Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose Tolerance

Background: Chronic kidney disease (CKD) is a significant public health problem. It is still controversial if the metabolic syndrome (MS) is associated with CKD. Methods: Cross-sectional study of individuals at high risk of developing diabetes at the endocrine outpatient clinic of Hospital de Clín...

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Main Authors: Alessandra Locatelli Smith, Barbara Gastal Borges Fortes, André Dias Américo, Vanessa Piccoli, Sheila Piccoli Garcia, Brunna Jaeger, Juliana Zampieri, Ennio Rocha, Alice Xavier, Gabriele Ghisleni, Luis Henrique Canani, Fernando Gerchman
Format: Article
Language:English
Published: Hospital de Clinicas de Porto Alegre ; Universidade Federal do Rio Grande do Sul (UFRGS) 2011-04-01
Series:Clinical and Biomedical Research
Subjects:
Online Access:https://seer.ufrgs.br/index.php/hcpa/article/view/18619
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author Alessandra Locatelli Smith
Barbara Gastal Borges Fortes
André Dias Américo
Vanessa Piccoli
Sheila Piccoli Garcia
Brunna Jaeger
Juliana Zampieri
Ennio Rocha
Alice Xavier
Gabriele Ghisleni
Luis Henrique Canani
Fernando Gerchman
author_facet Alessandra Locatelli Smith
Barbara Gastal Borges Fortes
André Dias Américo
Vanessa Piccoli
Sheila Piccoli Garcia
Brunna Jaeger
Juliana Zampieri
Ennio Rocha
Alice Xavier
Gabriele Ghisleni
Luis Henrique Canani
Fernando Gerchman
author_sort Alessandra Locatelli Smith
collection DOAJ
description Background: Chronic kidney disease (CKD) is a significant public health problem. It is still controversial if the metabolic syndrome (MS) is associated with CKD. Methods: Cross-sectional study of individuals at high risk of developing diabetes at the endocrine outpatient clinic of Hospital de Clínicas de Porto Alegre. Fasting and 2h-plasma glucose levels, A1c, insulin, cholesterol, triglycerides, creatinine, and urinary albumin excretion were measured. MS was defined as the presence of three out of five of the following factors: hypertension, low HDL-cholesterol, high triglyceride levels, elevated plasma glucose, and high waist circumference. Glomerular filtration rate (GFR) was estimated by the Modified Diet in Renal Disease (MDRD) equation and insulin resistance was measure using the Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR). Correlation analyses were performed between each MS components and the GFR. Results: CKD was present in 20.9% of the subjects. GFR was lower in subjects with MS compared with those without MS (p = 0.019). Estimated GFR decreased with the increasing number of MS criteria (mean ± SD; zero or one criterion 103.09 ± 9.5 vs. two criteria 99.14 ± 21.2 vs. three criteria 90.9 ± 21.1 vs. four criteria 91.0 ± 19.4 vs. five criteria 80.9 ± 23.5 mL/min per 1.73m2; p = 0.053). Only systolic arterial blood pressure was related to eGFR (r = 0.280; p = 0.003). Discussion: According to our data, the previously described association between MS and decreased renal function was confirmed, mostly determined by the hypertension criterion. Conclusion: These data suggest that the relationship between MS and CKD is driven mostly by abnormalities in blood pressure homeostasis.
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spelling doaj.art-5704cbdcb1904669884be2ad8774aff22022-12-22T03:41:46ZengHospital de Clinicas de Porto Alegre ; Universidade Federal do Rio Grande do Sul (UFRGS)Clinical and Biomedical Research2357-97302011-04-0130410989Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose ToleranceAlessandra Locatelli SmithBarbara Gastal Borges FortesAndré Dias AméricoVanessa PiccoliSheila Piccoli GarciaBrunna JaegerJuliana ZampieriEnnio RochaAlice XavierGabriele GhisleniLuis Henrique CananiFernando Gerchman Background: Chronic kidney disease (CKD) is a significant public health problem. It is still controversial if the metabolic syndrome (MS) is associated with CKD. Methods: Cross-sectional study of individuals at high risk of developing diabetes at the endocrine outpatient clinic of Hospital de Clínicas de Porto Alegre. Fasting and 2h-plasma glucose levels, A1c, insulin, cholesterol, triglycerides, creatinine, and urinary albumin excretion were measured. MS was defined as the presence of three out of five of the following factors: hypertension, low HDL-cholesterol, high triglyceride levels, elevated plasma glucose, and high waist circumference. Glomerular filtration rate (GFR) was estimated by the Modified Diet in Renal Disease (MDRD) equation and insulin resistance was measure using the Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR). Correlation analyses were performed between each MS components and the GFR. Results: CKD was present in 20.9% of the subjects. GFR was lower in subjects with MS compared with those without MS (p = 0.019). Estimated GFR decreased with the increasing number of MS criteria (mean ± SD; zero or one criterion 103.09 ± 9.5 vs. two criteria 99.14 ± 21.2 vs. three criteria 90.9 ± 21.1 vs. four criteria 91.0 ± 19.4 vs. five criteria 80.9 ± 23.5 mL/min per 1.73m2; p = 0.053). Only systolic arterial blood pressure was related to eGFR (r = 0.280; p = 0.003). Discussion: According to our data, the previously described association between MS and decreased renal function was confirmed, mostly determined by the hypertension criterion. Conclusion: These data suggest that the relationship between MS and CKD is driven mostly by abnormalities in blood pressure homeostasis. https://seer.ufrgs.br/index.php/hcpa/article/view/18619DiabetesMetabolyc SyndromeChronic Kidney Disease.
spellingShingle Alessandra Locatelli Smith
Barbara Gastal Borges Fortes
André Dias Américo
Vanessa Piccoli
Sheila Piccoli Garcia
Brunna Jaeger
Juliana Zampieri
Ennio Rocha
Alice Xavier
Gabriele Ghisleni
Luis Henrique Canani
Fernando Gerchman
Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose Tolerance
Clinical and Biomedical Research
Diabetes
Metabolyc Syndrome
Chronic Kidney Disease.
title Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose Tolerance
title_full Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose Tolerance
title_fullStr Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose Tolerance
title_full_unstemmed Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose Tolerance
title_short Hypertension is the Main Determinant Behind the Association Between Metabolic Syndrome and Chronic kidney Disease in Subjects with Different Degrees of Glucose Tolerance
title_sort hypertension is the main determinant behind the association between metabolic syndrome and chronic kidney disease in subjects with different degrees of glucose tolerance
topic Diabetes
Metabolyc Syndrome
Chronic Kidney Disease.
url https://seer.ufrgs.br/index.php/hcpa/article/view/18619
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