title: Treatment of metabolic syndrome slows progression of diabetic nephropathy.
abstract: BACKGROUND
  Metabolic syndrome contributes to the development of albuminuria and to the decrease of glomerular filtration rate (GFR) in type 2 diabetes patients. The aim of this study was to analyze the effect of MS treatment on the progression of diabetic nephropathy (DN).
  
  
  METHODS
  This was a retrospective and comparative cohort study. Baseline and follow-up data related to the presence of metabolic syndrome, microalbuminuria (mA), and GFR were obtained in individuals with type 2 diabetes. Subjects were classified in two groups: (1) With correction of metabolic syndrome and (2) without correction of metabolic syndrome at follow-up. Furthermore, they were stratified in four subgroups: (A) Without metabolic syndrome at baseline and at follow-up, (B) with metabolic syndrome and correction of metabolic syndrome, (C) without metabolic syndrome and development of metabolic syndrome, and (D) with metabolic syndrome and persistence of metabolic syndrome.
  
  
  RESULTS
  Final GFR and mA were lower and higher, respectively, in group 2 versus 1 [89.8±3 2.3 vs. 98.3±32.0 mL/min, P=0.010, and 51.0 (13.5-195) vs. 7.9 (4-31) mg/day, P<0.001, respectively]. Lack of metabolic syndrome correction [hazard ratio (HR)=2.8, 95% confidence interval (CI) 1.9-4.2, P<0.001], being in subgroups C (HR=2.05, 95% CI 1.03-4.1, P=0.04) and D (HR=3.3, 95% CI 2.0-5.3, P<0.001), and the presence of two (HR=3.4, 95% CI 1.9-6.1, P<0.001), three (HR=5.0, 95% CI 2.5-9.9, P<0.001), and four (HR=4.2, 95% CI 1.5-12.1, P=0.006) metabolic syndrome components were independent factors associated with development of mA in Cox regression analysis adjusted for age, gender, baseline mA and GFR, glycosylated hemoglobin (HbA1c), hypertension, and obesity.
  
  
  CONCLUSIONS
  Metabolic syndrome treatment and control are independently associated with a lesser progression of DN.
authors.affiliation: Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
authors.forename: Edgar G
authors.initials: EG
authors.lastname: Duran-Perez
authors.forename: Paloma
authors.initials: P
authors.lastname: Almeda-Valdes
authors.forename: Daniel
authors.initials: D
authors.lastname: Cuevas-Ramos
authors.forename: Eugenia
authors.initials: E
authors.lastname: Campos-Barrera
authors.forename: Liliana
authors.initials: L
authors.lastname: Muñoz-Hernandez
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Gomez-Perez
mesh_terms: D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D003928:Diabetic Nephropathies / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D008962:Models, Theoretical; D051437:Renal Insufficiency / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors