title: Renal function and metabolic syndrome components on cardiovascular and all-cause mortality.
abstract: OBJECTIVE
  Impaired renal function and metabolic syndrome have been associated with risk of cardiovascular disease (CVD). We investigated their roles in CVD and all-cause death among ethnic Chinese population.
  
  
  METHODS
  We followed up a cohort of 11429 men and 7472 women aged 20 years and older for an average 4.9 years (median: 3.5, inter-quartile range: 2.7-7.9) from the tertiary hospital health check-up population.
  
  
  RESULTS
  CVD death rates increased when the quintiles of each variable progressed. Metabolic syndrome was a significant predictor for CVD death, with relative risk of up to 4.68. In the multivariate adjusted model that included metabolic syndrome, quintiles of serum creatinine concentrations, estimated glomerular filtration rate (GFR), and uric acids were significantly associated CVD death, with the highest relative risk of creatinine concentration (11.22, 95% confidence interval [CI]: 2.43-51.7, P for trend: <0.001). Serum creatinine concentrations and estimated GFR had the higher areas under ROC curves of CVD death (0.76, 95% CI: 0.71-0.80 for creatinine and 0.76, 95% CI: 0.72-0.81 for estimated GFR). The two marker models showed that metabolic syndrome and impaired renal function had the most significant roles in predicting CVD deaths; the multivariate relative risk was 30.6 (95% CI: 3.7-254, P: 0.002) in participants with the highest creatinine and presence of metabolic syndrome compared with those with the lowest and absence of metabolic syndrome.
  
  
  CONCLUSIONS
  Impaired renal function and metabolic syndrome are important risk factors for CVD and all-cause deaths among ethnic Chinese.
authors.affiliation: Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. klchien@ha.mc.ntu.edu.tw
authors.forename: Kuo-Liong
authors.initials: KL
authors.lastname: Chien
authors.forename: Hsiu-Ching
authors.initials: HC
authors.lastname: Hsu
authors.forename: Yuan-Teh
authors.initials: YT
authors.lastname: Lee
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000401:mortality*; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D016208:Databases, Factual; D005260:Female; D005919:Glomerular Filtration Rate; D006306:Health Surveys; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D051437:Renal Insufficiency / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D003404:Creatinine