The relationship of metabolic syndrome and cardiovascular disease and mortality in maintenance hemodialysis patients

Abstract

Objective To investigate the potential contributing effects of metabolic syndrome (MS) on cardiovascular events and mortality in maintenance hemodialysis (MHD) patients. Methods According to the diagnostic criteria for MS set by Chinese Diabetes Society, 201 subjects undergoing MHD were assigned into MS group(n=78) or non-MS group(n=123), in August 2009. General and laboratory data were collected for cross-sectional analyses, and the participants were followed up for 36 months. Cardiovascular events, cause of death and time were recorded for longitudinal analyses. Results Prevalence of MS was 38.8%. Weight, waist circumference, triglyceride, total cholesterol, low density lipoprotein, fasting glucose level, uric acid and high-sensitivity C-reactive protein were significant higher in MS group compared to non-MS group, but duration of dialysis and high-density lipoprotein were lower (P<0.05). During the 36 months follow-up, cumulative incidence of cardiovascular events, cardiovascular and all-cause mortality were 41.0% (32/78), 19.2% (15/78), 28.2% (22/78), in MS group respectively. Those of non-MS group were 22.8% (28/123), 10.6% (13/123), 17.1% (21/123). There was significant difference between patients with and without MS in cumulative incidence of cardiovascular events (χ2=7.601, P=0.006). There was relationship between the number of metabolic syndrome parameters and cardiovascular events (r=0.236, P=0.001). Kaplan-Meier curves showed the relationship between two groups did not remained statistically significant in cardiovascular and all-cause mortality. Impaired glycometabolism in 5 parameters of MS was a cardiovascular mortality risk factor in MHD patients. Conclusions The prevalence of MS is high in MHD patients. MS is a risk factor of cardiovascular events, but it is not associated with cardiovascular and all-cause 3-year mortality in patients with MHD. Key words: Metabolic syndrome; Maintenance hemodialysis; Cardiovascular disease; Mortality