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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.

CONCLUSION

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.

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  • Authors+Show Affiliations

    ,

    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.

    ,

    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.

    ,

    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 Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.

    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.

    Source

    PloS one 10:10 2015 pg e0139369

    MeSH

    Aged
    Blood Glucose
    Blood Pressure
    C-Reactive Protein
    Cohort Studies
    Comorbidity
    Cross-Sectional Studies
    Fasting
    Female
    Humans
    Inflammation
    Insulin Resistance
    Male
    Metabolic Syndrome
    Models, Biological
    New York City
    Prevalence
    Renal Insufficiency, Chronic
    Triglycerides
    Waist Circumference

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    26431218

    Citation

    Zammit, Andrea R., et al. "Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance." PloS One, vol. 10, no. 10, 2015, pp. e0139369.
    Zammit AR, Katz MJ, Derby C, et al. Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance. PLoS ONE. 2015;10(10):e0139369.
    Zammit, A. R., Katz, M. J., Derby, C., Bitzer, M., & Lipton, R. B. (2015). Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance. PloS One, 10(10), pp. e0139369. doi:10.1371/journal.pone.0139369.
    Zammit AR, et al. Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance. PLoS ONE. 2015;10(10):e0139369. PubMed PMID: 26431218.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance. AU - Zammit,Andrea R, AU - Katz,Mindy J, AU - Derby,Carol, AU - Bitzer,Markus, AU - Lipton,Richard B, Y1 - 2015/10/02/ PY - 2015/06/11/received PY - 2015/09/12/accepted PY - 2015/10/3/entrez PY - 2015/10/3/pubmed PY - 2016/6/9/medline SP - e0139369 EP - e0139369 JF - PloS one JO - PLoS ONE VL - 10 IS - 10 N2 - 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. CONCLUSION: 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/26431218/Chronic_Kidney_Disease_in_Non_Diabetic_Older_Adults:_Associated_Roles_of_the_Metabolic_Syndrome_Inflammation_and_Insulin_Resistance_ L2 - http://dx.plos.org/10.1371/journal.pone.0139369 DB - PRIME DP - Unbound Medicine ER -