Association of relatives of hemodialysis patients with metabolic syndrome, albuminuria and Framingham Risk Score.

Jiun-Chi Huang,Szu-Chia Chen,Shang-Jyh Hwang,Jer-Chia Tsai,Ming-Yen Lin,Jer-Ming Chang,Hung-Chun Chen,Giuseppe Novelli

doi:10.1371/journal.pone.0096362

Abstract

Background and AimMetabolic syndrome (MetS), albuminuria, and the Framingham Risk Score (FRS) are significant predictors for cardiovascular disease (CVD). However, the relationship and clinical significance of these CVD predictors in individuals with a family history of end-stage renal disease (ESRD) are unclear. We investigated the association of relatives of hemodialysis (HD) patients with MetS, albuminuria, and the FRS.MethodsOne hundred and sixty-six relatives of HD patients and 374 age- and sex- matched community controls were enrolled. MetS was defined using the Adult Treatment Panel III for Asians. Albuminuria was defined as urine albumin-to-creatinine ratio ≥30 mg/g. CVD risk was evaluated by the FRS.ResultsA significantly higher prevalence of MetS (19.9% vs. 12.5%, P = 0.026), albuminuria (12.7% vs. 5.1%, P = 0.002) and high FRS risk ≥10% of 10-year risk (15.7% vs. 8.5%, P = 0.013) was found in relatives of HD patients compared to their counterpart controls. In multivariate analysis, being relatives of HD patients (vs. controls) was an independent determinant for MetS (odds ratio [OR], 1.785; 95% confidence interval [CI], 1.045 to 3.050), albuminuria (OR, 2.891; 95% CI, 1.431 to 5.841), and high FRS risk (OR, 1.863; 95% CI, 1.015 to 3.418). Higher low-density lipoprotein cholesterol (OR, 1.034; 95% CI, 1.017 to 1.052) and betel nut chewing (OR, 13.994; 95% CI, 3.384 to 57.871) were independent determinants for having a high FRS risk in relatives of HD patients.ConclusionsBeing relatives of HD patients was independently associated with MetS, albuminuria and high FRS risk, suggesting family members of ESRD patients may have higher CVD risks through the interactions of renal risk factors. Proactive surveillance of these CVD predictors and preventive strategies should be targeted to this high-risk population.

Highlights

Cardiovascular disease (CVD) has been recognized as the world’s major healthcare burden in recent decades, accounting for 17.3 million deaths in 2012 [1]
There were no differences in the prevalence of diabetes, history of betel nut chewing, waist circumference, fasting glucose, triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C), uric acid, or Estimated Glomerular Filtration Rate (eGFR) between these two groups
Values expressed as odds ratio (OR) and 95% confidence interval (CI)

Summary

Introduction

Cardiovascular disease (CVD) has been recognized as the world’s major healthcare burden in recent decades, accounting for 17.3 million deaths in 2012 [1]. CVD is multifactorial in origin, and the established risk factors for CVD include family history, older age, hypertension, diabetes mellitus (DM), smoking and dyslipidemia. Several markers have been identified in clinical settings as significant predictors for CVD. Metabolic syndrome (MetS), a clustering of central obesity, hypertension, fasting hyperglycemia, and dyslipidemia, has been considered as a risk factor for type 2 DM and CVD [4,5]. Albuminuria, MetS, and the FRS could function as strong predictors for CVD in the general population [3,4,8]. Metabolic syndrome (MetS), albuminuria, and the Framingham Risk Score (FRS) are significant predictors for cardiovascular disease (CVD). The relationship and clinical significance of these CVD predictors in individuals with a family history of end-stage renal disease (ESRD) are unclear. We investigated the association of relatives of hemodialysis (HD) patients with MetS, albuminuria, and the FRS

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