Metabolic Syndrome without Diabetes or Hypertension Still Necessitates Early Screening for Chronic Kidney Disease: Information from a Chinese National Cross-Sectional Study

PLoS One. 2015 Jul 10;10(7):e0132220. doi: 10.1371/journal.pone.0132220. eCollection 2015.

Abstract

Metabolic syndrome (MS) is prevalent, with an increasing contribution to the incidence of chronic kidney disease (CKD). The study of the relationship between them is important. The CKD survey, a national cross-sectional study, provided a large database to accomplish this study. The study population were 41 131 adults from this survey between 2008 and 2009. CKD was defined as estimate glomerular filtration rate (eGFR) less than 60 mL/min per 1.73 m2 or the presence of albuminuria. MS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (ATPIII), ATPIII-modified or International Diabetes Federation (IDF) criteria. Logistic regression model was applied to study the impact of MS or its components on CKD or its components. The age and sex standardized prevalence of MS by ATPIII, ATPIII-modified and IDF criteria was 11.77% (11.13%-12.40%), 21.51% (20.69%-22.34%) and 16.67% (15.92-17.42)% respectively. Multivariate logistic regression models showed that MS and its components were associated with higher CKD prevalence. The risk for CKD and its components increased with the number of MS components. After adjusting for hypertension and diabetes, the odds ratios of MS for CKD decreased, but remained significantly more than 1 between 1.16(95%CI 1.07-1.26) and 1.37 (95% CI 1.25-1.50) across the different models. Similar results were found with albuminuria, while for decreased eGFR, after adjusting for hypertension and diabetes, the odds ratios of MS and MS components (except elevated TG) became insignificant. In conclusion, MS is prevalent and associated with a higher prevalence of CKD. Different MS components are associated with different risks for CKD, even after adjusting for hypertension and diabetes, which may mainly be contributed more by the increased risk for albuminuria than that for decreased eGFR. More attention must be paid to the population with MS, including those with elevated blood pressure and serum glucose.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albuminuria / complications
  • Albuminuria / physiopathology
  • Asian People*
  • China
  • Cross-Sectional Studies
  • Diabetes Mellitus / pathology*
  • Diabetes Mellitus / physiopathology
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Hypertension / complications*
  • Hypertension / physiopathology
  • Male
  • Mass Screening*
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / physiopathology
  • Middle Aged
  • Odds Ratio
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / diagnosis*
  • Renal Insufficiency, Chronic / physiopathology

Grants and funding

This study was supported by the National Key Technology R&D Program from the Ministry of Science and Technology (China; 2007BAI04B10); the Science and Technology Commission of Shanghai (08dz1900502 and 07JC14037); the Natural Science Funds of Ning Xia (NZ08102); the Science and Technology Department, the National Natural Science Funds (30660069); the National Natural Science Foundation of China; the Department of Health, Jiangsu Province (H200936); the Key Scientific and Technology Project from the Sichuan Science and Technology Department (05SG1635); the Program for New Century Excellent Talents in University from the Ministry of Education (China; BMU2009131); the International Society of Nephrology Research Committee; and the China Health and Medical Development Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.