Metabolic Syndrome, C-Reactive Protein, and Chronic Kidney Disease in Nondiabetic, Nonhypertensive Adults

Abstract

Metabolic syndrome has been suggested as a risk factor for chronic kidney disease (CKD). Inflammation is associated with both metabolic syndrome and CKD. We investigated inter-relationships between C-reactive protein (CRP), metabolic syndrome, and CKD among 9586 subjects without diabetes or hypertension. Metabolic syndrome was defined according to the criteria of the revised Adult Treatment Panel III. CKD was defined as a glomerular filtration rate <60 mL/min/1.73 m(2) or as albuminuria. A CRP cutpoint of 3 mg/L was used to differentiate high and low CRP groups. Chronic kidney disease was present in 6.2% of subjects without metabolic syndrome and in 13.1% of subjects with the syndrome (P < .001). In a multivariate model, high blood pressure (BP) (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.24-1.95), high fasting glucose (OR, 1.47; 95% CI, 1.19-1.81), abdominal obesity (OR, 1.52; 95% CI, 1.22-1.81), and high CRP (OR, 1.53; 95% CI, 1.18-1.98) were independently associated with prevalent CKD. Compared with low CRP/without metabolic syndrome, the multivariate-adjusted odds for CKD of high CRP/without metabolic syndrome and low CRP/with metabolic syndrome were 1.48 (95% CI, 1.10-2.0) and 1.90 (95% CI, 1.47-2.45), respectively. Subjects with high CRP and metabolic syndrome had a 3.26-fold greater odds of having CKD (95% CI, 2.00-5.31). Metabolic syndrome and high CRP were independently associated with increased prevalence of CKD. The odds of CKD increased in the setting of high CRP and metabolic syndrome.