Epidemiological Investigation Of Metabolic Syndrome In Sichuan Province And Research On The Correlation Between It And Chronic Kidney Disease

Objective:To investigate the prevalence of metabolic syndrome and its related risk factors in adults (age≥18 years old) at the urban and rural areas in Sichuan Province, and to analyze the correlationship between metabolic syndrome and chronic kidney disease. Method:Stratified random sampling method was used to select 3300 permanent residents (age≥18 years old) in the Wuhou district in Chengdu city (the urban areas) and the Guanghan district in Deyang city (the rural areas). The risk factors for metabolic syndrome and chronic kidney disease are tested, including:①the medical examinations:height, weight, waist circumference, hip circumference, blood pressure and pulse rate;②the laboratory examination:urine routine examination, serum creatinine and fasting blood examination, blood sugar, uric acid, cholesterol, triglycerides, high density lipid protein and low-density lipoprotein) and questionnaire survey (demographic data, history of chronic diseases, etc.).Results:In the 3204 investigated adults, response rate was 91.6%after the normalization of the ages and sex(the school population normalization was adopted), The prevalence of metabolic syndrome is 8.6%(95% CI is 7.6%～9.6%). The difference between men and women has statistical significance (the prevalence of the men is 6.1% and the prevalence of the women is 13.8%, P<0.001). However, the difference between urban and rural areas has no statistical significance (the prevalence at the rural area is 10.0% and the prevalence at the urban area is 9.9%, P=0.971). For five components of metabolic syndrome diagnosis; central obesity, high blood pressure, high triglyceride (TG), low high-density lipoprotein cholesterol (HDL-C) and high prevalence rate of PFG, the prevalence's are 26.1%,28.5% 64.7%,43.0% and 16.8% respectively. After normalization, the prevalence are 22.4%, 22.7%,64.5%,45.4% and 13.4% respectively. The MS, high blood pressure, high FPG, and central obesity increased with the increment of the age. HDL decreased with the increment of the age. From 18 to 49 years, the hyperlipemia is the mainly abnormality. From 50 to 59 years old, the hyperlipemia, the high blood pressure, and the high FPG are the mainly abnormality. From 60 to 95 years, the high blood pressure, the high FPG are the mainly abnormality. The logistic regression analysis shows that the renal history, the LDL-C, the age, the BMI and the gender (female) are the independented risk factors for metabolic syndrome. In the 3024 survey patients,579 have CKD and 2445 have not. The prevalence of CKD after the normalization of ages and genders(the school population normalization) is 16.5%. In the 3024 survey patients,346 have albuminuria and 2678 have not. The prevalence of the albuminuria after the normalization of ages and genders (the school population normalization) is 9.5%. In the MS patients,79 are CKD; and the prevalence rate is 26.2%. To be compared with the non-MS patients(the prevalence is 18.4%), the prevalence rate has statistical significance (P=0.001); In the MS patients,44 have white albuminuria and the prevalence rate is 14.6%. To be compared with non-MS patients(the prevalence of CKD is 11.1%), the prevalence rate has no statistical significance(P=0.068). The corelationship analyses between individual components of metabolic abnormalities and elevated ACR, low HDL-C, high FPG, high blood pressure, and central obesity have correlation(P<0.05). the values of OR(95%CI) are 0.647(0.511～0.818),3.285(2.571～4.198),2.892(2.303～3.633),1.433(1.126～1.824). The high-FPG was the greatest effective factor for the elevated ACR (OR=3.285). The central obesity+1 component, the central obesity+2 components, the central obesity+3 components and the central obesity +4 components have significant correlation with the elevated ACR (P<0.05). The factor OR values(95%CI) are 1.722(1.031～2.872),3.075(1.944～4.864),2.330(1.294～4.194)and 2.884(1.78～7.827) respectively. With the increase of metabolic components, the risk of elevated ACR increasing; It was the highest risk (OR=3.075) that the central obesity+2 composition for elevated ACR. The corelationship between individual components of metabolic abnormalities and CKD, low HDL-C, high FPG, high blood pressure, and central obesity have significant correlations(P<0.05). the OR values(95%CI) are0.524(0.432～0.636),3.499(2.838～4.312),2.138(1.771～2.582),1.502(1.234～1.828). The high-FPG is the greatest impact for the CKD (OR=3.499). The central obesity+1 component, the central obesity+2 components, the central obesity+3 components and the central obesity+4 components have significant correlations with the elevated ACR (P <0.05). The factor OR values(95%CI) are 1.737(1.105～2.731),2.236(1.542-3.509), 2.093(1.263～3.466)和2.700(1.279～5.698) respectively. With the increase of metabolic components, the risk of CKD increasing; The highest risk (OR=2.700) for CKD is the central obesity+4 composition. Multiple logistic regression analysis indicates that the age segmentation, the gender, the low HDL-C, the high FPG, the LDL-C, and the high uric acid are independent risk factors of CKD.Conclusions:1. In Sichuan province, the prevalence rate of metabolic syndrome is 8.6%; and the prevalence rate of the women is higher than that of the men, but no difference was found between the rural and the urban. The renal history, the LDL-C, the age section, the BMI segmentation and g the ender (female) are the independent risk factors of metabolic syndrome.2. In the metabolic syndrome, the prevalence of CKD is significantly higher than that of the non-metabolic syndrome; the metabolic syndrome prevalence may increase the ACR and non-metabolic syndrome has no difference. With the increase of the central obesity within the metabolic basis the prevalence of CKD and the ACR increases; and the MS metabolic syndrome group is lower HDL-C, higher FPG and blood pressure are independent risk CKD factors.