Abstract
Elderly patients with type 2 diabetes (T2DM) are more prone to developing diabetic kidney disease (DKD). Patients with DKD can develop albuminuria, and some studies have suggested an association between metabolic syndrome and albuminuria. The prevalence of both metabolic syndrome and albuminuria increases with age. We evaluated the association of these risk factors with worsening renal function and albuminuria progression in 460 T2DM patients with a mean age of 72 years. During the 5-year follow-up period, progression of albuminuria and worsening of renal function were observed in 97 (21.2%) and 23 (5.1%) patients, respectively. After adjusting for confounding factors, the group with metabolic syndrome had a higher multivariable-adjusted hazard ratio (HR) for worsening renal function (P = 0.038) and albuminuria progression (P = 0.039) than the group without metabolic syndrome. When patients were divided into four groups according to the presence of metabolic syndrome and/or albuminuria, the HR gradually increased. The group with both albuminuria and metabolic syndrome exhibited the highest cumulative incidence of worsening renal function (P = 0.003). When we redefined metabolic syndrome to exclude the blood pressure (BP) component, similar results were obtained. We concluded that the presence of metabolic syndrome independently predicts the progression of renal disease in elderly patients with T2DM. The use of both metabolic syndrome and albuminuria provides a better risk stratification model for DKD progression than albuminuria alone.
Highlights
There were no significant differences in gender, smoking, fasting plasma glucose (FPG), total cholesterol (TC), LDL, diastolic blood pressure (DBP), glutamic pyruvic transaminase (GPT), lipid-lowering medication, and ACEI or ARB medications www.nature.com/scientificreports between the four groups
Multiple studies have reported that microalbuminuria is associated with a decline in renal function, ESRD, and adverse outcomes in CKD20–22
Microalbuminuria has been associated with perivascular disease and stroke[28,29]
Summary
Both microalbuminuria and metabolic syndrome were significantly associated with worsening renal function (Table 2, Model 1 and Model 2). Metabolic syndrome without the BP component could predict worsening renal function (HR 3.20; 95% CI 1.43–7.15; P = 0.005) but not albuminuria progression.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
