Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults
Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults
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DOI：
10.1681/asn.2005010106
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发表时间：
2005-07-01
影响因子：
13.6
通讯作者：
Chertow, GM
中科院分区：
文献类型：
--
作者：
Kurella, M;Lo, JC;Chertow, GM
代谢综合征是糖尿病和心血管疾病发展的危险因素;然而，没有前瞻性研究将代谢综合征作为慢性肾脏病（CKD）的危险因素进行研究。共有10，096名参与社区动脉粥样硬化风险研究的非糖尿病参与者组成了研究队列，他们的基线肾功能正常。代谢综合征是根据国家胆固醇教育计划的最新指南定义的。新发CKD定义为基线时eGFR ≥ 60 ml/min/1.73 m2的患者中，研究第9年估计GFR（eGFR）< 60 ml/min/1.73 m2。9年随访后，691例（7%）参与者发生CKD。代谢综合征参与者发生CKD的多变量校正比值比（OR）为1.43（95%置信区间[CI] 1.18至1.73）。与没有代谢综合征特征的参与者相比，具有代谢综合征的一个，两个，三个，四个或五个特征的参与者的CKD OR为1.13（95% CI，0.89至1.45）、1.53（95% CI，1.18至1.98）、1.75（95% CI，1.32至2.33）、1.84（95% CI，1.27至2.67）和2.45（95% CI，1.32至4.54）。在9年的随访中调整了糖尿病和高血压的后续发展后，代谢综合征参与者中CKD事件的OR为1.24（95%CI，1.01至1.51）。代谢综合征与非糖尿病成人CKD发病风险增加独立相关。
The metabolic syndrome is a risk factor for the development of diabetes and cardiovascular disease; however, no prospective studies have examined the metabolic syndrome as a risk factor for chronic kidney disease (CKD). A total of 10,096 nondiabetic participants who were in the Atherosclerosis Risk in Communities study and had normal baseline kidney function composed the study cohort. The metabolic syndrome was defined according to recent guidelines from the National Cholesterol Education Program. Incident CKD was defined as an estimated GFR (eGFR) < 60 ml/min per 1.73 m(2) at study year 9 among those with an eGFR >= 60 ml/min per 1.73 m(2) at baseline. After 9 yr of follow-up, 691 (7%) participants developed CKD. The multivariable adjusted odds ratio (OR) of developing CKD in participants with the metabolic syndrome was 1.43 (95% confidence interval [CI] 1.18 to 1.73). Compared with participants with no traits of the metabolic syndrome, those with one, two, three, four, or five traits of the metabolic syndrome had OR of CKD of 1.13 (95% CI, 0.89 to 1.45), 1.53 (95% CI, 1.18 to 1.98), 1.75 (95% CI, 1.32 to 2.33), 1.84 (95% CI, 1.27 to 2.67), and 2.45 (95% CI, 1.32 to 4.54), respectively. After adjusting for the subsequent development of diabetes and hypertension during the 9 yr of follow-up, the OR of incident CKD among participants with the metabolic syndrome was 1.24 (95% Cl, 1.01 to 1.51). The metabolic syndrome is independently associated with an increased risk for incident CKD in nondiabetic adults.