Renal function and metabolic syndrome components on cardiovascular and all-cause mortality
Kuo-Liong Chien1, Hsiu-Ching Hsu, Yuan-Teh Lee
1Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. klchien@ha.mc.ntu.edu.tw
Insights
Impaired renal function and metabolic syndrome significantly increase the risk of cardiovascular disease (CVD) and all-cause death in Chinese adults. Early detection and management are crucial for preventing adverse outcomes.
Area of Science:
- Cardiovascular epidemiology
- Renal function assessment
- Metabolic syndrome research
Background:
- Cardiovascular disease (CVD) poses a significant global health burden.
- Metabolic syndrome and impaired renal function are independently linked to increased CVD risk.
- The combined impact of these conditions on CVD and mortality in ethnic Chinese populations requires further investigation.
Purpose of the Study:
- To investigate the independent and combined roles of impaired renal function and metabolic syndrome in predicting cardiovascular disease (CVD) and all-cause mortality.
- To assess the predictive value of specific renal function markers, including serum creatinine and estimated glomerular filtration rate (GFR), for CVD outcomes.
- To analyze these associations within a large cohort of the ethnic Chinese population.
Main Methods:
- A prospective cohort study involving 11,429 men and 7,472 women aged 20 years and older.
- Participants were followed for an average of 4.9 years from a tertiary hospital health check-up population.
- Statistical analyses included multivariate adjusted models and Receiver Operating Characteristic (ROC) curve analysis to evaluate risk predictors.
Main Results:
- Metabolic syndrome was a significant predictor of CVD death, with a relative risk up to 4.68.
- Impaired renal function markers, including serum creatinine and estimated GFR, were strongly associated with CVD death, with the highest relative risk observed for creatinine concentration (11.22).
- The combination of high creatinine and metabolic syndrome showed a markedly elevated multivariate relative risk of 30.6 for CVD death compared to individuals without these risk factors.
Conclusions:
- Both impaired renal function and metabolic syndrome are significant and independent risk factors for cardiovascular disease (CVD) and all-cause mortality in the ethnic Chinese population.
- Serum creatinine and estimated GFR demonstrate strong predictive capabilities for CVD death.
- The synergistic effect of impaired renal function and metabolic syndrome highlights their critical role in cardiovascular risk stratification and prevention strategies.
Objectives:
Impaired renal function and metabolic syndrome have been associated with risk of cardiovascular disease (CVD). We investigated their roles in CVD and all-cause death among ethnic Chinese population.
Methods:
We followed up a cohort of 11429 men and 7472 women aged 20 years and older for an average 4.9 years (median: 3.5, inter-quartile range: 2.7-7.9) from the tertiary hospital health check-up population.
Results:
CVD death rates increased when the quintiles of each variable progressed. Metabolic syndrome was a significant predictor for CVD death, with relative risk of up to 4.68. In the multivariate adjusted model that included metabolic syndrome, quintiles of serum creatinine concentrations, estimated glomerular filtration rate (GFR), and uric acids were significantly associated CVD death, with the highest relative risk of creatinine concentration (11.22, 95% confidence interval [CI]: 2.43-51.7, P for trend: <0.001). Serum creatinine concentrations and estimated GFR had the higher areas under ROC curves of CVD death (0.76, 95% CI: 0.71-0.80 for creatinine and 0.76, 95% CI: 0.72-0.81 for estimated GFR). The two marker models showed that metabolic syndrome and impaired renal function had the most significant roles in predicting CVD deaths; the multivariate relative risk was 30.6 (95% CI: 3.7-254, P: 0.002) in participants with the highest creatinine and presence of metabolic syndrome compared with those with the lowest and absence of metabolic syndrome.
Conclusions:
Impaired renal function and metabolic syndrome are important risk factors for CVD and all-cause deaths among ethnic Chinese.
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