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Metabolic Syndrome and Risk of Developing Chronic Kidney Disease in Japanese Adults

Abstract

Metabolic syndrome is a risk factor for the development of cardiovascular disease. Few prospective studies, however, have examined metabolic syndrome as a risk factor for chronic kidney disease (CKD) in an Asian population. We studied the occurrence of CKD in 6,371 subjects without CKD or diabetes mellitus at baseline 1997 through 2002 in Okinawa, Japan. CKD was defined as dipstick-positive proteinuria (≥1+) or a low estimated glomerular filtration rate (<60 mL/min/1.73 m2). Metabolic syndrome was defined according to the modified criteria of the Adult Treatment Panel III in which body mass index (≥25 kg/m2) was substituted for the waist circumference measurement. Logistic analysis was used to analyze the effect of metabolic syndrome on the development of CKD. During the 5-year follow-up, 369 (5.7%) participants developed CKD. After adjusting for age, sex, current cigarette smoking and alcohol drinking habits at baseline, the relative risk of developing CKD was 1.86 (95% confidence interval: 1.43–2.41, p<0.0001) in subjects with metabolic syndrome. Compared with those without metabolic syndrome risk components, the adjusted relative risk (95% confidence interval) was 1.49 (1.10–2.01), 1.89 (1.38–2.59), and 2.65 (1.19–3.68) in those with 1, 2, or ≥3 metabolic syndrome risk components, respectively. Metabolic syndrome is a significant risk factor for the development of CKD in the Japanese population. Detection and treatment of metabolic syndrome should be stressed as a strategy to prevent CKD.

References

  1. Lakka HM, Laalsonen DE, Lakka TA, et al: The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709–2716.

    Article  Google Scholar 

  2. Takeuchi H, Saitoh S, Takagi S, et al: Metabolic syndrome and cardiac disease in Japanese men: applicability of the concept of metabolic syndrome defined by the National Cholesterol Education Program–Adult Treatment Panel III to Japanese men—the Tanno and Sobetsu Study. Hypertens Res 2005; 28: 203–208.

    Article  Google Scholar 

  3. Japanese Society for Dialysis Therapy : An overview of regular dialysis treatment in Japan: as of December 21, 2005. http://www.jsdt.or.jp

  4. Iseki K, Tozawa M, Iseki C, Takishita S, Ogawa Y : Demographic trends in the Okinawa Dialysis Study (OKIDS) registry (1971–2000). Kidney Int 2002; 61: 668–675.

    Article  Google Scholar 

  5. Usami T, Koyama K, Takeuchi O, Morozumi K, Kimura G : Regional variations in the incidence of end-stage renal failure in Japan. JAMA 2000; 284: 2622–2624.

    CAS  Article  Google Scholar 

  6. Tanaka H, Shimabukuro T, Shimabukuro M : High prevalence of metabolic syndrome among men in Okinawa. J Atheroscler Thromb 2005; 12: 284–288.

    Article  Google Scholar 

  7. Iseki K, Kohagura K, Sakima A, et al: Changes in the demographic and prevalence of chronic kidney disease in Okinawa, Japan (1993 to 2002). Hypertens Res 2007; 30: 55–62.

    CAS  Article  Google Scholar 

  8. Chen J, Muntner P, Hamm LL, et al: The metabolic syndrome and chronic kidney disease in U.S. adults. Ann Intern Med 2004; 140: 167–174.

    Article  Google Scholar 

  9. Tanaka H, Shiohira Y, Uezu Y, Higa A, Iseki K : Metabolic syndrome and chronic kidney disease in Okinawa, Japan. Kidney Int 2006; 69: 369–374.

    CAS  Article  Google Scholar 

  10. Kurella M, Lo JC, Chertow GM : Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults. J Am Soc Nephrol 2005; 16: 2134–2140.

    Article  Google Scholar 

  11. Mandavilli A, Cyranoski D : Asia's big problem. Nat Med 2004; 10: 325–327.

    CAS  Article  Google Scholar 

  12. Ninomiya T, Kiyohara Y, Kubo M, et al: Metabolic syndrome and CKD in a general Japanese population: the Hisayama Study. Am J Kidney Dis 2006; 48: 383–391.

    Article  Google Scholar 

  13. Tozawa M, Iseki K, Iseki C, Oshiro S, Ikemiya Y, Takishita S : Influence of smoking and obesity on the development of proteinuria. Kidney Int 2002; 62: 956–962.

    Article  Google Scholar 

  14. Tozawa M, Iseki K, Iseki C, Oshiro S, Ikemiya Y, Takishita S : Triglyceride, but not total cholesterol or low-density lipoprotein cholesterol levels, predict development of proteinuria. Kidney Int 2002; 62: 1743–1749.

    CAS  Article  Google Scholar 

  15. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults : Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285: 2486–2497.

  16. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D, Modification of Diet in Renal Disease Study Group: A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 1999; 130: 461–470.

    CAS  Article  Google Scholar 

  17. Kopple JD : National kidney foundation K/DOQI clinical practice guidelines for nutrition in chronic renal failure. Am J Kidney Dis 2001; 37 ( 1 Suppl 2): S66–S70.

    CAS  Article  Google Scholar 

  18. Petrie A, Sabin C : Medical Statistics at a Glance. Oxford, Blackwell Science, Ltd, 2000, pp 64–66.

    Google Scholar 

  19. Levey AS, Eckardt KU, Tsukamoto Y, et al: Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int 2005; 67: 2089–2100.

    Article  Google Scholar 

  20. Kramer H, Luke A, Bidani A, Cao G, Cooper R, McGee D : Obesity and prevalent and incident CKD: the Hypertension Detection and Follow-Up Program. Am J Kidney Dis 2005; 46: 587–594.

    Article  Google Scholar 

  21. Ejerblad E, Fored CM, Lindblad P, Fryzek J, McLaughlin JK, Nyren O : Obesity and risk for chronic renal failure. J Am Soc Nephrol 2006; 17: 1695–1702.

    CAS  Article  Google Scholar 

  22. Bonnet F, Deprele C, Sassolas A, et al: Excessive body weight as a new independent risk factor for clinical and pathological progression in primary IgA nephritis. Am J Kidney Dis 2001; 37: 720–727.

    CAS  Article  Google Scholar 

  23. Gelber RP, Kurth T, Kausz AT, et al: Association between body mass index and CKD in apparently healthy men. Am J Kidney Dis 2005; 46: 871–880.

    Article  Google Scholar 

  24. Hsu CY, McCulloch CE, Iribarren C, Darbinian J, Go AS : Body mass index and risk for end-stage renal disease. Ann Intern Med 2006; 144: 21–28.

    Article  Google Scholar 

  25. Ribstein J, du Cailar G, Mimran A : Combined renal effects of overweight and hypertension. Hypertension 1995; 26: 610–615.

    CAS  Article  Google Scholar 

  26. Kasiske BL, Crosson JT : Renal disease in patients with massive obesity. Arch Intern Med 1986; 146: 1105–1109.

    CAS  Article  Google Scholar 

  27. Henegar JR, Bigler SA, Henegar LK, Tyagi SC, Hall JE : Functional and structural changes in the kidney in the early stages of obesity. J Am Soc Nephrol 2001; 12: 1211–1217.

    CAS  PubMed  Google Scholar 

  28. Gu JW, Wang J, Stockton A, Lokitz B, Henegar L, Hall JE : Cytokine gene expression profiles in kidney medulla and cortex of obese hypertensive dogs. Kidney Int 2004; 66: 713–721.

    CAS  Article  Google Scholar 

  29. Muntner P, Coresh J, Smith JC, Eckfeldt J, Klag MJ : Plasma lipids and risk of developing renal dysfunction: the atherosclerosis risk in communities study. Kidney Int 2000: 58: 293–301.

    CAS  Article  Google Scholar 

  30. Keane WF, O'Donnell MP, Kasiske BL, Kim Y : Oxidative modification of low-density lipoproteins by mesangial cells. J Am Soc Nephrol 1993; 4: 187–194.

    CAS  PubMed  Google Scholar 

  31. Nishida Y, Yorioka N, Oda H, Yamakido M : Effect of lipoproteins on cultured human mesangial cells. Am J Kidney Dis 1997; 29: 919–930.

    CAS  Article  Google Scholar 

  32. Berfield AK, Andress DL, Abrass CK : IGF-1−induced lipid accumulation impairs mesangial cell migration and contractile function. Kidney Int 2002; 62: 1229–1237.

    CAS  Article  Google Scholar 

  33. Wang Z, Jiang T, Li J, et al: Regulation of renal lipid metabolism, lipid accumulation, and glomerulosclerosis in FVBdb/db mice with type 2 diabetes. Diabetes 2005; 54: 2328–2335.

    CAS  Article  Google Scholar 

  34. Klag MJ, Whelton PK, Randall BL, et al: Blood pressure and end-stage renal disease in men. N Engl J Med 1996; 334: 13–18.

    CAS  Article  Google Scholar 

  35. Tozawa M, Iseki K, Iseki C, Kinjo K, Ikemiya Y, Takishita S : Blood pressure predicts risk of developing end-stage renal disease in men and women. Hypertension 2003; 41: 1341–1345.

    CAS  Article  Google Scholar 

  36. Hsu CY, McCulloch CE, Darbinian J, Go AS, Iribarren C : Elevated blood pressure and risk of end-stage renal disease in subjects without baseline kidney disease. Arch Intern Med 2005; 165: 923–928.

    Article  Google Scholar 

  37. Segura J, Campo C, Gil P, et al: Development of chronic kidney disease and cardiovascular prognosis in essential hypertensive patients. J Am Soc Nephrol 2004; 15: 1616–1622.

    Article  Google Scholar 

  38. Nakai S, Wada A, Kitaoka T, et al: An overview of dialysis treatment in Japan (as of Dec. 31, 2004). J Jpn Soc Dial Ther 2006; 39: 1–22.

    Article  Google Scholar 

  39. Kuriyama S : Impact of overweight and obesity on medical care costs, all-cause mortality, and the risk of cancer in Japan. J Epidemiol 2006; 16: 139–144.

    Article  Google Scholar 

  40. Chen YM, Ho SC, Lam SS, Chan SS : Validity of body mass index and waist circumference in the classification of obesity as compared to percent body fat in Chinese middle-aged women. Int J Obes (Lond) 2006; 30: 918–925.

    Article  Google Scholar 

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Correspondence to Kunitoshi Iseki.

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Tozawa, M., Iseki, C., Tokashiki, K. et al. Metabolic Syndrome and Risk of Developing Chronic Kidney Disease in Japanese Adults. Hypertens Res 30, 937–943 (2007). https://doi.org/10.1291/hypres.30.937

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Keywords

  • obesity
  • triglyceride
  • high-density lipoprotein cholesterol
  • blood pressure
  • fasting glucose

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