The impact of metabolic syndrome on chronic kidney disease development. Insights from a big prospective study

• Published in: European journal of clinical investigation Vol. 53; no. 4; pp. e13945 - n/a
• Main Authors: Fanaei, Seyedeh Melika, Mehran, Ladan, Amouzegar, Atieh, Masoumi, Safdar, Amouzegar, Atefeh, Azizi, Freidoun
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2023
• Subjects: Adult; chronic kidney disease; Corticoids; Corticosteroids; Cross-Sectional Studies; diabetes; Diabetes Mellitus; Female; High density lipoprotein; Humans; Hypertension; Hypertension - complications; Kidney diseases; Kidneys; Male; Metabolic disorders; Metabolic syndrome; Metabolic Syndrome - epidemiology; Middle Aged; Prospective Studies; Renal Insufficiency, Chronic - epidemiology; Risk Factors; Subgroups; metabolic syndrome; chronic kidney disease; diabetes; hypertension
• ISSN: 0014-2972; 1365-2362; 1365-2362
• DOI: 10.1111/eci.13945

Background 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. Material and Method 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−). Result 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. Conclusion 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. After an 18‐year follow‐up of 8987 participants, chronic kidney disease significantly developed in patients with metabolic syndrome, having diabetes or hypertension and more number of traits, especially in the elderly. Metabolic syndrome without having hypertension and diabetes was not associated with the increased risk of chronic kidney disease. Among components of metabolic syndrome, elevated waist circumference and reduced high‐density lipoprotein were not associated with the incidence of chronic kidney disease.