Metabolic Syndrome Is Associated With Rapid Estimated Glomerular Filtration Rate Decline In A Chinese Community-Based Population

Zhongli Wu; Yimeng Jiang; Jia Jia; Danmei He; Pengfei Sun; Jianping Li; Yong Huo; Fangfang Fan; Yan Zhang

doi:10.2147/DMSO.S217326

Metabolic Syndrome Is Associated With Rapid Estimated Glomerular Filtration Rate Decline In A Chinese Community-Based Population

Diabetes Metab Syndr Obes. 2019 Oct 11:12:2085-2093. doi: 10.2147/DMSO.S217326. eCollection 2019.

Authors

Zhongli Wu¹, Yimeng Jiang¹, Jia Jia¹, Danmei He¹, Pengfei Sun¹, Jianping Li¹, Yong Huo¹, Fangfang Fan¹, Yan Zhang¹

Affiliation

¹ Department of Cardiology, Peking University First Hospital, Beijing, People's Republic of China.

Abstract

Purpose: This study aimed to determine the relationship between the metabolic syndrome (MetS) and rapid estimated glomerular filtration rate (eGFR) decline in a Chinese community-based population.

Patients and methods: A total of 3108 participants were recruited between December 2011 and July 2014 from an observational study cohort designed for the study of atherosclerotic diseases in Beijing, China. The outcome was a rapid eGFR decline. Subgroup and interaction analyses were performed with respect to a number of covariates.

Results: Over a median follow-up period of 2.34 (IQR: 2.29-2.41) years, the overall incidence of rapid eGFR decline was 7.24%. We found that the MetS was significantly associated with the risk of rapid eGFR decline (odds ratio [OR]=1.69, 95% confidence interval [CI]: 1.28-2.23, p<0.001) in a model adjusted for age, sex, and eGFR, and this relationship remained significant after adjustment for smoking, drinking, and low-density lipoprotein-cholesterol (OR=1.78, 95% CI: 1.34-2.35, p<0.001). Waist circumference (OR=1.38, 95% CI: 1.04-1.83, p=0.027), triglycerides (OR=1.40, 95% CI: 1.05-1.86, p=0.022), blood pressure (OR=2.05, 95% CI: 1.49-2.82, p<0.001), and fasting plasma glucose (OR=2.12, 95% CI: 1.57-2.85, p<0.001), but not high-density lipoprotein-cholesterol (OR=1.26, 95% CI: 0.94-1.69, p=0.117), were positively associated with the risk of rapid eGFR decline. Similarly, an increase in the number of MetS components present was associated with an increase in the risk of rapid eGFR decline. Furthermore, this association was modified by smoking status (OR=3.78, 95% CI: 1.68-8.49, p-interaction=0.030).

Conclusion: The MetS independently predicted rapid eGFR decline in a Chinese community-based cohort recruited for the study of atherosclerosis. The relationship between the MetS and the risk of rapid eGFR decline was modified by smoking status.

Keywords: atherosclerosis; estimated glomerular filtration rate; kidney function; metabolic abnormalities.

Grants and funding

This study was supported by grants from the University of Michigan – Peking University Health Science Centre (UM-PUHSC) Joint Institute for Translational and Clinical Research (grant numbers BMU20110177 and BMU20160530) and Projects of the National Natural Science Foundation of China (grant number 81703288).