Renal manifestations of metabolic syndrome in type 2 diabetes.

AIM

The association between metabolic syndrome (MS) and renal outcomes in diabetic patients remains unclear. We conducted a cross-sectional study to assess the association between MS and albuminuria and decreased glomerular filtration rate (GFR) in type 2 diabetic patients.

METHODS

We studied a total of 1003 adult Japanese patients with type 2 diabetes, 582 men, with a mean (+/-S.D.) age of 62+/-12 years. Patients with macroalbuminuria, defined as a urinary albumin-to-creatinine ratio (ACR) > or =300 mg/g Cr, and those with renal insufficiency, defined as serum creatinine > or =2.0 mg/dl, were excluded. MS was assessed according to Japanese definition proposed in 2005. Microalbuminuria and decreased GFR were defined as ACR of 30-299 mg/g Cr and estimated GFR <60 ml/min/1.73 m(2), respectively.

RESULTS

The prevalence of microalbuminuria was significantly higher in patients with MS than those without. In contrast, the prevalence of decreased GFR was comparable between patients with and without MS. Waist circumference was selected as a significant variable in the logistic regression analysis for microalbuminuria.

CONCLUSION

Microalbuminuria, but not decreased GFR, is independently associated with MS and solely with increased waist circumference in Japanese patients with type 2 diabetes.