Fanaei Seyedeh Melika, Mehran Ladan, Amouzegar Atieh, Masoumi Safdar, Amouzegar Atefeh, Azizi Freidoun
Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Eur J Clin Invest. 2023 Apr;53(4):e13945. doi: 10.1111/eci.13945. Epub 2023 Jan 12.
Chronic kidney disease (CKD) can progress over time and cause renal replacement therapy. Studies showed the association between metabolic syndrome (MetS) and CKD. Current evidence is from cross-sectional studies. There is a need for the robust data from big prospective cohort studies with long-term follow-up. This study investigated the association between CKD and MetS after 18 years of follow-up.
Among 15,255 participants aged ≥20 years at baseline (1999-2005), after exclusion of CKD, cancer, and use of corticosteroids, 8987 participants entered the study and followed at a three-year cycle up to 2018. All participants were divided into five subgroups: (1) MetS-free, (2) MetS (DM+, HTN-), (3) MetS+ (DM-, HTN+), (4) MetS+ (DM+, HTN+) and (5) MetS+ (DM-, HTN-).
At baseline, the mean age of the participants was 39.8 ± 13.3 years; 4996 (55.6%) were females. CKD was developed in 2038 (22.7%) subjects during 18 years of follow-up, of whom 1107 had MetS. After adjusting for the confounding variables, MetS (DM+, HTN+) subgroup had the highest risk of CKD (HR = 1.51, 95% CI = 1.32-1.71). MetS subjects with five components had a higher incidence rate of CKD (HR = 1.43, 95% CI = 1.22-1.68). There was no association between high waist circumference (WC) (HR = 1.08, 95% CI = 0.99-1.19) and high-density lipoprotein (HDL) (HR = 1.07, 95% CI = 0.98-1.18) with CKD.
CKD significantly develops in patients with MetS. Metabolic syndrome was associated with the development of chronic kidney disease incidence. Hypertension, diabetes, and age were strong indicators, while abdominal obesity and reduced HDL were not associated with the incidence of CKD.
慢性肾脏病（CKD）会随时间进展并导致肾脏替代治疗。研究表明代谢综合征（MetS）与CKD之间存在关联。目前的证据来自横断面研究。需要来自大型前瞻性队列研究且有长期随访的可靠数据。本研究调查了18年随访后CKD与MetS之间的关联。
在基线期（1999 - 2005年）年龄≥20岁的15255名参与者中，排除患有CKD、癌症以及使用皮质类固醇的患者后，8987名参与者进入研究，并以三年为一个周期随访至2018年。所有参与者被分为五个亚组：（1）无代谢综合征组，（2）代谢综合征（糖尿病阳性、高血压阴性）组，（3）代谢综合征阳性（糖尿病阴性、高血压阳性）组，（4）代谢综合征阳性（糖尿病阳性、高血压阳性）组和（5）代谢综合征阳性（糖尿病阴性、高血压阴性）组。
在基线期，参与者的平均年龄为39.8±13.3岁；4996名（55.6%）为女性。在18年的随访期间，2038名（22.7%）受试者发生了CKD，其中1107名患有代谢综合征。在对混杂变量进行校正后，代谢综合征（糖尿病阳性、高血压阳性）亚组发生CKD的风险最高（风险比[HR]=1.51，95%置信区间[CI]=1.32 - 1.71）。具有五个组分的代谢综合征受试者发生CKD的发生率更高（HR = 1.43，95% CI = 1.22 - 1.68）。高腰围（WC）（HR = 1.08，95% CI = 0.99 - 1.19）和高密度脂蛋白（HDL）（HR = 1.07，95% CI = 0.98 - 1.18）与CKD之间无关联。
代谢综合征患者中CKD显著发生。代谢综合征与慢性肾脏病发病率的发展相关。高血压、糖尿病和年龄是强指标，而腹部肥胖和HDL降低与CKD的发病率无关。
