An association of metabolic syndrome and chronic kidney disease from a 10-year prospective cohort study

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• 作者：Ji Hye Huh^a ; Dhananjay Yadav^b ; Jae Seok Kim^c ; Jung-Woo Son^d ; Eunhee Choi^e ; ^{eunhee_choi@yonsei.ac.kr} ; Seong Hwan Kim^f ; Chol Shin^f ; Ki-Chul Sung^g ; Jang Young Kim^d ; ^{kimjang713@gmail.com}
• 关键词：Metabolic syndrome ; Chronic kidney disease ; Rapid decline of GFR ; Insulin resistance
• 刊名：Metabolism
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：67
• 期：Complete
• 页码：54-61
• 全文大小：341 K
• 卷排序：67

文摘

Although metabolic abnormalities have been considered important risk factors of chronic kidney disease (CKD), the impact of metabolic syndrome (MS) and insulin resistance on renal function deterioration is poorly understood. We investigated the association between MS and incident CKD/rapid decline of estimated glomerular filtration rate (eGFR) in a 10-year population-based longitudinal study.Material and MethodsAmong 10,030 subjects, 6065 without history of CKD or cardiovascular disease at baseline were analyzed using data generated from the Ansan–Ansung cohort of the Korean Genome Epidemiology Study. Participants were categorized into two groups based on the presence of MS at baseline. Incident CKD was defined as eGFR < 60 ml/min per 1.73 m2, and rapid decline of eGFR was defined as > 3 ml/min per 1.73 m2/yr over 10 years.ResultsDuring the 10-year follow-up period, CKD developed in 893 subjects (14.7%). Compared to subjects without MS, the odds ratio (OR; 95% confidence interval, CI) of incident CKD in those with MS was 1.38 (1.16–1.64) after controlling for confounding factors. The risk of rapid decline of eGFR was also higher in subjects with MS than those without MS (OR: 1.20, 95% CI: 1.04–1.39). In addition, we found that higher levels of homeostatic model assessment of insulin resistance (HOMA-IR) were associated with incident CKD and rapid decline of eGFR independently of traditional CKD risk factors (OR: 1.24, 95% CI: 1.04–1.47).ConclusionBoth MS and insulin resistance were independent risk factors of incident CKD and rapid decline of eGFR in healthy Korean population.