Chen Jing, Gu Dongfeng, Chen Chung-Shiuan, Wu Xigui, Hamm L Lee, Muntner Paul, Batuman Vecihi, Lee Chien-Hung, Whelton Paul K, He Jiang
Department of Medicine, Tulane University School of Medicine, 1430 Tulane Avenue, SL-45, New Orleans, LA 70112, USA, and the Cardiovascular Institute and Fuwai Hospital, Beijing, China.
Nephrol Dial Transplant. 2007 Apr;22(4):1100-6. doi: 10.1093/ndt/gfl759. Epub 2007 Feb 1.
The metabolic syndrome is a common risk factor for cardiovascular and chronic kidney disease (CKD) in Western populations. We examined the relationship between the metabolic syndrome and risk of CKD in Chinese adults.
A cross-sectional survey was conducted in a nationally representative sample of 15 160 Chinese adults aged 35-74 years. The metabolic syndrome was defined as the presence of three or more of the following risk factors: elevated blood pressure, low high density lipoprotein (HDL)-cholesterol, high triglycerides, elevated plasma glucose and abdominal obesity. CKD was defined as an estimated glomerular filtration rate<60 ml/min/1.73 m2 and elevated serum creatinine was defined as >or=1.14 mg/dl in men and >or=0.97 mg/dl in women (>or=95th percentile of serum creatinine in Chinese men and women aged 35-44 years without hypertension or diabetes, respectively).
The multivariate-adjusted odds ratios [95% confidence interval (CI)] of CKD and elevated serum creatinine in participants with compared to those without the metabolic syndrome were 1.64 (1.16, 2.32) and 1.36 (1.07, 1.73), respectively. Compared to participants without any components of the metabolic syndrome, the multivariate-adjusted odds ratios (95% CI) of CKD were 1.51 (1.02, 2.23), 1.50 (0.97, 2.32), 2.13 (1.30, 3.50) and 2.72 (1.50, 4.93) for those with 1, 2, 3, and 4 or 5 components, respectively. The corresponding multivariate-adjusted odds ratios (95% CI) of elevated serum creatinine were 1.11 (0.88, 1.40), 1.39 (1.07, 2.04), 1.47 (1.06, 2.04) and 2.00 (1.32, 3.03), respectively.
These findings suggest that the metabolic syndrome might be an important risk factor for CKD in Chinese adults.
代谢综合征是西方人群中心血管疾病和慢性肾脏病(CKD)的常见危险因素。我们研究了中国成年人中代谢综合征与CKD风险之间的关系。
对15160名年龄在35 - 74岁的具有全国代表性的中国成年人进行了横断面调查。代谢综合征被定义为存在以下三种或更多危险因素:血压升高、高密度脂蛋白(HDL)胆固醇降低、甘油三酯升高、血糖升高和腹型肥胖。CKD被定义为估计肾小球滤过率<60 ml/min/1.73 m2,血清肌酐升高在男性中定义为≥1.14 mg/dl,在女性中定义为≥0.97 mg/dl(分别为35 - 44岁无高血压或糖尿病的中国男性和女性血清肌酐的第95百分位数)。
与无代谢综合征的参与者相比,患有代谢综合征的参与者发生CKD和血清肌酐升高的多因素调整优势比[95%置信区间(CI)]分别为1.64(1.16,2.32)和1.36(1.07,1.73)。与无代谢综合征任何组分的参与者相比,有1、2、3以及4或5个组分的参与者发生CKD的多因素调整优势比(95%CI)分别为1.51(1.02,2.23)、1.50(0.97,2.32)、2.13(1.30,3.50)和2.72(1.50,4.93)。血清肌酐升高的相应多因素调整优势比(95%CI)分别为1.11(0.88,1.40)、1.39(1.07,2.04)、1.47(1.06,2.04)和2.00(1.32,3.03)。
这些发现表明,代谢综合征可能是中国成年人CKD的一个重要危险因素。