The association between the individual and combined components of metabolic syndrome and chronic kidney disease among African Americans: The Jackson Heart study

Abstract

Background

Recent studies estimate that approximately 26.3 million people in the United States have chronic kidney disease (CKD) and many more are at risk of developing the condition. The association between specific metabolic syndrome (MetS) components and CKD in African American individuals is uncertain.

Methods

Baseline data from 4,933 participants were analyzed. MetS was defined as the presence of three or more of the following components: elevated blood pressure, elevated fasting blood glucose, elevated triglycerides, low high-density lipoprotein cholesterol, and abdominal obesity. CKD was defined as a glomerular filtration rate of less than 60 mL/min1.73 m² or the presence of either albuminuria or dialysis. Decreased renal function was defined as an eGFR <60 mL/min1.73 m². Multiple logistic regression models were used to estimate the odds (95% CI) of CKD that were associated with individual components of MetS, MetS, the number of MetS components, specific combinations of MetS components, and decreased renal function; adjusted for covariates.

Results

Prevalence of MetS and CKD was 42.0% and 19.4% respectively. Elevated blood pressure (71.8%), abdominal obesity (65.8%), elevated fasting blood glucose (32.2%), and elevated triglycerides (16.2%) were significantly associated with increased odds of CKD. After multivariable adjustment, participants with MetS had a 2.22-fold (adjusted odds ratio, AOR, 2.22, 95% CI 1.78-2.78) increase in the odds of CKD compared to participants without MetS. Compared to participants with no components of MetS, those with one or more component had a significant increase in the odds CKD. In addition, MetS and its components were associated with decreased renal function. Of the ten combinations of three components present, the combination of elevated fasting blood glucose, elevated triglycerides and abdominal obesity was associated with the highest odds for CKD (AOR, 25.11, 95% CI 6.94-90.90). Of the five combinations of four MetS components present, the combination of elevated blood pressure, elevated triglycerides, elevated fasting blood glucose and abdominal obesity resulted in the highest odds for CKD (AOR, 27.06, 95% CI 7.21-101.60).

Conclusion

MetS, individual MetS components, the number of MetS components, and specific combinations of MetS components are independently associated with CKD. MetS and its individual components were significantly associated with decreased renal function.