title: Comparison of association of glomerular filtration rate with metabolic syndrome in a community-based population using the CKD-EPI and MDRD study equations.
abstract: BACKGROUND
  Targeting metabolic syndrome (MetS) in early chronic kidney disease (CKD) is essential to reduce cardiovascular complications. We compared the association of kidney function estimated by two glomerular filtration rate (GFR) equations with MetS in community population.
  
  
  METHODS
  We analyzed 12,700 participants from 2009 to 2010 the Korea National Health Survey data. GFR was estimated using the CKD Epidemiology Collaboration equation (GFR(CKD-EPI)) and the Modification of Diet in Renal Disease study equation (GFR(MDRD)).
  
  
  RESULTS
  The prevalence of MetS increased from the highest GFR category (>105 ml/min/1.73 m(2)) to the lowest (<60 ml/min/1.73 m(2)) using both equations (GFR(CKD-EPI), 14.1% to 62.3%; GFR(MDRD), 18.4% to 62.9%). Participants reclassified to higher GFR(CKD-EPI) category (upward) from GFR(MDRD) had lower prevalence of MetS than those moved downward (Net reclassification improvement 13.7%, P<0.001). Compared with GFR ≥105 ml/min/1.73 m(2), mildly impaired GFR(CKD-EPI) (75-89 ml/min/1.73 m(2)) was independently associated with increased odds of MetS (OR 1.30, 95% CI 1.09-1.56, P=0.003) in multivariate analysis, whereas GFR(MDRD) was not (OR 1.08, 95% CI 0.92-1.27, P=0.344).
  
  
  CONCLUSIONS
  Compared with GFR(MDRD), GFR(CKD-EPI) showed better association with prevalence of MetS, particularly in normal to mildly impaired GFR range. GFR(CKD-EPI) may improve risk stratification of individuals with MetS according to kidney function in community-based population.
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Republic of Korea.
authors.forename: Namki
authors.initials: N
authors.lastname: Hong
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jaewon
authors.initials: J
authors.lastname: Oh
authors.affiliation: Division of Endocrinology, Yonsei University College of Medicine, Republic of Korea.
authors.forename: Yong-ho
authors.initials: YH
authors.lastname: Lee
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jong Chan
authors.initials: JC
authors.lastname: Youn
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sungha
authors.initials: S
authors.lastname: Park
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang-Hak
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Republic of Korea.
authors.forename: Soyoon
authors.initials: S
authors.lastname: Kim
authors.affiliation: Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Republic of Korea.
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Jee
authors.affiliation: Divison of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: smkang@yuhs.ac.
authors.forename: Seok-Min
authors.initials: SM
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D003625:Data Collection; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D008875:Middle Aged; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors
keywords: Chronic kidney disease; Kidney function; Metabolic syndrome