Metabolic syndrome predicts new onset of chronic kidney disease in 5,829 patients with type 2 diabetes: a 5-year prospective analysis of the Hong Kong Diabetes Registry.
Metabolic syndrome predicts new onset of chronic kidney disease in 5,829 patients with type 2 diabetes: a 5-year prospective analysis of the Hong Kong Diabetes Registry.
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DOI：
10.2337/dc08-0971
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发表时间：
2008-12
期刊：
影响因子：
16.2
通讯作者：
Hong Kong Diabetes Registry
中科院分区：
文献类型：
--
作者：
Luk AO;So WY;Ma RC;Kong AP;Ozaki R;Ng VS;Yu LW;Lau WW;Yang X;Chow FC;Chan JC;Tong PC;Hong Kong Diabetes Registry
2型糖尿病是世界范围内终末期肾病的主要原因。除高血糖和高血压外，其他代谢因素也可能决定肾脏预后。我们在1995年至2005年期间登记的5，829例中国2型糖尿病患者中研究了代谢综合征与新发慢性肾脏病（CKD）的风险相关性。研究设计和方法--代谢综合征的定义采用国家胆固醇教育计划成人治疗组III标准，亚洲肥胖定义。使用为中国人群修改的简化肾脏疾病饮食改良公式计算估计肾小球滤过率（eGFR）。新发CKD定义为删失时eGFR <60 ml/min/1.73 m2。基线时患有CKD的受试者从分析中排除。随访时间中位数为4.6年（四分位距：1.9-7.3年），741例患者发生CKD。与无代谢综合征的受试者相比，代谢综合征受试者CKD的多变量校正风险比（HR）为1.31（95%CI 1.12-1.54，P = 0.001）。相对于除糖尿病外无其他代谢综合征组分的受试者，具有2、3、4和5种代谢综合征组分的受试者CKD风险增加的HR为1.15（0.83-1.60，P = 0.407）1.32（0.94-1.86，P = 0.112）、1.64（1.17-2.32，P = 0.004）和2.34（1.54-3.54，P < 0.001）。中心性肥胖、高血脂、高血压和低BMI等代谢综合征特征是CKD的独立预测因子。结论：在2型糖尿病患者中，代谢综合征的存在独立预测了CKD的发生。
OBJECTIVE—Type 2 diabetes is the leading cause of end-stage renal disease worldwide. Aside from hyperglycemia and hypertension, other metabolic factors may determine renal outcome. We examined risk associations of metabolic syndrome with new onset of chronic kidney disease (CKD) in 5,829 Chinese patients with type 2 diabetes enrolled between 1995 and 2005. RESEARCH DESIGN AND METHODS—Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III criteria with the Asian definition of obesity. Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease formula modified for the Chinese population. New onset of CKD was defined as eGFR <60 ml/min per 1.73 m2 at the time of censor. Subjects with CKD at baseline were excluded from the analysis. RESULTS—After a median follow-up duration of 4.6 years (interquartile range: 1.9–7.3 years), 741 patients developed CKD. The multivariable-adjusted hazard ratio (HR) of CKD was 1.31 (95% CI 1.12–1.54, P = 0.001) for subjects with metabolic syndrome compared with those without metabolic syndrome. Relative to subjects with no other components of metabolic syndrome except for diabetes, those with two, three, four, and five metabolic syndrome components had HRs of an increased risk of CKD of 1.15 (0.83–1.60, P = 0.407) 1.32 (0.94–1.86, P = 0.112), 1.64 (1.17–2.32, P = 0.004), and 2.34 (1.54–3.54, P < 0.001), respectively. The metabolic syndrome traits of central obesity, hypertriglyceridemia, hypertension, and low BMI were independent predictors for CKD. CONCLUSIONS—The presence of metabolic syndrome independently predicts the development of CKD in subjects with type 2 diabetes.
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影响因子：
3.5
作者：
Tong, P. C. Y.;Kong, A. P.;Cockram, C. S.
通讯作者：
Cockram, C. S.
影响因子：
16.2
作者：
Ford, ES
通讯作者：
Ford, ES
影响因子：
3.5
作者：
PIWERNETZ, K;HOME, PD;KRANS, M
通讯作者：
KRANS, M
影响因子：
16.2
作者：
Tong, Peter C.;Kong, Alice P.;Cockram, Clive S.
通讯作者：
Cockram, Clive S.
影响因子：
4.2
作者：
Lamacchia, Olga;Nicastro, Vincenzo;Cignarelli, Mauro
通讯作者：
Cignarelli, Mauro