Association Of Combinations Of Metabolic Syndrome Risk Factors And Chronic Kidney Disease

BackgroundMetabolic syndrome (MetS), characterized by abdominal obesity, elevated blood pressure (BP), elevated triglyceride level (TG), low high-density lipoprotein (HDL) cholesterol level, and elevated fasting glucose level (FBG) is a common disorder. In addition to the generally recognized relationship between the metabolic syndrome and the future development of diabetes mellitus type2(DM Type2) and cardiovascular disease, there are some evidence suggesting possible association between MetS and chronic kidney disease (CKD). A number of cross-sectional studies and cohort studies from different countries have supported the association of MetS with CKD, and there is a graded relationship between number of metabolic syndrome elements and risk for CKD. MetS is no longer a major health concern only in the developed Western countries, but also in China where its prevalence increases with age. The early identification and treatment of different elements of the MetS may not only help prevent or slow down the progression of the CKD, which in turn may lead to end-stage renal disease (ESRD) but also may improve patient outcome.Objectives The objectives of the present study were to assess, whether the aggregation of MetS elements was associated with an unfavorable estimated glomerular filtration rate (eGFR), when eGFR was used for evidence of CKD in subjects with MetS who underwent a routine health examination, and to investigate if different combinations of elements of MetS carry different risk predictability for CKD.MethodsSubjects who underwent health examinations in the Health Management Center of Sir Run Run Shaw Hospital from January2010to September2010were studied in the chronic kidney disease analyses. All of the subjects received a standard demographic questionnaire and thorough physical examination in the Health Management Center. A blood sample was collected from each subject after at least12hours fasting. All biochemical analyses were performed within2hours of blood sampling. Serum total cholesterol levels (TC), triglycerides, high-density lipoprotein cholesterol (HDL), creatinine and glucose were measured using a Beckman LX20autoanalyzer. A random untimed urine sample was obtained and was measured by autionmax-4280automatic urine dry chemistry analyzer of Kyoto, Japan.Results1. According to the criteria of revised ATP III and IDF, the odds ratios of chronic kidney disease in subjects with the MetS compared with Non-MetS were2.217(95%CI,1.891-2.599) and2.202(95%CI,1.867-2.596), separately.2. Subjects with3,4,5elements of the MetS had an increased OR for CKD1.278(95%CI,1.044-1.565),2.206(95%CI,1.756-2.771) and6.229(95%CI,4.602-8.431), compared with individuals with none of the elements.3. Compared with two elements combinations, obesity+elevated blood pressure, elevated blood pressure+elevated fasting glucose had odds of1.569(95%CI,1.120-2.198), and3.067(95%CI,1.996-4.713), respectively. The combination of elevated fasting glucose+elevated blood pressure+abdominal obesity,(OR,2.525;95%CI,1.369-4.657), had the greatest risk for CKD among those with three elements.Conclusion:Taken together, our study suggests that not all combinations of elements lead to the diagnosis of the syndrome convey equal risk. Combinations of elevated blood pressure and fasting blood glucose appear to be more important than the diagnosis of MetS in predicting CKD.