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Metabolic syndrome is a predictor of decreased renal function among community-dwelling middle-aged and elderly Japanese.
Int Urol Nephrol. 2019 Dec; 51(12):2285-2294.IU

Abstract

PURPOSE

Metabolic syndrome (MetS) is increasing worldwide with the continuous increase in obesity prevalence. Chronic kidney disease (CKD) is also a major public health problem, but there is controversy over whether baseline MetS is a predictor of decreased renal function among Japanese community-dwelling middle-aged and elderly Japanese.

METHODS

We conducted a prospective cohort study designed as part of the Nomura study. We recruited a random sample of 410 men aged 68 ± 8 (mean ± standard deviation; range, 50-95) years and 549 women aged 69 ± 7 (50-84) years during their annual health examination in a single community. We examined the relationship between baseline MetS and renal dysfunction after a 3-year evaluation based on estimated glomerular filtration rate (eGFRCKDEPI) using the CKD-EPI equations modified by the Japan coefficient. CKD was defined as dipstick-positive proteinuria (> or = 1 +) or a low eGFRCKDEPI (< 60 mL/min/1.73 m2).

RESULTS

Of the 959 participants, 413 (43.1%) had MetS at baseline. Annual eGFR decline rate was significantly greater in those with MetS than in those without MetS, and the annual eGFR decline rate of < - 1.2 mL/min/1.73 m2/year increased significantly in relation to presence of baseline MetS, especially low HDL cholesterol (HDL-C). Moreover, the incidence rate of CKD after 3 years was 13.5% and increased significantly in relation to presence of baseline MetS, especially its components such as elevated HbA1c. The multivariate-adjusted odd ratio (OR) for CKD in participants with MetS versus those without MetS was 1.55 (0.99-2.43). The multivariate-adjusted ORs for rapid annual eGFR decline rate were significantly high in patients aged ≥ 65 years and presence of medication, regardless of gender and eGFR value.

CONCLUSIONS

Low HDL-C and elevated HbA1c levels correlated significantly with eGFR decline in a short period of 3 years. MetS also showed a significant association with eGFR decline. This study suggests the importance of low HDL-C and elevated HbA1c in the effect of MetS on eGFR decline rather than obesity among Japanese community-dwelling middle-aged and elderly Japanese without CKD.

Authors+Show Affiliations

Department of Community Medicine, Ehime University Graduate School of Medicine, Shizugawa, Toon-city, Ehime, 791-0204, Japan. rykawamo@m.ehime-u.ac.jp. Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nnomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan. rykawamo@m.ehime-u.ac.jp.Department of Community Medicine, Ehime University Graduate School of Medicine, Shizugawa, Toon-city, Ehime, 791-0204, Japan. Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nnomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan.Department of Community Medicine, Ehime University Graduate School of Medicine, Shizugawa, Toon-city, Ehime, 791-0204, Japan. Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nnomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan.Department of Community Medicine, Ehime University Graduate School of Medicine, Shizugawa, Toon-city, Ehime, 791-0204, Japan.Department of Community Medicine, Ehime University Graduate School of Medicine, Shizugawa, Toon-city, Ehime, 791-0204, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31642000

Citation

Kawamoto, Ryuichi, et al. "Metabolic Syndrome Is a Predictor of Decreased Renal Function Among Community-dwelling Middle-aged and Elderly Japanese." International Urology and Nephrology, vol. 51, no. 12, 2019, pp. 2285-2294.
Kawamoto R, Akase T, Ninomiya D, et al. Metabolic syndrome is a predictor of decreased renal function among community-dwelling middle-aged and elderly Japanese. Int Urol Nephrol. 2019;51(12):2285-2294.
Kawamoto, R., Akase, T., Ninomiya, D., Kumagi, T., & Kikuchi, A. (2019). Metabolic syndrome is a predictor of decreased renal function among community-dwelling middle-aged and elderly Japanese. International Urology and Nephrology, 51(12), 2285-2294. https://doi.org/10.1007/s11255-019-02320-0
Kawamoto R, et al. Metabolic Syndrome Is a Predictor of Decreased Renal Function Among Community-dwelling Middle-aged and Elderly Japanese. Int Urol Nephrol. 2019;51(12):2285-2294. PubMed PMID: 31642000.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic syndrome is a predictor of decreased renal function among community-dwelling middle-aged and elderly Japanese. AU - Kawamoto,Ryuichi, AU - Akase,Taichi, AU - Ninomiya,Daisuke, AU - Kumagi,Teru, AU - Kikuchi,Asuka, Y1 - 2019/10/22/ PY - 2019/06/01/received PY - 2019/10/11/accepted PY - 2019/10/24/pubmed PY - 2020/4/10/medline PY - 2019/10/24/entrez KW - Chronic kidney disease KW - Decline rate KW - Metabolic syndrome KW - eGFRCKDEPI SP - 2285 EP - 2294 JF - International urology and nephrology JO - Int Urol Nephrol VL - 51 IS - 12 N2 - PURPOSE: Metabolic syndrome (MetS) is increasing worldwide with the continuous increase in obesity prevalence. Chronic kidney disease (CKD) is also a major public health problem, but there is controversy over whether baseline MetS is a predictor of decreased renal function among Japanese community-dwelling middle-aged and elderly Japanese. METHODS: We conducted a prospective cohort study designed as part of the Nomura study. We recruited a random sample of 410 men aged 68 ± 8 (mean ± standard deviation; range, 50-95) years and 549 women aged 69 ± 7 (50-84) years during their annual health examination in a single community. We examined the relationship between baseline MetS and renal dysfunction after a 3-year evaluation based on estimated glomerular filtration rate (eGFRCKDEPI) using the CKD-EPI equations modified by the Japan coefficient. CKD was defined as dipstick-positive proteinuria (> or = 1 +) or a low eGFRCKDEPI (< 60 mL/min/1.73 m2). RESULTS: Of the 959 participants, 413 (43.1%) had MetS at baseline. Annual eGFR decline rate was significantly greater in those with MetS than in those without MetS, and the annual eGFR decline rate of < - 1.2 mL/min/1.73 m2/year increased significantly in relation to presence of baseline MetS, especially low HDL cholesterol (HDL-C). Moreover, the incidence rate of CKD after 3 years was 13.5% and increased significantly in relation to presence of baseline MetS, especially its components such as elevated HbA1c. The multivariate-adjusted odd ratio (OR) for CKD in participants with MetS versus those without MetS was 1.55 (0.99-2.43). The multivariate-adjusted ORs for rapid annual eGFR decline rate were significantly high in patients aged ≥ 65 years and presence of medication, regardless of gender and eGFR value. CONCLUSIONS: Low HDL-C and elevated HbA1c levels correlated significantly with eGFR decline in a short period of 3 years. MetS also showed a significant association with eGFR decline. This study suggests the importance of low HDL-C and elevated HbA1c in the effect of MetS on eGFR decline rather than obesity among Japanese community-dwelling middle-aged and elderly Japanese without CKD. SN - 1573-2584 UR - https://www.unboundmedicine.com/medline/citation/31642000/Metabolic_syndrome_is_a_predictor_of_decreased_renal_function_among_community_dwelling_middle_aged_and_elderly_Japanese_ L2 - https://doi.org/10.1007/s11255-019-02320-0 DB - PRIME DP - Unbound Medicine ER -