Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Clin J Am Soc Nephrol. 2011 Oct;6(10):2364-73. doi: 10.2215/CJN.02180311. Epub 2011 Aug 18.
Observational studies have reported an association between metabolic syndrome (MetS) and microalbuminuria or proteinuria and chronic kidney disease (CKD) with varying risk estimates. We aimed to systematically review the association between MetS, its components, and development of microalbuminuria or proteinuria and CKD. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS AND POPULATION: We searched MEDLINE (1966 to October 2010), SCOPUS, and the Web of Science for prospective cohort confidence interval (CI) studies that reported the development of microalbuminuria or proteinuria and/or CKD in participants with MetS. Risk estimates for eGFR <60 ml/min per 1.73 m(2) were extracted from individual studies and pooled using a random effects model. The results for proteinuria outcomes were not pooled because of the small number of studies.
Eleven studies (n = 30,146) were included. MetS was significantly associated with the development of eGFR <60 ml/min per 1.73 m(2) (odds ratio, 1.55; 95% CI, 1.34, 1.80). The strength of this association seemed to increase as the number of components of MetS increased (trend P value = 0.02). In patients with MetS, the odds ratios (95% CI) for development of eGFR <60 ml/min per 1.73 m(2) for individual components of MetS were: elevated blood pressure 1.61 (1.29, 2.01), elevated triglycerides 1.27 (1.11, 1.46), low HDL cholesterol 1.23 (1.12, 1.36), abdominal obesity 1.19 (1.05, 1.34), and impaired fasting glucose 1.14 (1.03, 1.26). Three studies reported an increased risk for development of microalbuminuria or overt proteinuria with MetS.
MetS and its components are associated with the development of eGFR <60 ml/min per 1.73 m(2) and microalbuminuria or overt proteinuria.
观察性研究报告称，代谢综合征（MetS）与微量白蛋白尿或蛋白尿以及慢性肾脏病（CKD）之间存在关联，但风险估计值各不相同。我们旨在系统回顾 MetS 及其组成部分与微量白蛋白尿或蛋白尿以及 CKD 的发展之间的关联。
设计、环境、参与者及测量和人群：我们在 MEDLINE（1966 年至 2010 年 10 月）、SCOPUS 和 Web of Science 中检索了前瞻性队列置信区间（CI）研究，这些研究报告了 MetS 患者中微量白蛋白尿或蛋白尿和/或 CKD 的发展情况。从个体研究中提取 eGFR <60 ml/min per 1.73 m(2)的风险估计值，并使用随机效应模型进行汇总。由于研究数量较少，因此未对蛋白尿结果进行汇总。
共纳入 11 项研究（n=30146）。MetS 与 eGFR <60 ml/min per 1.73 m(2)的发展显著相关（比值比，1.55；95%CI，1.34，1.80）。随着 MetS 组成部分数量的增加，这种关联似乎变得更强（趋势 P 值=0.02）。在患有 MetS 的患者中，MetS 各个组成部分发展为 eGFR <60 ml/min per 1.73 m(2)的比值比（95%CI）分别为：血压升高 1.61（1.29，2.01），甘油三酯升高 1.27（1.11，1.46），高密度脂蛋白胆固醇降低 1.23（1.12，1.36），腹型肥胖 1.19（1.05，1.34），空腹血糖受损 1.14（1.03，1.26）。有 3 项研究报告称 MetS 与微量白蛋白尿或显性蛋白尿的发生风险增加相关。
MetS 及其组成部分与 eGFR <60 ml/min per 1.73 m(2)以及微量白蛋白尿或显性蛋白尿的发展相关。
