The Metabolic Syndrome and Chronic Kidney Disease in U.S. Adults

The Metabolic Syndrome and Chronic Kidney Disease in U.S. Adults

Jing Chen, MD, MSc;
Paul Muntner, PhD;
L. Lee Hamm, MD;
Daniel W. Jones, MD;
Vecihi Batuman, MD;
Vivian Fonseca, MD;
Paul K. Whelton, MD, MSc; and
Jiang He, MD, PhD

From Tulane University Schools of Medicine and Public Health and Tropical Medicine, New Orleans, Louisiana, and University of Mississippi School of Medicine, Jackson, Mississippi.

Abstract

Background: The metabolic syndrome is a common risk factor for cardiovascular disease.

Objective: To examine the association between the metabolic syndrome and risk for chronic kidney disease and microalbuminuria.

Design: Cross-sectional study.

Setting: The Third National Health and Nutrition Examination Survey.

Patients: Participants 20 years of age or older were studied in the chronic kidney disease (n = 6217) and microalbuminuria (n = 6125) analyses.

Measurements: The metabolic syndrome was defined as the presence of 3 or more of the following risk factors: elevated blood pressure, low high-density lipoprotein cholesterol level, high triglyceride level, elevated glucose level, and abdominal obesity. Chronic kidney disease was defined as a glomerular filtration rate less than 60 mL/min per 1.73 m², and microalbuminuria was defined as a urinary albumin–creatinine ratio of 30 to 300 mg/g.

Results: The multivariate-adjusted odds ratios of chronic kidney disease and microalbuminuria in participants with the metabolic syndrome compared with participants without the metabolic syndrome were 2.60 (95% CI, 1.68 to 4.03) and 1.89 (CI, 1.34 to 2.67), respectively. Compared with participants with 0 or 1 component of the metabolic syndrome, participants with 2, 3, 4, and 5 components of chronic kidney disease had multivariate-adjusted odds ratios of 2.21 (CI, 1.16 to 4.24), 3.38 (CI, 1.48 to 7.69), 4.23 (CI, 2.06 to 8.63), and 5.85 (CI, 3.11 to 11.0), respectively. The corresponding multivariate-adjusted odds ratios of microalbuminuria for participants with 3, 4, and 5 components were 1.62 (CI, 1.10 to 2.38), 2.45 (CI, 1.55 to 3.85), and 3.19 (CI, 1.96 to 5.19), respectively.

Conclusions: These findings suggest that the metabolic syndrome might be an important factor in the cause of chronic kidney disease.

Article and Author Information

Grant Support: In part by grant U01 DK60963 from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland. Dr. Chen is supported by a Building Interdisciplinary Research Careers in Women's Health Scholarship (K12 HD43451) from the National Institutes of Health, Bethesda, Maryland.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Jiang He, MD, PhD, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112; e-mail, jhe{at}tulane.edu.
Current Author Addresses: Drs. Chen, Muntner, Hamm, Batuman, Fonseca, and Whelton: Tulane University, 1430 Tulane Avenue, New Orleans, LA 70112.
Dr. Jones: University of Mississippi, 2500 North State Street, Jackson, MS 39216.
Dr. He: Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112.
Author Contributions: Conception and design: J. Chen, J. He.
Analysis and interpretation of the data: J. Chen, P. Muntner, J. He.
Drafting of the article: J. Chen, J. He.
Critical revision of the article for important intellectual content: J. Chen, P. Muntner, L.L. Hamm, D.W. Jones, V. Batuman, V. Fonseca, P.K. Whelton, J. He.
Final approval of the article: J. Chen, P. Muntner, L.L. Hamm, D.W. Jones, V. Batuman, V. Fonseca, P.K. Whelton, J. He.
Statistical expertise: J. Chen, P. Muntner, J. He.
Obtaining of funding: J. He.
Administrative, technical, or logistic support: J. He.