Metabolic syndrome component combinations and chronic kidney disease: The severance cohort study

Abstract

OBJECTIVES: The effects of ethnicity and gender can produce varying results when evaluating risk of chronic kidney disease (CKD) development and metabolic syndrome (MetS) components. The risks of specific MetS component combinations and incident CKD are unclear. The aim of this study was to investigate the relationship between the combination of MetS components and CKD. METHODS: This prospective cohort study included 15,401 participants. Koreans 20-84 years of age were followed for 5.2 years. The NCEP-ATP III definition of MetS was used. CKD was defined as an estimated glomerular filtration rate of <60ml/min/1.73m(2) by the simplified Modification of Diet in Renal Disease equation. RESULTS: The incidence rate per 1000 person-years of CKD was determined in men (13.8) and women (14.1) with MetS. In a multivariate Cox proportional hazard model controlling for age and lifestyle variables, increased CKD risk in men (hazard ratio 1.45, 95% confidence interval 1.20-1.76) and women (1.52, 1.19-1.93) with Mets was found compared to those without MetS. Incidence and HRs for CKD elevated with increasing numbers of MetS components in men and women (P for trend <0.0001). The risks associated with MetS varied by combination of causative factors. High blood pressure (BP) and low high-density lipoprotein (HDL) were more likely to be associated with risk of CKD development. CONCLUSIONS: BP and HDL were the leading risk factors for CKD development in healthy Koreans. The association between MetS and kidney dysfunction were significantly independent of traditional cardiovascular risk factors.