title: Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance.
abstract: BACKGROUND
  The aims of the study were to examine the association between CKD and the metabolic syndrome (MetS) and its components in older adults. We also explored two possible pathways linking the metabolic syndrome with CKD: inflammation as measured by high sensitivity C-Reactive Protein (hsCRP) and insulin resistance as measured by HOMA-IR.
  
  
  METHODS
  Community-dwelling non-diabetic 70+ adults from the Einstein Aging Study participated in the study. We defined CKD as eGFR below 60mL/min/1.73m2. MetS was defined according to recent guidelines from the National Cholesterol Education Program. Binary logistic regressions were used to assess the association between the metabolic syndrome, its components and CKD with adjustments for demographics, HOMA-IR and hsCRP.
  
  
  RESULTS
  Of 616 participants (mean age = 79.3 years, 65.5% female), 25% had MetS and 26.5% had CKD. Participants with CKD had a significantly higher prevalence of the MetS than individuals without CKD (34.4% vs. 24.3%). Binary logistic regression models showed that CKD was associated with MetS (OR = 1.72, 95%CI = 1.13-2.61). The association was unaltered by adjustment for hsCRP but altered by adjustment for HOMA-IR. As the number of MetS components increased the relative odds of CKD also increased. None of the individual components was independently associated with CKD.
  
  
  CONCLUSIONS
  MetS is associated with CKD in non-diabetic older adults. Results showed that as the number of MetS components increased so did the odds for CKD. HOMA-IR seems to be in the casual pathway linking MetS to CKD.
authors.affiliation: Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New Yourk, United States of America; Einstein Aging Study, Albert Einstein College of Medicine, Bronx, New York, United States of America.
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Zammit
authors.affiliation: Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New Yourk, United States of America; Einstein Aging Study, Albert Einstein College of Medicine, Bronx, New York, United States of America.
authors.forename: Mindy J
authors.initials: MJ
authors.lastname: Katz
authors.affiliation: Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New Yourk, United States of America; Einstein Aging Study, Albert Einstein College of Medicine, Bronx, New York, United States of America.
authors.forename: Carol
authors.initials: C
authors.lastname: Derby
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
authors.forename: Markus
authors.initials: M
authors.lastname: Bitzer
authors.affiliation: Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New Yourk, United States of America; Einstein Aging Study, Albert Einstein College of Medicine, Bronx, New York, United States of America; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, United States of America.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D008954:Models, Biological; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D014280:Triglycerides; D002097:C-Reactive Protein