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Metabolic syndrome and renal injury.

Sheen YJ, Sheu WH - Cardiol Res Pract (2011)

Bottom Line: Given the same eGFR level, urine albumin might be a better risk marker to predict progression of CKD and future development of cardiovascular diseases (CVDs).Serum Cystatin C is emerging as a new biomarker for early detection of renal injury associated with MetS and cardiovascular risk.Hyperinsulinemia, activation of rennin-angiotensin-aldosterone system, increase of oxidative stress, and inflammatory cytokines are proposed to be the plausible biological link between MetS and CKD.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital Department of Health, Executive Yuan, No. 199, Sec. 1, Sanmin Road, Taichung 403, Taiwan.

ABSTRACT
Both metabolic syndrome (MetS) and chronic kidney disease (CKD) are major global health issues. Current clinical markers used to reflect renal injury include albuminuria and estimated glomerular filtration rate (eGFR). Given the same eGFR level, urine albumin might be a better risk marker to predict progression of CKD and future development of cardiovascular diseases (CVDs). Serum Cystatin C is emerging as a new biomarker for early detection of renal injury associated with MetS and cardiovascular risk. In addition to each component, MetS per se influences the incidence and prognosis of renal injury and the odds ratios increased with the increase in the number of metabolic abnormalities. Hyperinsulinemia, activation of rennin-angiotensin-aldosterone system, increase of oxidative stress, and inflammatory cytokines are proposed to be the plausible biological link between MetS and CKD. Weight control, stick control of blood pressure, glucose, and lipids disorders may lead to lessening renal injury and even the subsequent CVD.

No MeSH data available.


Related in: MedlinePlus

Mechanisms of insulin resistance with the consequent development of renal injury and the target of treatments. SNS: sympathetic nervous system, RAS: renin-angiotensin system, PPAR: peroxisome proliferator-activated receptors, ACEI: angiotensin-converting enzyme inhibitor, ARB: angiotensin II receptor blocker, TZD: thiazolidinediones.
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Related In: Results  -  Collection


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fig1: Mechanisms of insulin resistance with the consequent development of renal injury and the target of treatments. SNS: sympathetic nervous system, RAS: renin-angiotensin system, PPAR: peroxisome proliferator-activated receptors, ACEI: angiotensin-converting enzyme inhibitor, ARB: angiotensin II receptor blocker, TZD: thiazolidinediones.

Mentions: Cystatin C is suggested to be a new biomarker for the early detection of acute renal injury, MetS, and cardiovascular risk [52–55, 64–66]. According to the results of the Chennai Urban Rural Epidemiology Study (CURES) (MetS was defined using National Cholesterol Education Program criteria for adults modified for waist measured using the World Health Organization Asia Pacific guidelines. Serum cystin-C was estimated by a high-sensitivity particle-enhancing nephelometry assay), it showed that subjects with four or five metabolic abnormalities had the highest cystatin C level. With decreasing number of metabolic abnormalities, the cystatin C levels decreased linearly (P for trend <.001), and it concluded that Cystatin C levels are highly correlated with the number of metabolic abnormalities in Asian Indians [67]. Previous evidence suggested that the measurement of serum cystatin C may be useful for evaluating cardiovascular risk profile [54]. A study reported that the association of cystatin C level with all-cause and CVD mortality is even stronger than that of GFR with these outcomes in stage 3 or 4 CKD [66]. Furthermore, cystatin C is considered to be a marker of inflammation as well as renal function [64]. Among elderly persons without CKD, cystatin C is a prognostic biomarker of risk for death, CVD and CKD, and seems to identify a preclinical state of kidney dysfunction that cannot be completely detected by measurement of serum creatinine or eGFR [65]. However, more clinical studies will be required to evaluate the clinical usefulness and cost effectiveness as compared with traditional markers.


Metabolic syndrome and renal injury.

Sheen YJ, Sheu WH - Cardiol Res Pract (2011)

Mechanisms of insulin resistance with the consequent development of renal injury and the target of treatments. SNS: sympathetic nervous system, RAS: renin-angiotensin system, PPAR: peroxisome proliferator-activated receptors, ACEI: angiotensin-converting enzyme inhibitor, ARB: angiotensin II receptor blocker, TZD: thiazolidinediones.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3065010&req=5

fig1: Mechanisms of insulin resistance with the consequent development of renal injury and the target of treatments. SNS: sympathetic nervous system, RAS: renin-angiotensin system, PPAR: peroxisome proliferator-activated receptors, ACEI: angiotensin-converting enzyme inhibitor, ARB: angiotensin II receptor blocker, TZD: thiazolidinediones.
Mentions: Cystatin C is suggested to be a new biomarker for the early detection of acute renal injury, MetS, and cardiovascular risk [52–55, 64–66]. According to the results of the Chennai Urban Rural Epidemiology Study (CURES) (MetS was defined using National Cholesterol Education Program criteria for adults modified for waist measured using the World Health Organization Asia Pacific guidelines. Serum cystin-C was estimated by a high-sensitivity particle-enhancing nephelometry assay), it showed that subjects with four or five metabolic abnormalities had the highest cystatin C level. With decreasing number of metabolic abnormalities, the cystatin C levels decreased linearly (P for trend <.001), and it concluded that Cystatin C levels are highly correlated with the number of metabolic abnormalities in Asian Indians [67]. Previous evidence suggested that the measurement of serum cystatin C may be useful for evaluating cardiovascular risk profile [54]. A study reported that the association of cystatin C level with all-cause and CVD mortality is even stronger than that of GFR with these outcomes in stage 3 or 4 CKD [66]. Furthermore, cystatin C is considered to be a marker of inflammation as well as renal function [64]. Among elderly persons without CKD, cystatin C is a prognostic biomarker of risk for death, CVD and CKD, and seems to identify a preclinical state of kidney dysfunction that cannot be completely detected by measurement of serum creatinine or eGFR [65]. However, more clinical studies will be required to evaluate the clinical usefulness and cost effectiveness as compared with traditional markers.

Bottom Line: Given the same eGFR level, urine albumin might be a better risk marker to predict progression of CKD and future development of cardiovascular diseases (CVDs).Serum Cystatin C is emerging as a new biomarker for early detection of renal injury associated with MetS and cardiovascular risk.Hyperinsulinemia, activation of rennin-angiotensin-aldosterone system, increase of oxidative stress, and inflammatory cytokines are proposed to be the plausible biological link between MetS and CKD.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Hospital Department of Health, Executive Yuan, No. 199, Sec. 1, Sanmin Road, Taichung 403, Taiwan.

ABSTRACT
Both metabolic syndrome (MetS) and chronic kidney disease (CKD) are major global health issues. Current clinical markers used to reflect renal injury include albuminuria and estimated glomerular filtration rate (eGFR). Given the same eGFR level, urine albumin might be a better risk marker to predict progression of CKD and future development of cardiovascular diseases (CVDs). Serum Cystatin C is emerging as a new biomarker for early detection of renal injury associated with MetS and cardiovascular risk. In addition to each component, MetS per se influences the incidence and prognosis of renal injury and the odds ratios increased with the increase in the number of metabolic abnormalities. Hyperinsulinemia, activation of rennin-angiotensin-aldosterone system, increase of oxidative stress, and inflammatory cytokines are proposed to be the plausible biological link between MetS and CKD. Weight control, stick control of blood pressure, glucose, and lipids disorders may lead to lessening renal injury and even the subsequent CVD.

No MeSH data available.


Related in: MedlinePlus