Metabolic syndrome and CKD in a general Japanese population: the Hisayama Study.
BACKGROUND
Metabolic syndrome has been linked with various atherosclerotic diseases, but has not been evaluated sufficiently as a risk factor for the development of chronic kidney disease (CKD) in the general population.


METHODS
We followed up 1,440 community-dwelling individuals without CKD aged 40 years or older for 5 years and examined the effects of metabolic syndrome, defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria, on the development of CKD.


RESULTS
During follow-up, 88 subjects experienced CKD. The age- and sex-adjusted 5-year cumulative incidence of CKD was significantly greater in subjects with than without metabolic syndrome (10.6% versus 4.8%; P < 0.01). In multivariate analysis, even after adjustment for other confounding factors, including insulinemia, metabolic syndrome remained an independent risk factor for the occurrence of CKD (odds ratio, 2.08; 95% confidence interval [CI], 1.23 to 3.52). Compared with subjects with 1 or fewer metabolic syndrome component, multivariate-adjusted odd ratios for CKD in subjects with 2, 3, and 4 or more metabolic syndrome components were 1.13 (95% CI, 0.60 to 2.12), 1.90 (95% CI, 0.98 to 3.69), and 2.79 (95% CI, 1.32 to 5.90), respectively. The rate of change in kidney function during 5 years decreased significantly in subjects with 4 or more metabolic syndrome components compared with those with 1 or fewer component in the age group of 40 to 59 years, whereas it also was significantly low in subjects with 3 metabolic syndrome components in the group aged 60 years or older.


CONCLUSIONS
Our findings suggest that metabolic syndrome is a significant risk factor for the development of CKD in the general population.
Ninomiya
Toshiharu
T
Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nino@envmed.med.kyushu-u.ac.jp
Kiyohara
Yutaka
Y
Kubo
Michiaki
M
Yonemoto
Koji
K
Tanizaki
Yumihiro
Y
Doi
Yasufumi
Y
Hirakata
Hideki
H
Iida
Mitsuo
M
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D016021:Epidemiologic Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors