetS individual components and development of CKD.

Incidence of metabolic syndrome and determinants of its progression in Southern Iran: A 5-year longitudinal follow-up study

Background

Metabolic syndrome (MetS) is a cluster of conditions increasing the risk of serious diseases. This study aimed to define the predictors of MetS incident in a community-based cohort in Southern Iran, during a mean follow-up period of 5.1 years.

Materials and Methods

During the mean follow-up period of 5.1 years, a cohort study was conducted on 819 Iranian adults aged ≥18 years at baseline and followed to determine the incidence and predictors of MetS progression in Shiraz, a main urban region in the southern part of Iran. The International Diabetes Federation Guideline was used to detect the MetS. Multiple Cox's proportional hazards models were also used to estimate the predictors of new-onset MetS.

Results

The prevalence of MetS was 25.9% at baseline, and the overall incidence of subsequent MetS was 5.45% (95% confidence interval [CI]: 4.47-6.59). The incidence of MetS was significantly higher in women (7.12% [95% CI: 5.52-9.05]) than in men (3.92% [95% CI: 2.80-5.34]). Moreover, it increased by 5.02 (95% CI, 3.75-6.58) among individuals who had one metabolic component and by 12.65 (95% CI, 9.72-16.18) for those who had three or more components (P < 0001). The incidence of MetS was also analyzed using the multiple Cox's proportional hazards model for potential risk factors, and it was revealed that female gender (hazard ratio [HR] 2.45; 95% CI: 1.33, 4.50; P = 0.004), higher body mass index (HR 3.13; 95% CI: 1.43.6.84; P = 0.012), increased abdominal obesity (HR 1.45; 95% CI 0.85, 2.46; P = 0.045), smoking (HR 4.79; 95% CI 2.09, 10.97; P < 0.001), and lower high-density lipoprotein (HR 0.53; 95% CI: 0.29, 1.00; P = 0.044) significantly predicted the onset of MetS at baseline; however, age, systolic and diastolic blood pressure, serum uric acid, fasting blood glucose, cholesterol, triglyceride and creatinine, estimated glomerular filtration rate, marital status, level of education, and level of physical activity did not independently predict the onset of MetS when other covariates were considered.

Conclusion

This study showed the high-incidence rates of MetS in males and females residing in Southern Iran. Therefore, the prevention through community-based lifestyle modification should be implemented to reduce the burden of MetS and its complications.