Metabolic Syndrome and Kidney Disease: A Systematic Review and Meta-analysis
Open accessAbstract
BACKGROUND AND OBJECTIVES: Observational studies have reported an association between metabolic syndrome (MetS) and microalbuminuria or proteinuria and chronic kidney disease (CKD) with varying risk estimates. We aimed to systematically review the association between MetS, its components, and development of microalbuminuria or proteinuria and CKD. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS AND POPULATION: We searched MEDLINE (1966 to October 2010), SCOPUS, and the Web of Science for prospective cohort confidence interval (CI) studies that reported the development of microalbuminuria or proteinuria and/or CKD in participants with MetS. Risk estimates for eGFR <60 ml/min per 1.73 m(2) were extracted from individual studies and pooled using a random effects model. The results for proteinuria outcomes were not pooled because of the small number of studies. RESULTS: Eleven studies (n = 30,146) were included. MetS was significantly associated with the development of eGFR <60 ml/min per 1.73 m(2) (odds ratio, 1.55; 95% CI, 1.34, 1.80). The strength of this association seemed to increase as the number of components of MetS increased (trend P value = 0.02). In patients with MetS, the odds ratios (95% CI) for development of eGFR <60 ml/min per 1.73 m(2) for individual components of MetS were: elevated blood pressure 1.61 (1.29, 2.01), elevated triglycerides 1.27 (1.11, 1.46), low HDL cholesterol 1.23 (1.12, 1.36), abdominal obesity 1.19 (1.05, 1.34), and impaired fasting glucose 1.14 (1.03, 1.26). Three studies reported an increased risk for development of microalbuminuria or overt proteinuria with MetS. CONCLUSIONS: MetS and its components are associated with the development of eGFR <60 ml/min per 1.73 m(2) and microalbuminuria or overt proteinuria.
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Longitudinal studies suggest that prediabetes is a risk factor for subsequent CKD, but it is unclear whether this prospective association is attributable to prediabetes itself, increased incidence of diabetes, or common causes.
“Longitudinal studies suggest that prediabetes is a risk factor for subsequent CKD but it is unclear whether this prospective association is attributable to the effects of prediabetes itself, increased incidence of diabetes, or common causes contributing to both hyperglycaemia and kidney pathology.59,60”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [60]
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139 · see citing works
Toprak, Ö., Kurt, H., Sarı, Y., Şarkış, C., Us, H., & Kırık, A. (2017) · Kidney & Blood Pressure Research · doi:10.1159/000468530 · Cited by 29,769 · see citing works
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944 · see citing works
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011 · see citing works
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667 · see citing works
Dermyshi, E., Wang, Y., Yan, C., Hong, W., Qiu, G., Gong, X., & Zhang, T. (2017) · Neonatology · doi:10.1159/000454668 · Cited by 24,577 · see citing works
Stroup, D. F. (2000) · JAMA · doi:10.1001/jama.283.15.2008 · Cited by 20,623 · see citing works
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C. (2009) · Circulation · doi:10.1161/circulationaha.109.192644 · Cited by 14,860 · see citing works
Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Circulation · doi:10.1161/circulationaha.105.169404 · Cited by 11,961 · see citing works
Prevalence and Trends in Obesity Among US Adults, 1999-2008
