title: Associations of metabolic syndrome and its components with cardiovascular outcomes among non-diabetic patients undergoing maintenance peritoneal dialysis.
abstract: BACKGROUND
  Metabolic syndrome (MS) is thought to be a risk marker for cardiovascular diseases in the general population and in patients with chronic kidney disease. This study investigated whether the presence of MS also modifies cardiovascular (CV) outcomes among non-diabetic patients undergoing long-term peritoneal dialysis (PD).
  
  
  METHODS
  We enrolled 280 patients from a medical centre in North Taiwan who began PD between January 1999 and December 2005 and followed them until December 2009. MS was defined by the modified National Cholesterol Educational Programme (Adult Treatment Panel III) criteria. All parameters and biochemical data were collected by chart review. Patient outcomes (overall and CV death, fatal or non-fatal CV events) were recorded during the follow-up period. Survival was analysed by the Kaplan-Meier method, and the influence of MS and its components on outcomes were analysed by Cox regression models.
  
  
  RESULTS
  The average follow-up period was 49.2 months. Non-diabetic patients with MS had worse outcomes than those without MS or at risk for MS, but better than their diabetic counterparts. By multivariate analysis, MS was independently associated with increased risk for CV death (hazard ratio, HR = 13.27) and fatal or non-fatal CV events (HR = 10.50). Among five MS components, hypertriglyceridaemia, low high-density lipoprotein levels and hyperglycaemia were significant risk factors for adverse CV outcomes.
  
  
  CONCLUSIONS
  MS is a potent risk marker for adverse CV outcomes in non-diabetic patients on PD. Timely interventions targeting specific component of this syndrome may be required in this subset of patients.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.
authors.forename: Chia-Te
authors.initials: CT
authors.lastname: Liao
authors.forename: Tze-Wah
authors.initials: TW
authors.lastname: Kao
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Chou
authors.forename: Ming-Shiou
authors.initials: MS
authors.lastname: Wu
authors.forename: Yung-Ming
authors.initials: YM
authors.lastname: Chen
authors.forename: Hsueh-Fang
authors.initials: HF
authors.lastname: Chuang
authors.forename: Kuan-Yu
authors.initials: KY
authors.lastname: Hung
authors.forename: Tzong-Shinn
authors.initials: TS
authors.lastname: Chu
authors.forename: Kwan-Dun
authors.initials: KD
authors.lastname: Wu
authors.forename: Tun-Jun
authors.initials: TJ
authors.lastname: Tsai
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D010530:Peritoneal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate