Landecho MF, Colina I, Huerta A, Fortuno A, Zalba G, Beloqui O. Relación entre las fases precoces de la enfermedad renal y el síndrome metabólico. Rev Esp Cardiol 2011 May;64(5):373-378.
Advanced kidney disease is a major health problem
due to its association with high cardiovascular morbidity and mortality. Early
recognition of advanced kidney disease is the mainstay to avoid its progression.
Since metabolic syndrome and insulin resistance are risk factors for both
cardiovascular and advanced kidney disease, we investigated the relationship of
early kidney disease (EKD) with metabolic syndrome and insulin resistance, and
their association with surrogate markers of arteriosclerosis. METHODS: We studied
1498 subjects. Insulin resistance was defined as HOMA >/=3.7 mmol (muU)/L(2) and
EKD as stages 1 and 2 of the NKF-KDOQI. Carotid intima-media thickness was used
as a surrogate marker of arteriosclerosis. RESULTS: The presence of one trait of
metabolic syndrome was associated with an odds ratio (OR) for EKD of 2.3 (95%
confidence interval [CI], 1.18-4.48) that increased to 6.72 (95% CI, 3.56-13.69)
in subjects with the syndrome. All the traits of the syndrome except low level of
high-density lipoproteins showed an increased OR for EKD. Increasing HOMA was
also directly correlated with higher OR for EKD, being as high as 3.89 (95% CI,
1.99-7.59) for subjects in the fourth quartile. Subjects with the syndrome plus
EKD showed an increased intima-media thickness compared with those without kidney
disease. CONCLUSIONS: Insulin resistance and all metabolic syndrome traits except
low level of high-density lipoproteins were significantly associated with an
increased OR for EKD. Both metabolic syndrome and EKD were independently and
additively related to the presence of surrogate markers of arteriosclerosis.