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Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance.

Zammit AR, Katz MJ, Derby C, Bitzer M, Lipton RB - PLoS ONE (2015)

Bottom Line: We defined CKD as eGFR below 60mL/min/1.73m2.The association was unaltered by adjustment for hsCRP but altered by adjustment for HOMA-IR.None of the individual components was independently associated with CKD.

View Article: PubMed Central - PubMed

Affiliation: 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.

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.

No MeSH data available.


Related in: MedlinePlus

Proportion of study participants with specific number of components of the metabolic syndrome.
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pone.0139369.g002: Proportion of study participants with specific number of components of the metabolic syndrome.

Mentions: Table 1 lists the demographic and clinical characteristics of the population according to participants with and without the metabolic syndrome. Of the 616 participants included in the study, the mean age was 79.3 (SD = 5.5), 34.7% were male and 25.8% were black. 25% of the cohort met criteria for the metabolic syndrome and 26.5% were classified as having CKD. In contrast to participants without the metabolic syndrome, those with the metabolic syndrome had fewer years of education, significantly lower levels of eGFR and significantly higher prevalence rates of CKD. They also had higher mean level of hsCRP, and significantly higher levels of insulin resistance (Table 1). Fig 1 shows the most prevalent components of the metabolic syndrome, which were high blood pressure (n = 500, 81.2%) and elevated waist circumference (n = 276, 44.8%); and Fig 2 shows that most of these older individuals had at least 2 metabolic syndrome component risk factors present (n = 226, 32.7%). In total there were 151 (26.5%) participants defined as having CKD on the basis of eGFR. Participants classified as CKD had a significantly higher proportion of the metabolic syndrome than those without CKD (34.4% vs. 24.3%, p = .017). They were also on average significantly older (80.5 vs. 78.9, p = .004) and showed significantly higher HOMR-IR (8.29 vs. 5.42, p = .012) and higher mean hsCRP, although not significantly different from the no CKD group (4.04 vs. 3.39, p = 2.00). Table 2 shows the means and prevalence of individual metabolic syndrome components according to presence of CKD. Participants with CKD had significantly higher prevalence of elevated fasting glucose, elevated triglycerides and low HDL cholesterol than individuals without CKD.


Chronic Kidney Disease in Non-Diabetic Older Adults: Associated Roles of the Metabolic Syndrome, Inflammation, and Insulin Resistance.

Zammit AR, Katz MJ, Derby C, Bitzer M, Lipton RB - PLoS ONE (2015)

Proportion of study participants with specific number of components of the metabolic syndrome.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592063&req=5

pone.0139369.g002: Proportion of study participants with specific number of components of the metabolic syndrome.
Mentions: Table 1 lists the demographic and clinical characteristics of the population according to participants with and without the metabolic syndrome. Of the 616 participants included in the study, the mean age was 79.3 (SD = 5.5), 34.7% were male and 25.8% were black. 25% of the cohort met criteria for the metabolic syndrome and 26.5% were classified as having CKD. In contrast to participants without the metabolic syndrome, those with the metabolic syndrome had fewer years of education, significantly lower levels of eGFR and significantly higher prevalence rates of CKD. They also had higher mean level of hsCRP, and significantly higher levels of insulin resistance (Table 1). Fig 1 shows the most prevalent components of the metabolic syndrome, which were high blood pressure (n = 500, 81.2%) and elevated waist circumference (n = 276, 44.8%); and Fig 2 shows that most of these older individuals had at least 2 metabolic syndrome component risk factors present (n = 226, 32.7%). In total there were 151 (26.5%) participants defined as having CKD on the basis of eGFR. Participants classified as CKD had a significantly higher proportion of the metabolic syndrome than those without CKD (34.4% vs. 24.3%, p = .017). They were also on average significantly older (80.5 vs. 78.9, p = .004) and showed significantly higher HOMR-IR (8.29 vs. 5.42, p = .012) and higher mean hsCRP, although not significantly different from the no CKD group (4.04 vs. 3.39, p = 2.00). Table 2 shows the means and prevalence of individual metabolic syndrome components according to presence of CKD. Participants with CKD had significantly higher prevalence of elevated fasting glucose, elevated triglycerides and low HDL cholesterol than individuals without CKD.

Bottom Line: We defined CKD as eGFR below 60mL/min/1.73m2.The association was unaltered by adjustment for hsCRP but altered by adjustment for HOMA-IR.None of the individual components was independently associated with CKD.

View Article: PubMed Central - PubMed

Affiliation: 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.

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.

No MeSH data available.


Related in: MedlinePlus