Metabolic syndrome, components, and cardiovascular disease prevalence in chronic kidney disease: findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

Abstract

Background/aims: Metabolic syndrome may increase the risk for incident cardiovascular disease (CVD) and all-cause mortality in the general population. It is unclear whether, and to what degree, metabolic syndrome is associated with CVD in chronic kidney disease (CKD). We determined metabolic syndrome prevalence among individuals with a broad spectrum of kidney dysfunction, examining the role of the individual elements of metabolic syndrome and their relationship to prevalent CVD.

Methods: We evaluated four models to compare metabolic syndrome or its components to predict prevalent CVD using prevalence ratios in the Chronic Renal Insufficiency Cohort (CRIC) Study.

Results: Among 3,939 CKD participants, the prevalence of metabolic syndrome was 65% and there was a significant association with prevalent CVD. Metabolic syndrome was more common in diabetics (87.5%) compared with non-diabetics (44.3%). Hypertension was the most prevalent component, and increased triglycerides the least prevalent. Using the bayesian information criterion, we found that the factors defining metabolic syndrome, considered as a single interval-scaled variable, was the best of four models of metabolic syndrome, both for CKD participants overall and for diabetics and non-diabetics separately.

Conclusion: The predictive value of this model for future CVD outcomes will subsequently be validated in longitudinal analyses.

Fig. 1

Pie charts showing prevalence of metabolic syndrome in CKD in participants without (upper row) or with (lower row) diabetes. Each row is divided into three eGFR ranges, as labeled. Those with <3 metabolic syndrome components are the white slices beginning at the 12 o'clock position going counterclockwise. The next slices, continuing counterclockwise, represent 3, 4 or all 5 metabolic syndrome components.