Metabolic syndrome, but not insulin resistance, is associated with an increased risk of renal function decline

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 34; no. 2; pp. 269 - 275
• Main Authors: Li, Youbao, Xie, Di, Qin, Xianhui, Tang, Genfu, Xing, Houxun, Li, Zhiping, Xu, Xiping, Xu, Xin, Hou, Fanfan
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2015
• Subjects: Adult; Age Factors; Aged; China; diabetes; Female; Follow-Up Studies; Gastroenterology and Hepatology; Glomerular Filtration Rate; Humans; Hypercholesterolemia; Hypercholesterolemia - blood; Hypercholesterolemia - epidemiology; hypertension; Hypertension - epidemiology; Insulin Resistance; kidney diseases; Kidney Function Tests - methods; Male; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - physiopathology; Middle Aged; odds ratio; Renal function decline; Renal Insufficiency - blood; Renal Insufficiency - diagnosis; Renal Insufficiency - epidemiology; Renal Insufficiency - etiology; Risk Factors; Rural Chinese population; eGFR; Rural Chinese population; RFD; Hypercholesterolemia; Mets; Renal function decline; Insulin resistance; IR; Metabolic syndrome; CKD; estimated glomerular filtration rate; Chronic kidney disease
• ISSN: 0261-5614; 1532-1983; 1532-1983
• DOI: 10.1016/j.clnu.2014.04.002

The purpose of this study was to evaluate the effect of metabolic syndrome (Mets) and insulin resistance (IR) on the risk of renal function decline (RFD) in a rural Chinese cohort. A total of 2696 subjects aged 40–71 years with normal renal function were followed-up for 7 years. RFD was defined using the Kidney Disease: Improving Global Outcome definition, i.e., a drop in estimated glomerular filtration rate (eGFR) category accompanied by a 25% or greater drop in eGFR from baseline or a sustained decline in eGFR of more than 5 mL/min/1.73 m2/year. During the 7-year follow-up, 9.0% of the subjects developed RFD. Subjects with Mets at baseline had an increased risk of RFD with an adjusted odds ratio (OR) of 1.77 (95%CI: 1.25–2.52), and there was a graded relationship between the numbers of Mets components and the risk for RFD. Exclusion of the subjects with hypertension (1.65; 0.99–2.75) or diabetes (1.86; 1.30–2.67) at baseline or further adjustment for IR (1.72; 1.15–2.57) did not substantially change the association between Mets and the risk of RFD. Moreover, the ORs of Mets status for RFD in the older group (≥55 years) were 2.14 (1.06–4.33) times of that in the younger group (<55 years) and 2.26 (1.07–4.78) times in hypercholesterolemia group (≥5.2 mmol/L) of that in the normal (<5.2 mmol/L) group. The baseline IR was not associated with the risk for RFD. Mets, but not IR, was associated with an increased risk for RFD. And there was a detrimental interaction of Mets with older age and hypercholesterolemia on the risk of RFD.