Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
School of Medicine, University of Tasmania, Hobart, Australia.
Metab Syndr Relat Disord. 2023 Oct;21(8):460-467. doi: 10.1089/met.2023.0007. Epub 2023 Aug 9.
Relationships between metabolic syndrome (MetS), inflammation, and chronic kidney disease (CKD) have been reported, but long-term follow-up studies are limited. This study aimed to investigate whether MetS and C-reactive protein (CRP) from young adulthood associated with the risk of subclinical kidney damage (SKD), a surrogate measure for CKD, in mid-adulthood. One thousand fifteen participants from the Childhood Determinants of Adult Health study aged 26-36 years at baseline (2004-2006) were followed up at age 36-49 (2014-2019). Log-binomial regression was used to determine whether MetS and high CRP in young adulthood and from young to mid-adulthood predicted the risk of SKD (an estimated glomerular filtration rate [eGFR] of 30-60 mL/min/1.73 m or an eGFR >60 mL/min/1.73 m with a urine albumin-creatinine ratio ≥2.5 mg/mmol [males] or ≥3.5 mg/mmol [females]) in midlife. Having MetS in young adulthood was associated with an increased risk of SKD in midlife (adjusted relative risk [aRR] = 2.67, 95% confidence interval [CI]: 1.24-5.76). Participants with MetS and high CRP as young adults had a greater risk of having SKD in midlife (aRR = 4.27, 95% CI: 1.61-11.30) compared with those without MetS and high CRP. Furthermore, for participants with persistent MetS, the aRR of SKD in midlife was 4.08 (95% CI: 1.84-9.05) compared with those without MetS from young to mid-adulthood. No significant associations were found between CRP in young adulthood, or change in CRP from young to mid-adulthood, and SKD in midlife. MetS in young adulthood, with and without high CRP, and persistent MetS were associated with an increased risk of SKD in middle midlife.
代谢综合征（MetS）、炎症和慢性肾脏病（CKD）之间的关系已被报道，但长期随访研究有限。本研究旨在探讨年轻成年时的 MetS 和 C 反应蛋白（CRP）是否与中年时亚临床肾脏损害（SKD）的风险相关，SKD 是 CKD 的替代指标。在基线（2004-2006 年）时年龄为 26-36 岁的来自儿童决定成人健康研究的 1105 名参与者，在中年（2014-2019 年）时进行了随访。使用对数二项式回归来确定年轻成年时的 MetS 和高 CRP，以及年轻到中年时的 CRP 变化是否预测了中年时 SKD 的风险（估算肾小球滤过率[eGFR]为 30-60 mL/min/1.73 m 或 eGFR>60 mL/min/1.73 m 但尿白蛋白/肌酐比值≥2.5 mg/mmol [男性]或≥3.5 mg/mmol [女性]）。 年轻成年时患有 MetS 与中年时 SKD 的风险增加相关（调整后的相对风险[aRR] = 2.67，95%置信区间[CI]：1.24-5.76）。与年轻成年时没有 MetS 和高 CRP 的参与者相比，同时患有 MetS 和高 CRP 的参与者中年时发生 SKD 的风险更高（aRR = 4.27，95% CI：1.61-11.30）。此外，对于持续患有 MetS 的参与者，中年时 SKD 的 aRR 为 4.08（95% CI：1.84-9.05），而从年轻到中年时没有 MetS 的参与者则为 4.08。年轻成年时的 CRP 或从年轻到中年时 CRP 的变化与中年时的 SKD 之间没有显著关联。 年轻成年时的 MetS，无论是否伴有高 CRP，以及持续的 MetS，与中年时 SKD 的风险增加相关。
