Belarbia Anis, Nouira Safa, Sahtout Wissal, Guedri Yosra, Achour Abdellatif
Department of Nephrology, Dialysis and Transplantation, Sahloul's University Hospital, Sousse, Tunisia.
Saudi J Kidney Dis Transpl. 2015 Sep;26(5):931-40. doi: 10.4103/1319-2442.164573.
To determine the prevalence of metabolic syndrome (MS) in chronic kidney disease (CKD) patients as well as its effects on the progression of CKD, we conducted a prospective, longitudinal study including 180 patients with chronic renal failure followed at the outpatient service of Nephrology at the Saloul's University Hospital of Sousse (Tunisia) over six months. Our study population consisted of 101 men and 79 women. Chronic glomerulonephritis (36.6%) was the most frequent nephropathy. The mean serum creatinine was 249 ± 200 mmol/L and the mean estimated glomerular filtration rate (eGFR) was 55.8 ± 49.2 mL/min. Cardiovascular (CV) impairment was found in 27.2% of the patients. The prevalence of MS was 42.2%. Women had significantly more abdominal obesity than men. Subjects with MS were significantly older and predominantly females who had higher blood pressure and body mass index (BMI). CV complications were more frequent among the MS subjects than among the controls. Glycemia, triglycerides, total cholesterol and low-density lipoprotein-cholesterol (LDL-c) were significantly higher in the group of CKD patients with MS. However, the occurrence of MS was not influenced by the nature of nephropathy, the degree of the CKD and the use of renin-angiotensin blockers or statins. In multivariate analysis, predictors of occurrence of MS in our series included older age, female gender and higher BMI and LDL-c levels. The prevalence of MS in patients with CKD is higher than the general population. These patients should receive special multidisciplinary care to limit CV complications.
为了确定慢性肾脏病（CKD）患者中代谢综合征（MS）的患病率及其对CKD进展的影响，我们进行了一项前瞻性纵向研究，纳入了180例慢性肾衰竭患者，这些患者在突尼斯苏塞萨卢勒大学医院肾脏病门诊接受了为期6个月的随访。我们的研究人群包括101名男性和79名女性。慢性肾小球肾炎（36.6%）是最常见的肾病。平均血清肌酐为249±200 mmol/L，平均估计肾小球滤过率（eGFR）为55.8±49.2 mL/min。27.2%的患者存在心血管（CV）损害。MS的患病率为42.2%。女性的腹型肥胖明显多于男性。患有MS的受试者年龄明显更大，且主要为女性，她们的血压和体重指数（BMI）更高。MS受试者的CV并发症比对照组更频繁。患有MS的CKD患者组的血糖、甘油三酯、总胆固醇和低密度脂蛋白胆固醇（LDL-c）明显更高。然而，MS的发生不受肾病类型、CKD程度以及肾素 - 血管紧张素阻滞剂或他汀类药物使用的影响。在多变量分析中，我们系列中MS发生的预测因素包括年龄较大、女性性别以及较高的BMI和LDL-c水平。CKD患者中MS的患病率高于一般人群。这些患者应接受特殊的多学科护理以限制CV并发症。
