Associations of Metabolic Syndrome With Inflammation in CKD: Results From the Third National Health and Nutrition Examination Survey (NHANES III)

Abstract

Although metabolic syndrome is associated with inflammation in the general population, it is unknown whether similar associations exist in patients with chronic kidney disease. +7 cross-sectional associations of metabolic syndrome and its component conditions (diabetes, hypertension, hypertriglyceridemia, abdominal obesity, and low high-density lipoprotein cholesterol level) with inflammation (C-reactive protein level > 3 mg/L) were examined by using logistic regression models in groups with high (>90 mL/min/1.73 m2 [>1.50 mL/s]), moderate (45 to 89 mL/min/1.73 m2 [0.75 to 1.49 mL/s]), and low (<45 mL/min/1.73 m2 [<0.75 mL/s]) creatinine clearances in 15,314 subjects participating in the Third National Health and Nutrition Examination Survey. Adjusted for demographics, smoking, history of myocardial infarction or stroke, exercise level, and use of cholesterol medications, the presence of metabolic syndrome was associated with greater odds for inflammation in the groups with high (odds ratio, 2.55; 95% confidence interval [CI], 1.99 to 3.27), moderate (odds ratio, 2.17; 95% CI, 1.81 to 2.60), and low (odds ratio, 1.87; 95% CI, 1.36 to 2.56) creatinine clearances. When all 5 components of metabolic syndrome were included in the same model, only hypertension, abdominal obesity, and low high-density lipoprotein level were associated significantly with inflammation in all 3 groups. There also was a graded association between number of component conditions of metabolic syndrome and inflammation within each creatinine-clearance group. Metabolic syndrome is associated with inflammation in patients with varying levels of kidney function. Future studies are warranted to determine in patients with chronic kidney disease whether there is a synergistic effect of metabolic syndrome and inflammation on the incidence of atherosclerotic events and whether interventions targeted toward metabolic syndrome might modulate inflammation.