Flegal, K. M. (2010) · JAMA · doi:10.1001/jama.2009.2014 · Cited by 7,580 · see citing works
Eckel, R. H., Alberti, K., Grundy, S. M., & Zimmet, P. (2010) · The Lancet · doi:10.1016/s0140-6736(09)61794-3 · Cited by 6,283 · see citing works
Finucane, M. M., Stevens, G. A., Cowan, M. J., Danaei, G., Lin, J. K., Paciorek, C. J., Singh, G. M., Gutierrez, H. R., Lu, Y., Bahalim, A. N., et al. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62037-5 · Cited by 4,050 · see citing works
The Metabolic Syndrome and Cardiovascular Risk
Mottillo, S., Filion, K. B., Genest, J., Joseph, L., Pilote, L., Poirier, P., Rinfret, S., Schiffrin, E. L., & Eisenberg, M. J. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.05.034 · Cited by 3,009 · see citing works
Klahr, S., Levey, A. S., Beck, G. J., Caggiula, A. W., Hunsicker, L., Kusek, J. W., & Striker, G. (1994) · New England Journal of Medicine · doi:10.1056/nejm199403313301301 · Cited by 2,328 · see citing works
Metabolic Syndrome and Risk of Incident Cardiovascular Events and Death
Gami, A. S., Witt, B. J., Howard, D. E., Erwin, P. J., Gami, L. A., Somers, V. K., & Montori, V. M. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.09.032 · Cited by 1,888 · see citing works
Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., Gordon, D. J., Krauss, R. M., Savage, P. J., Smith, S. C., et al. (2005) · Cardiology in Review · doi:10.1097/01.crd.0000380842.14048.7e · Cited by 1,600 · see citing works
Evaluation of the Quality of Prognosis Studies in Systematic Reviews
Hayden, J. A., Côté, P., & Bombardier, C. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-144-6-200603210-00010 · Cited by 1,452 · see citing works
The Metabolic Syndrome and Chronic Kidney Disease in U.S. Adults
Chen, J., Muntner, P., Hamm, L. L., Jones, D. W., Batuman, V., Fonseca, V. A., Whelton, P. K., & He, J. (2004) · Annals of Internal Medicine · doi:10.7326/0003-4819-140-3-200402030-00007 · Cited by 1,354 · see citing works
Metabolic Syndrome and Risk of Cardiovascular Disease: A Meta-Analysis
Galassi, A., Reynolds, K., & He, J. (2006) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.02.031 · Cited by 1,205 · see citing works
Ervin, R. B. (2009) · PubMed · Cited by 1,003 · see citing works
Wisse, B. E. (2004) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000141966.69934.21 · Cited by 927 · see citing works
Tabák, A. G., Jokela, M., Akbaraly, T. N., Brunner, E. J., Kivimäki, M., & Witte, D. R. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60619-x · Cited by 898 · see citing works
Association between body-mass index and risk of death in more than 1 million Asians
Zheng, W., McLerran, D. F., Rolland, B., Zhang, X., Inoue, M., Matsuo, K., He, J., Gupta, P. C., Ramadas, K., Tsugane, S., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1010679 · Cited by 885 · see citing works
Tan, C. T., Ma, S., Wai, D. C. H., Chew, S. K., & Tai, E. S. (2004) · Diabetes Care · doi:10.2337/diacare.27.5.1182 · Cited by 824 · see citing works
Metabolic Syndrome and the Risk for Chronic Kidney Disease among Nondiabetic Adults
Kurella, M., Lo, J. C., & Chertow, G. M. (2005) · Journal of the American Society of Nephrology · doi:10.1681/asn.2005010106 · Cited by 709 · see citing works
Association between obesity and kidney disease: A systematic review and meta-analysis
Wang, Y., Chen, X., Song, Y., Caballero, B. H., & Cheskin, L. J. (2007) · Kidney International · doi:10.1038/sj.ki.5002586 · Cited by 682 · see citing works
Muntner, P., Coresh, J., Smith, J. C., Eckfeldt, J., & Klag, M. J. (2000) · Kidney International · doi:10.1046/j.1523-1755.2000.00165.x · Cited by 667 · see citing works
