Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital Department of Health, Executive Yuan, No. 199, Sec. 1, Sanmin Road, Taichung 403, Taiwan.
Cardiol Res Pract. 2011 Mar 13;2011:567389. doi: 10.4061/2011/567389.
Both metabolic syndrome (MetS) and chronic kidney disease (CKD) are major global health issues. Current clinical markers used to reflect renal injury include albuminuria and estimated glomerular filtration rate (eGFR). Given the same eGFR level, urine albumin might be a better risk marker to predict progression of CKD and future development of cardiovascular diseases (CVDs). Serum Cystatin C is emerging as a new biomarker for early detection of renal injury associated with MetS and cardiovascular risk. In addition to each component, MetS per se influences the incidence and prognosis of renal injury and the odds ratios increased with the increase in the number of metabolic abnormalities. Hyperinsulinemia, activation of rennin-angiotensin-aldosterone system, increase of oxidative stress, and inflammatory cytokines are proposed to be the plausible biological link between MetS and CKD. Weight control, stick control of blood pressure, glucose, and lipids disorders may lead to lessening renal injury and even the subsequent CVD.
代谢综合征(MetS)和慢性肾脏病(CKD)都是全球性的重大健康问题。目前用于反映肾脏损伤的临床标志物包括蛋白尿和估算肾小球滤过率(eGFR)。在相同的 eGFR 水平下,尿白蛋白可能是预测 CKD 进展和未来心血管疾病(CVDs)发生的更好风险标志物。血清胱抑素 C 作为一种新的生物标志物,用于早期检测与 MetS 相关的肾脏损伤和心血管风险。除了各个组成部分外,MetS 本身也会影响肾脏损伤的发生和预后,并且随着代谢异常数量的增加,比值比也会增加。高胰岛素血症、肾素-血管紧张素-醛固酮系统的激活、氧化应激的增加和炎症细胞因子被认为是 MetS 和 CKD 之间可能存在的生物学联系。控制体重、控制血压、血糖和血脂异常可能会减少肾脏损伤,甚至减少随后的 CVD。