The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Clin Cardiol. 2020 Sep;43(9):949-956. doi: 10.1002/clc.23388. Epub 2020 May 29.
Metabolic syndrome (MS) and diabetes mellitus (DM) are risk factors for cardiovascular diseases in general population. However, there was a paucity of studies investigating their impact in primary glomerular diseases (PGD).
MS and concomitant DM are associated with higher risk of cardiovascular comorbidity in PGD.
In a retrospective observational design, we analyzed 3622 hospitalized adult PGD patients and compared the prevalence of cardiovascular comorbidity in non-MS, MS with and without DM. Risk factors for cardiovascular comorbidity were identified using univariate and multivariate logistic regression.
Among 3622 PGD patients, 308 (8.5%) cases accompanied with MS, including 180 (5.0%) patients with DM and 128 (3.5%) without DM. One hundred and sixty four (4.5%) cases coexisted with cardiovascular comorbidity. Patients with MS and concomitant DM exhibited a higher prevalence of cardiovascular comorbidity than those without MS stratified by estimated glomerular filtration rate and pathological types. Logistic regression showed that MS and concomitant DM (OR: 2.496, 95% CI: 1.600-3.894, P < .001), older age (OR: 1.060, 95% CI: 1.047-1.074, P < .001), male (OR: 1.536, 95% CI: 1.072-2.200, P = .019), higher level of serum ti (OR: 1.002, 95% CI: 1.001-1.003, P < .001), hyperuricemia (OR: 1.901, 95% CI: 1.327-2.725, P < .001), idiopathic membranous nephropathy (OR: 2.874, 95% CI: 1.244-6.640, P < .001) and focal segmental glomerulosclerosis (OR: 2.906, 95% CI: 1.147-7.358, P < .001) were independently associated with a higher risk for cardiovascular comorbidity.
In PGD patients, MS and concomitant DM are associated with an increased risk for cardiovascular comorbidity. More evidence for the causal link between MS/DM and cardiovascular outcomes is needed to be clarified.
代谢综合征(MS)和糖尿病(DM)是一般人群心血管疾病的危险因素。然而,很少有研究调查它们在原发性肾小球疾病(PGD)中的影响。
MS 和并发 DM 与 PGD 中的心血管合并症风险增加相关。
在回顾性观察设计中,我们分析了 3622 名住院成年 PGD 患者,并比较了非 MS、MS 伴或不伴 DM 患者的心血管合并症患病率。使用单变量和多变量逻辑回归确定心血管合并症的危险因素。
在 3622 名 PGD 患者中,308 例(8.5%)伴有 MS,其中 180 例(5.0%)患有 DM,128 例(3.5%)无 DM。164 例(4.5%)存在心血管合并症。与非 MS 患者相比,MS 伴 DM 的患者肾小球滤过率和病理类型分层的心血管合并症患病率更高。逻辑回归显示,MS 和并发 DM(OR:2.496,95%CI:1.600-3.894,P<.001)、年龄较大(OR:1.060,95%CI:1.047-1.074,P<.001)、男性(OR:1.536,95%CI:1.072-2.200,P=.019)、血清 ti 水平较高(OR:1.002,95%CI:1.001-1.003,P<.001)、高尿酸血症(OR:1.901,95%CI:1.327-2.725,P<.001)、特发性膜性肾病(OR:2.874,95%CI:1.244-6.640,P<.001)和局灶节段性肾小球硬化症(OR:2.906,95%CI:1.147-7.358,P<.001)与心血管合并症风险增加独立相关。
在 PGD 患者中,MS 和并发 DM 与心血管合并症风险增加相关。需要更多证据来阐明 MS/DM 与心血管结局之间的因果关系。