title: Metabolic syndrome and CKD in a general Japanese population: the Hisayama Study.
abstract: 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.
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. nino@envmed.med.kyushu-u.ac.jp
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
authors.forename: Michiaki
authors.initials: M
authors.lastname: Kubo
authors.forename: Koji
authors.initials: K
authors.lastname: Yonemoto
authors.forename: Yumihiro
authors.initials: Y
authors.lastname: Tanizaki
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirakata
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
mesh_terms: 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