Individual and Combined Components of Metabolic Syndrome with Chronic Kidney Disease in Individuals with Hypertension and/or Diabetes Mellitus Accompanied by Primary Health Care

Abstract

Luma de O Comini,1 Laura C de Oliveira,1 Luiza D Borges,1 Heloísa H Dias,1 Clara R S Batistelli,1 Luciana S da Silva,2 Tiago R Moreira,3 Rodrigo G da Silva,4 Rosângela M M Cotta1 1Department of Nutrition and Health, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil; 2Medicine School, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil; 3Department of Nursing and Medicine, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil; 4Clinical Director of the Hemodialysis Service, São João Batista Hospital, Viçosa, Minas Gerais, BrasilCorrespondence: Luma de O CominiDepartment of Nutrition and Health, Federal University of Viçosa, Viçosa, Annex Building of the Biological Sciences Center II, University Campus, s/nº. Sala 101. Federal University of Viçosa, Viçosa, MG CEP: 36570-900, BrazilTel [phone]Fax [phone]Email [email protected]: To identify the associations between MetS and its components and chronic kidney disease (CKD) in a population with arterial hypertension (AH), or diabetes mellitus (DM) accompanied by the Primary Health Care (PHC).Patients and methods: A cross-sectional study with 788 individuals diagnosed with AH and/or DM followed by PHC of Viçosa, Brazil. Anthropometric, biochemical and clinical measures were performed for the diagnosis of MetS and CKD. MetS was identified using the NCEP-ATPIII criteria. CKD was identified by estimating the glomerular filtration rate using the CKD-EPI equation. Logistic regression models were used to estimate the chances of CKD associated with MetS and its components and specific combinations of components.Results: The prevalence of MetS reported in the population was 65.4%, that of hidden CKD was 15.4%. The prevalence of CKD among participants with MetS was 75.2%. The most prevalent component of MetS in the population was AH (96.7%). Elevated fasting blood glucose, central obesity, and reduced HDL-c were significantly associated with an increased chance of CKD (OR = 2.80, 95% CI 1.76–4.45, OR = 1.68, 95% CI, 05–2.71, OR = 1.61, CI 95% 1.03–2.50, respectively). For the multivariate adjustment, the participants with MetS were 2 times more likely to have CKD than those without MetS (OR = 2.07; 95% CI, 1.25–3.44). The combination of three components of MetS high blood pressure, abdominal obesity and elevated fasting blood glucose and the combination of four components of MetS high blood pressure, reduced HDL-c, high fasting blood glucose and abdominal obesity were associated with increased odds of CKD (OR = 2.67, CI 95% 1.70–4.20, OR = 2.50, CI 95% 1.55–4.02, respectively).Conclusion: MetS, as well as its individual or combined components were independently associated with CKD in the population with AH and/or DM accompanied by PHC.Keywords: high blood pressure, abdominal obesity, hypertriglyceridemia, fasting blood glucose, HDL-c, estimated glomerular filtration rate

Keywords

• high blood pressure
• abdominal obesity
• hypertriglyceridemia
• fasting blood glucose
• hdl-c
• estimated glomerular filtration rate