Lee Jung Eun, Choi So Yeon, Huh Wooseong, Kim Yoon-Goo, Kim Dae Joong, Oh Ha Young
Division of Nephrology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Am J Hypertens. 2007 Nov;20(11):1189-94. doi: 10.1016/j.amjhyper.2007.04.020.
Metabolic syndrome has been suggested as a risk factor for chronic kidney disease (CKD). Inflammation is associated with both metabolic syndrome and CKD. We investigated inter-relationships between C-reactive protein (CRP), metabolic syndrome, and CKD among 9586 subjects without diabetes or hypertension.
Metabolic syndrome was defined according to the criteria of the revised Adult Treatment Panel III. CKD was defined as a glomerular filtration rate <60 mL/min/1.73 m(2) or as albuminuria. A CRP cutpoint of 3 mg/L was used to differentiate high and low CRP groups.
Chronic kidney disease was present in 6.2% of subjects without metabolic syndrome and in 13.1% of subjects with the syndrome (P < .001). In a multivariate model, high blood pressure (BP) (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.24-1.95), high fasting glucose (OR, 1.47; 95% CI, 1.19-1.81), abdominal obesity (OR, 1.52; 95% CI, 1.22-1.81), and high CRP (OR, 1.53; 95% CI, 1.18-1.98) were independently associated with prevalent CKD. Compared with low CRP/without metabolic syndrome, the multivariate-adjusted odds for CKD of high CRP/without metabolic syndrome and low CRP/with metabolic syndrome were 1.48 (95% CI, 1.10-2.0) and 1.90 (95% CI, 1.47-2.45), respectively. Subjects with high CRP and metabolic syndrome had a 3.26-fold greater odds of having CKD (95% CI, 2.00-5.31).
Metabolic syndrome and high CRP were independently associated with increased prevalence of CKD. The odds of CKD increased in the setting of high CRP and metabolic syndrome.
代谢综合征被认为是慢性肾脏病（CKD）的一个危险因素。炎症与代谢综合征和CKD均相关。我们在9586名无糖尿病或高血压的受试者中研究了C反应蛋白（CRP）、代谢综合征和CKD之间的相互关系。
代谢综合征根据修订的成人治疗小组III的标准定义。CKD定义为肾小球滤过率<60 mL/min/1.73 m²或蛋白尿。采用CRP切点3 mg/L来区分高CRP组和低CRP组。
无代谢综合征的受试者中CKD的患病率为6.2%，有代谢综合征的受试者中为13.1%（P<.001）。在多变量模型中，高血压（BP）（比值比[OR]，1.55；95%置信区间[CI]，1.24 - 1.95）、空腹血糖升高（OR，1.47；95%CI，1.19 - 1.81）、腹型肥胖（OR，1.52；95%CI，1.22 - 1.81）和高CRP（OR，1.53；95%CI，1.18 - 1.98）与CKD的患病率独立相关。与低CRP/无代谢综合征相比，高CRP/无代谢综合征和低CRP/有代谢综合征的CKD多变量调整比值分别为1.48（95%CI，1.10 - 2.0）和1.90（95%CI，1.47 - 2.45）。高CRP和代谢综合征的受试者患CKD的几率高3.26倍（95%CI，2.00 - 5.31）。
代谢综合征和高CRP与CKD患病率增加独立相关。在高CRP和代谢综合征的情况下，CKD的几率增加。
