Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Nephrol Dial Transplant. 2012 Apr;27(4):1410-5. doi: 10.1093/ndt/gfr498. Epub 2011 Sep 8.
Metabolic syndrome has been recently identified as a risk factor for chronic kidney disease (CKD). Since the five individual components of the metabolic syndrome have also been identified as risk factors for CKD, the metabolic syndrome diagnosis may represent an aggregate of CKD risk factors. On the other hand, the components of the metabolic syndrome are also associated with insulin resistance, which may directly mediate the increased CKD risk.
This study was a cross-sectional evaluation of the relationship between metabolic syndrome, insulin resistance and estimated glomerular filtration rate (eGFR) in 574 non-diabetic individuals. Insulin resistance was directly quantified using the insulin suppression test, and the metabolic syndrome components were measured. eGFR was calculated using the three validated estimation equations: the Chronic Kidney Disease Epidemiology Collaboration equation, the Mayo quadratic equation and the Modification of Diet in Renal Disease study equation.
While CKD prevalence was higher and mean eGFR was lower in individuals who met the metabolic syndrome criteria compared with those who did not, we did not observe a significant relationship between insulin resistance and eGFR. Of all of the components of the metabolic syndrome, only hypertension was significantly associated with CKD prevalence [odds ratio (95% confidence interval), 3.5 (1.2-10.1), P=0.02].
Although CKD is more common among individuals with the metabolic syndrome, insulin resistance is not a common factor.
代谢综合征最近被确定为慢性肾脏病（CKD）的一个风险因素。由于代谢综合征的五个个体成分也被确定为 CKD 的风险因素，因此代谢综合征的诊断可能代表 CKD 风险因素的总和。另一方面，代谢综合征的成分也与胰岛素抵抗有关，这可能直接介导 CKD 风险的增加。
本研究是对 574 例非糖尿病个体中代谢综合征、胰岛素抵抗和估计肾小球滤过率（eGFR）之间关系的横断面评估。使用胰岛素抑制试验直接量化胰岛素抵抗，测量代谢综合征成分。使用三种经过验证的估计方程计算 eGFR：慢性肾脏病流行病学合作方程、梅奥二次方程和肾脏病饮食改良研究方程。
与不符合代谢综合征标准的个体相比，符合代谢综合征标准的个体的 CKD 患病率更高，平均 eGFR 更低，但我们没有观察到胰岛素抵抗与 eGFR 之间存在显著关系。在代谢综合征的所有成分中，只有高血压与 CKD 患病率显著相关[比值比（95%置信区间），3.5（1.2-10.1），P=0.02]。
尽管代谢综合征患者的 CKD 更为常见，但胰岛素抵抗并不是常见的因素。
