Song Yun-Mi, Sung Joohon, Lee Kayoung
Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea.
Department of Epidemiology, School of Public Health, Seoul National University, Seoul, South Korea.
Clin Exp Nephrol. 2015 Oct;19(5):887-94. doi: 10.1007/s10157-015-1083-5. Epub 2015 Jan 30.
To examine cross-sectional and longitudinal relationships, including genetic and environmental correlations, of metabolic syndrome (MetS) and obesity with kidney function.
Subjects were 3,437 Korean adults of the Healthy Twin Study for cross-sectional relationships and 1,881 participants for longitudinal relationships (follow-up interval 3.7 ± 1.4 years). Obesity (body mass index ≥ 25 vs. <25 kg/m(2)), MetS, and chronic kidney disease [CKD; estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73 m(2) using the modification of diet in renal disease study equation)] were categorized at baseline and follow-up.
The prevalence and incidence of chronic kidney disease were 2.5 and 3.3 %, respectively. Compared to individuals without obesity and MetS, prevalent CKD was associated with MetS regardless of weight status [adjusted odds ratio (AOR) 4.19 for those with MetS but without obesity; AOR 4.63 for those with MetS and obesity]. Incident CKD was associated with obesity regardless of baseline metabolic status (AOR 2.03 for those with obesity but without MetS; AOR 2.85 for those with obesity and MetS). MetS at follow-up was associated with incident CKD regardless of baseline MetS (AOR 2.42-2.52). Sex-adjusted bivariate analyses show inverse environmental correlations of the number of MetS components and BMI at baseline, with eGFR at baseline and follow-up (ρ E, -0.26 to -0.42, P < 0.001).
MetS predicts prevalent CKD regardless of obesity, and obesity predicts incident CKD regardless of baseline MetS. Incident CKD is also associated with MetS at follow-up regardless of baseline MetS. These associations appear to be explained by shared environmental factors.
研究代谢综合征（MetS）和肥胖与肾功能的横断面及纵向关系，包括遗传和环境相关性。
在健康双胞胎研究中，3437名韩国成年人用于横断面关系研究，1881名参与者用于纵向关系研究（随访间隔3.7±1.4年）。肥胖（体重指数≥25 vs. <25 kg/m²）、MetS和慢性肾脏病[CKD；使用肾脏病饮食改良研究方程估算的肾小球滤过率（eGFR）（<60 mL/min/1.73 m²）]在基线和随访时进行分类。
慢性肾脏病的患病率和发病率分别为2.5%和3.3%。与无肥胖和MetS的个体相比，无论体重状况如何，CKD患病率均与MetS相关[无肥胖但有MetS者的校正比值比（AOR）为4.19；有MetS且肥胖者的AOR为4.63]。无论基线代谢状态如何，CKD发病率均与肥胖相关（无MetS但肥胖者的AOR为2.03；有MetS且肥胖者的AOR为2.85）。随访时的MetS与CKD发病率相关，无论基线MetS如何（AOR为2.42 - 2.52）。性别调整后的双变量分析显示，基线时MetS组分数量和BMI与基线及随访时的eGFR呈负向环境相关性（ρE，-0.26至-0.42，P<0.001）。
无论肥胖情况如何，MetS均可预测CKD患病率；无论基线MetS如何，肥胖均可预测CKD发病率。随访时的CKD发病率也与MetS相关，无论基线MetS如何。这些关联似乎由共同的环境因素解释。