Weight Loss Interventions in Chronic Kidney Disease
Navaneethan, S. D., Yehnert, H., Moustarah, F., Schreiber, M. J., Schauer, P. R., & Beddhu, S. (2009) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.02250409 · Cited by 386 · see citing works
Self-citationA central body fat distribution is related to renal function impairment, even in lean subjects
Pinto‐Sietsma, S., Navis, G., Janssen, W. M. T., de Zeeuw, D., Gans, R. O. B., & de Jong, P. E. (2003) · American Journal of Kidney Diseases · doi:10.1016/s0272-6386(03)00020-9 · Cited by 358 · see citing works
Obesity-Initiated Metabolic Syndrome and the Kidney
Bagby, S. P. (2004) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000141965.28037.ee · Cited by 253 · see citing works
Metabolic syndrome and all-cause mortality: a meta-analysis of prospective cohort studies
Wu, S., Liu, Z., & Ho, S. C. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9459-z · Cited by 244 · see citing works
Insulin Resistance and Microalbuminuria
Parvanova, A. I., Trevisan, R., Iliev, I. P., Dimitrov, B. D., Vedovato, M., Tiengo, A., Remuzzi, G., & Ruggenenti, P. L. (2006) · Diabetes · doi:10.2337/db05-1484 · Cited by 190 · see citing works
Luk, A. O. Y., So, W., Ronald, C. W., Kong, A. P. S., Ozaki, R., Ng, V. S. W., Yu, L. W. L., Lau, W. W. Y., Yang, X., Chow, F. C. C., et al. (2008) · Diabetes Care · doi:10.2337/dc08-0971 · Cited by 182 · see citing works
Metabolic Syndrome and CKD in a General Japanese Population: The Hisayama Study
Ninomiya, T., Kiyohara, Y., Kubo, M., Yonemoto, K., Tanizaki, Y., Doi, Y., Hirakata, H., & Iida, M. (2006) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2006.06.003 · Cited by 181 · see citing works
Metabolic Syndrome and the Development of CKD in American Indians: The Strong Heart Study
Lucove, J. C., Vupputuri, S. X., HEISS, G. M., North, K. E., & Russell, M. (2008) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2007.09.014 · Cited by 148 · see citing works
Bonnet, F., Marre, M., Halimi, J., Stengel, B., Lange, C., Laville, M., Tichet, J., & Balkau, B. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000226206.03560.ac · Cited by 122 · see citing works
Metabolic Syndrome and Risk of Developing Chronic Kidney Disease in Japanese Adults
Tozawa, M., Iseki, C., Tokashiki, K., Chinen, S., Kohagura, K., Kinjo, K., Takishita, S., & Iseki, K. (2007) · Hypertension Research · doi:10.1291/hypres.30.937 · Cited by 121 · see citing works
Tozawa, M., Iseki, K., Iseki, C., Oshiro, S., Ikemiya, Y., & Takishita, S. (2002) · Kidney International · doi:10.1046/j.1523-1755.2002.00626.x · Cited by 115 · see citing works
The metabolic syndrome and chronic kidney disease in a Southeast Asian cohort.
Kitiyakara, C., Yamwong, S., Cheepudomwit, S., Domrongkitchaiporn, S., Unkurapinun, N., Pakpeankitvatana, V., & Sritara, P. (2007) · Kidney International · doi:10.1038/sj.ki.5002128 · Cited by 113 · see citing works
Cosmo, S. D., Minenna, A., Ludovico, O., Mastroianno, S., Giorgio, A. D., Pirro, L., & Trischitta, V. (2005) · Diabetes Care · doi:10.2337/diacare.28.4.910 · Cited by 102 · see citing works
Association between Metabolic Syndrome and Risk of Stroke: A Meta-Analysis of Cohort Studies
Li, W., Ma, D., Liu, M., Liu, H., Feng, S., Hao, Z., Wu, B., & Zhang, S. (2008) · Cerebrovascular Diseases · doi:10.1159/000131672 · Cited by 91 · see citing works
Wu, S., Liu, Z., & Ho, S. C. (2010) · European Journal of Epidemiology · doi:10.1007/s10654-010-9496-7 · Cited by 89 · see citing works
