Kurella Manjula, Lo Joan C, Chertow Glenn M
University of California San Francisco, Department of Nephrology, Laurel Heights, 3333 California Street, Suite 430, San Francisco, CA 94118-1211, USA.
J Am Soc Nephrol. 2005 Jul;16(7):2134-40. doi: 10.1681/ASN.2005010106. Epub 2005 May 18.
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 m2 at study year 9 among those with an eGFR > or =60 ml/min per 1.73 m2 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% CI, 1.01 to 1.51). The metabolic syndrome is independently associated with an increased risk for incident CKD in nondiabetic adults.
代谢综合征是糖尿病和心血管疾病发生的一个危险因素；然而，尚无前瞻性研究将代谢综合征作为慢性肾脏病（CKD）的危险因素进行考察。共有10096名非糖尿病参与者纳入了该研究队列，这些参与者来自社区动脉粥样硬化风险研究，且基线肾功能正常。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。在基线时估算肾小球滤过率（eGFR）≥60 ml/（min·1.73 m²）的参与者中，将研究第9年时eGFR<60 ml/（min·1.73 m²）定义为发生CKD。经过9年的随访，691名（7%）参与者发生了CKD。患有代谢综合征的参与者发生CKD的多变量调整比值比（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1个、2个、3个、4个或5个特征的参与者发生CKD的OR分别为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）。在对随访9年期间糖尿病和高血压的后续发生情况进行校正后，患有代谢综合征的参与者发生CKD的OR为1.24（95% CI，1.01至1.51）。代谢综合征与非糖尿病成年人发生CKD的风险增加独立相关。
