Li Xu, Liang Qichen, Zhong Junfeng, Gan Liangying, Zuo Li
Department of Nephrology, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China.
J Clin Med. 2023 Feb 17;12(4):1614. doi: 10.3390/jcm12041614.
Observational studies have reported inconsistent findings in the relationship between metabolic syndrome (MetS), its components, and loss of renal function, mainly including eGFR decline, new-onset CKD, and ESRD. This meta-analysis was performed to investigate their potential associations.
PubMed and EMBASE were systematically searched from their inception to 21 July 2022. Observational cohort studies in English assessing the risk of renal dysfunction in individuals with MetS were identified. Risk estimates and their 95% confidence intervals (CIs) were extracted and pooled using the random-effects approach.
A total of 32 studies with 413,621 participants were included in the meta-analysis. MetS contributed to higher risks of renal dysfunction (RR = 1.50, 95% CI = 1.39-1.61) and, specifically, rapid decline in eGFR (RR 1.31, 95% CI 1.13-1.51), new-onset CKD (RR 1.47, 95% CI 1.37-1.58), as well as ESRD (RR 1.55, 95% CI 1.08-2.22). Moreover, all individual components of MetS were significantly associated with renal dysfunction, while elevated BP conveyed the highest risk (RR = 1.37, 95% CI = 1.29-1.46), impaired fasting glucose with the lowest and diabetic-dependent risk (RR = 1.20, 95% CI = 1.09-1.33).
Individuals with MetS and its components are at higher risk of renal dysfunction.
观察性研究报告了代谢综合征(MetS)及其各组分与肾功能丧失之间的关系存在不一致的结果,主要包括估算肾小球滤过率(eGFR)下降、新发慢性肾脏病(CKD)和终末期肾病(ESRD)。本荟萃分析旨在研究它们之间的潜在关联。
对PubMed和EMBASE从创刊至2022年7月21日进行系统检索。纳入了以英文发表的评估MetS患者肾功能不全风险的观察性队列研究。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(CI)。
本荟萃分析共纳入32项研究,413,621名参与者。MetS会增加肾功能不全的风险(风险比[RR]=1.50,95%CI=1.39-1.61),具体而言,会增加eGFR快速下降(RR 1.31,95%CI 1.13-1.51)、新发CKD(RR 1.47,95%CI 1.37-1.58)以及ESRD(RR 1.55,95%CI 1.08-2.22)的风险。此外,MetS的所有个体组分均与肾功能不全显著相关,其中血压升高带来的风险最高(RR=1.37,95%CI=1.29-1.46),空腹血糖受损带来的风险最低且与糖尿病相关(RR=1.20,95%CI=1.09-1.33)。
患有MetS及其组分的个体肾功能不全风险更高。