Metabolic Syndrome as an Independent Risk Factor of Chronic Kidney Disease in Southern Taiwan

BACKGROUND: Chronic kidney disease (CKD) is an important and noteworthy health issue worldwide. It is especially a problem in Taiwan because of its high prevalence and incidence. Metabolic syndrome is associated with CKD, but the mechanisms underlying this association have not been determined. In view of this, we evaluated the relationship between CKD and metabolic syndrome beyond the components of metabolic syndrome and characteristics of Taiwanese adults aged 40 years and above.METHODS: From January 2002 to December 2006, we conducted a community-based medical screening program in Chiayi County of 21,619 subjects aged 40 years and above. According to the National Kidney Foundation guidelines, subjects were considered to have CKD in our study if their estimated glomerular filtration rates were lower than 60 mL/min per 1.73 m2. Age, gender, and components of metabolic syndrome, including body mass index (BMI), systolic blood pressure, fasting plasma glucose, high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were considered potential confounders.RESULTS: Participants with metabolic syndrome were significantly more likely to have CKD than those without metabolic syndrome (29.3% and 19.6%, respectively; P ＜ 0.001). Multiple logistic regression models determined that old age, female gender, and metabolic syndrome were independent risk factors of CKD. The risk of CKD was significantly proportional to the number of metabolic syndrome components. Compared with those without metabolic syndrome, participants with two components of metabolic syndrome had a 1.407-fold (95% confidence interval [CI], 1.256-1.575; P ＜ 0.001) increased risk while those with more than three components had a 1.695-fold (95% CI, 1.497-1.919; P ＜ 0.001) increased risk of CKD. Higher BMI, lower HDL-C levels, and higher TG levels were significantly associated with an increased risk of CKD.CONCLUSIONS: Metabolic syndrome is an independent risk factor for CKD in Taiwanese adults. Therefore, an effective screening program for early detection of people with metabolic syndrome is required.