Rashidbeygi Elaheh, Safabakhsh Maryam, Delshad Aghdam Saeideh, Mohammed Shimels Hussien, Alizadeh Shahab
Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
Diabetes Metab Syndr. 2019 Jan-Feb;13(1):830-843. doi: 10.1016/j.dsx.2018.12.006. Epub 2018 Dec 8.
BACKGROUND & AIM: Previous studies have explored the relation of metabolic syndrome (MetS), its components and the risk of albuminuria/proteinuria but their results are inconsistent. Then, we aimed to conduct a meta-analysis in order to resolve these controversies.
PubMed and Scopus were systematically searched from their inception to 1 march 2018. Risk estimates and their 95% confidence intervals were extracted and pooled using the random-effects approach.
A total of 57 studies, 44 studies on albuminuria and 13 studies on proteinuria, with a total sample size of 10,603,067 participants, were included in this meta-analysis. Overall, MetS was contributed to higher risks of proteinuria (OR = 2.08, 95%CI = 1.85-2.34) and albuminuria (OR = 1.92, 95%CI = 1.71-2.15), independent of diabetes status; although, this relationship was more noticeable in studies that used the WHO definition of MetS and in non-East Asian populations. Also, the relationship between MetS and proteinuria was sex independent, while, for albuminuria was significant only in men. MetS components such as obesity, impaired fasting glucose, elevated blood pressure and hypertriglyceridemia were associated with significant increases in proteinuria and albuminuria risk, while lower HDL-Cholesterol was only linked to greater risk of proteinuria. Moreover, the total impact of MetS on proteinuria was more remarkable than each component of the syndrome and an escalating dose-response association was found between the number of MetS components and albuminuria risk.
MetS and its components are potential risk factors for albuminuria and proteinuria.
既往研究探讨了代谢综合征(MetS)及其组分与白蛋白尿/蛋白尿风险的关系,但其结果并不一致。因此,我们旨在进行一项荟萃分析以解决这些争议。
对PubMed和Scopus从创刊至2018年3月1日进行系统检索。采用随机效应模型提取并汇总风险估计值及其95%置信区间。
本荟萃分析共纳入57项研究,其中44项关于白蛋白尿,13项关于蛋白尿,总样本量为10603067名参与者。总体而言,无论糖尿病状态如何,MetS均会增加蛋白尿(OR = 2.08,95%CI = 1.85 - 2.34)和白蛋白尿(OR = 1.92,95%CI = 1.71 - 2.15)的风险;不过,这种关系在采用世界卫生组织MetS定义的研究以及非东亚人群中更为明显。此外,MetS与蛋白尿的关系不受性别影响,而与白蛋白尿的关系仅在男性中显著。MetS的组分如肥胖、空腹血糖受损、血压升高和高甘油三酯血症与蛋白尿和白蛋白尿风险的显著增加相关,而低高密度脂蛋白胆固醇仅与蛋白尿风险增加有关。此外,MetS对蛋白尿的总体影响比该综合征的各组分更显著,并且发现MetS组分数量与白蛋白尿风险之间存在剂量反应关系增强。
MetS及其组分是白蛋白尿和蛋白尿的潜在危险因素。