Association of the metabolic syndrome with mortality and major adverse cardiac events: A large chronic kidney disease cohort

作者：Lorenz M. Pammer, Claudia Lamina, Ulla T. Schultheiß, Fruzsina Kotsis, Barbara Kollerits, Helena Stockmann, Jan Lipovsek, Heike Meiselbach, Martin Busch, Kai‐Uwe Eckardt, Florian Kronenberg, for the GCKD Investigators · 发表于：Journal of Internal Medicine · 年份：2021 · DOI：10.1111/joim.13355 · 被引用次数：78 · 研究领域：Chronic Kidney Disease and Diabetes、Diabetes, Cardiovascular Risks, and Lipoproteins、Diabetes Treatment and Management

BACKGROUND: Metabolic syndrome with its key components insulin resistance, central obesity, dyslipidaemia, and hypertension is associated with a high risk for cardiovascular events and all-cause mortality in the general population. However, evidence that these findings apply to patients with chronic kidney disease (CKD) with moderately reduced estimated glomerular filtration rate and/or albuminuria is limited. OBJECTIVES: We aimed to investigate the association between metabolic syndrome and its components with all-cause mortality and cardiovascular outcomes in CKD patients. METHODS: Prospective observation of a cohort of 5110 CKD patients from the German Chronic Kidney Disease study with 3284 (64.3%) of them having a metabolic syndrome at baseline. RESULTS: During the follow-up of 6.5 years, 605 patients died and 650 patients experienced major cardiovascular events. After extended data adjustment, patients with a metabolic syndrome had a higher risk for all-cause mortality (hazard ratio [HR] = 1.26, 95% confidence interval [CI]: 1.04-1.54) and cardiovascular events (HR = 1.48, 95% CI: 1.22-1.79). The risk increased steadily with a growing number of metabolic syndrome components (increased waist circumference, glucose, triglycerides, hypertension and decreased HDL cholesterol): HR per component = 1.09 (95% CI: 1.02-1.17) for all-cause mortality and 1.23 (95% CI: 1.15-1.32) for cardiovascular events. This resulted in hazard ratios between 1.50 and 2.50 in the case when four or...