Metabolic syndrome and concomitant diabetes mellitus are associated with higher risk of cardiovascular comorbidity in patients with primary glomerular diseases: A retrospective observational study

Clin Cardiol. 2020 Sep;43(9):949-956. doi: 10.1002/clc.23388. Epub 2020 May 29.

Abstract

Background: Metabolic syndrome (MS) and diabetes mellitus (DM) are risk factors for cardiovascular diseases in general population. However, there was a paucity of studies investigating their impact in primary glomerular diseases (PGD).

Hypothesis: MS and concomitant DM are associated with higher risk of cardiovascular comorbidity in PGD.

Methods: In a retrospective observational design, we analyzed 3622 hospitalized adult PGD patients and compared the prevalence of cardiovascular comorbidity in non-MS, MS with and without DM. Risk factors for cardiovascular comorbidity were identified using univariate and multivariate logistic regression.

Results: Among 3622 PGD patients, 308 (8.5%) cases accompanied with MS, including 180 (5.0%) patients with DM and 128 (3.5%) without DM. One hundred and sixty four (4.5%) cases coexisted with cardiovascular comorbidity. Patients with MS and concomitant DM exhibited a higher prevalence of cardiovascular comorbidity than those without MS stratified by estimated glomerular filtration rate and pathological types. Logistic regression showed that MS and concomitant DM (OR: 2.496, 95% CI: 1.600-3.894, P < .001), older age (OR: 1.060, 95% CI: 1.047-1.074, P < .001), male (OR: 1.536, 95% CI: 1.072-2.200, P = .019), higher level of serum ti (OR: 1.002, 95% CI: 1.001-1.003, P < .001), hyperuricemia (OR: 1.901, 95% CI: 1.327-2.725, P < .001), idiopathic membranous nephropathy (OR: 2.874, 95% CI: 1.244-6.640, P < .001) and focal segmental glomerulosclerosis (OR: 2.906, 95% CI: 1.147-7.358, P < .001) were independently associated with a higher risk for cardiovascular comorbidity.

Conclusions: In PGD patients, MS and concomitant DM are associated with an increased risk for cardiovascular comorbidity. More evidence for the causal link between MS/DM and cardiovascular outcomes is needed to be clarified.

Keywords: cardiovascular comorbidity; diabetes mellitus; metabolic syndrome; primary glomerular diseases; risk factor.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • China / epidemiology
  • Comorbidity
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology*
  • Female
  • Glomerulonephritis / diagnosis
  • Glomerulonephritis / epidemiology*
  • Heart Disease Risk Factors
  • Humans
  • Male
  • Metabolic Syndrome / diagnosis
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Young Adult