title: An association of metabolic syndrome and chronic kidney disease from a 10-year prospective cohort study.
abstract: OBJECTIVE
  Although metabolic abnormalities have been considered important risk factors of chronic kidney disease (CKD), the impact of metabolic syndrome (MS) and insulin resistance on renal function deterioration is poorly understood. We investigated the association between MS and incident CKD/rapid decline of estimated glomerular filtration rate (eGFR) in a 10-year population-based longitudinal study.
  
  
  METHODS
  Among 10,030 subjects, 6065 without history of CKD or cardiovascular disease at baseline were analyzed using data generated from the Ansan-Ansung cohort of the Korean Genome Epidemiology Study. Participants were categorized into two groups based on the presence of MS at baseline. Incident CKD was defined as eGFR <60ml/min per 1.73m2, and rapid decline of eGFR was defined as >3ml/min per 1.73m2/yr over 10years.
  
  
  RESULTS
  During the 10-year follow-up period, CKD developed in 893 subjects (14.7%). Compared to subjects without MS, the odds ratio (OR; 95% confidence interval, CI) of incident CKD in those with MS was 1.38 (1.16-1.64) after controlling for confounding factors. The risk of rapid decline of eGFR was also higher in subjects with MS than those without MS (OR: 1.20, 95% CI: 1.04-1.39). In addition, we found that higher levels of homeostatic model assessment of insulin resistance (HOMA-IR) were associated with incident CKD and rapid decline of eGFR independently of traditional CKD risk factors (OR: 1.24, 95% CI: 1.04-1.47).
  
  
  CONCLUSIONS
  Both MS and insulin resistance were independent risk factors of incident CKD and rapid decline of eGFR in healthy Korean population.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Huh
authors.affiliation: Department of Preventive Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Yadav
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Jae Seok
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea.
authors.forename: Jung-Woo
authors.initials: JW
authors.lastname: Son
authors.affiliation: Institute of Life Style Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea,. Electronic address: eunhee_choi@yonsei.ac.kr.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi, South Korea.
authors.forename: Seong Hwan
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi, South Korea.
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
authors.affiliation: Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ki-Chul
authors.initials: KC
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yonsei University, Wonju College of Medicine, Wonju, Republic of Korea,. Electronic address: kimjang713@gmail.com.
authors.forename: Jang Young
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors
keywords: Chronic kidney disease; Insulin resistance; Metabolic syndrome; Rapid decline of GFR