Metabolic Syndrome and Decreased Estimated Glomerular Filtration Rate in Relation to Muscle Mass

This study aimed to evaluate the association between decreased estimated glomerular filtration rate (eGFR <60 mL/min/1.73 m²) and metabolic syndrome (MetS) according to muscle mass.

Body composition was measured in 3351 men and 4394 women aged between 19 and 97 years using the 2010-2011 Korea National Health and Nutrition Examination Survey data using dual-energy X-ray absorptiometry and low and high muscle mass. Groups were identified using the mean sex-specific appendicular muscle mass/height². eGFR was computed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation; MetS was defined by the Harmonized definition and International Diabetes Federation criteria.

When stratified by muscle mass and adjusted for covariates, MetS was not associated with decreased eGFR in men with high muscle mass, but was associated in men with low muscle mass (odds ratio 3.19-3.87). MetS was associated with decreased eGFR in women with high (odds ratio 2.41-2.68) and low (odds ratio 2.45-2.55) muscle mass. Men with MetS and low muscle mass, women with MetS and high muscle mass, and women with MetS and low muscle mass had 2.95-3.21, 2.23-2.59, and 2.75-2.76 times higher odds for decreased eGFR, respectively, compared with their MetS-free and high muscle mass counterparts, after adjusting for covariates. The odds ratio was not significant for men with high muscle mass and MetS.

MetS was associated with decreased eGFR in women, regardless of muscle mass, and in men with low muscle mass. High muscle mass in men may attenuate the association.