Ryu, S., Chang, Y., Woo, H., Lee, K., Kim, S., Kim, D., Kim, W. S., Suh, B.-S., Jeong, C., & Yoon, K. (2008) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2008.07.027 · Cited by 89 · see citing works
Association Between Insulin Resistance and Development of Microalbuminuria in Type 2 Diabetes
Hsu, C., Chang, H., Huang, M., Hwang, S.-J., Yang, Y., Tai, T., Yang, H.-J., Chang, C., Chang, C.-J., Li, Y., et al. (2011) · Diabetes Care · doi:10.2337/dc10-1718 · Cited by 86 · see citing works
Sun, F., Tao, Q.-S., & Zhan, S. (2010) · Nephrology · doi:10.1111/j.1440-1797.2009.01150.x · Cited by 82 · see citing works
Rashidi, A., Ghanbarian, A., & Azizi, F. (2007) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01020207 · Cited by 60 · see citing works
Watanabe, H., Obata, H., Watanabe, T., Sasaki, S., Nagai, K., & Aizawa, Y. (2009) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.1058 · Cited by 57 · see citing works
Hyperinsulinaemia, Insulin Resistance, Microalbuminuria and the Risk of Coronary Heart Disease
Yudkin, J. S. (1996) · Annals of Medicine · doi:10.3109/07853899608999104 · Cited by 43 · see citing works
The Metabolic Syndrome as a Risk Factor for Chronic Kidney Disease
Schelling, J. R., & Sedor, J. R. (2004) · Journal of the American Society of Nephrology · doi:10.1097/01.asn.0000141964.68839.bb · Cited by 42 · see citing works
Alberti (1998) · doi:10.1002/(sici)1096-9136(199807)15:7
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Prediabetes: a high-risk state for diabetes development
Tabák, A. G., Herder, C., Rathmann, W., Brunner, E. J., & Kivimäki, M. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60283-9 · Cited by 2,958 · see citing works
Cardiovascular-kidney-metabolic health: a presidential advisory from the American Heart Association
Ndumele, C. E., Rangaswami, J., Chow, S. L., Neeland, I. J., Tuttle, K. R., Khan, S. S., Coresh, J., Mathew, R. O., Baker-Smith, C. M., Carnethon, M. R., et al. (2023) · Circulation · doi:10.1161/cir.0000000000001184 · Cited by 2,208 · see citing works
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Byrne, C. D., & Targher, G. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.01.013 · Cited by 449 · see citing works
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Lin, L., Tan, W., Pan, X., Tian, E., Wu, Z., & Yang, J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.904001 · Cited by 139 · see citing works
Schwingshackl, L., & Hoffmann, G. (2014) · PLoS ONE · doi:10.1371/journal.pone.0097656 · Cited by 125 · see citing works
Bohula, E. A., Scirica, B. M., Inzucchi, S. E., McGuire, D. K., Keech, A. C., Smith, S. R., Kanevsky, E., Murphy, S. A., Leiter, L. A., Dwyer, J. P., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32328-6 · Cited by 94 · see citing works
Sohn, M., Kim, K., Uddin, M. J., Lee, G., Hwang, I., Kang, H., Kim, H., Lee, J. H., & Ha, H. (2017) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00596.2015 · Cited by 80 · see citing works
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- Authors
- Thomas, G., Sehgal, A. R., Kashyap, S. R., Srinivas, T. R., Kirwan, J. P., & Navaneethan, S. D.
- Affiliations
- Cleveland Clinic (US)
- MetroHealth Medical Center (US)
- Corresponding author
- Thomas, George
- Srinivas, Titte R.
- Navaneethan, Sankar D.
- ORCID
- Venue
- Clinical Journal of the American Society of Nephrology
- Published
- 2011-10
- Volume
- 6
- Issue
- 10
- Pages
- 2364-2373
- ISSN
- 1555-9041 (ISSN-L)
- PMC
- PMC3186450
- OpenAlex
- W2144383336
- Cited by
- 553
- References
- 51
- Citations by year
- 2026: 24 · 2025: 35 · 2024: 50 · 2023: 32 · 2022: 48 · 2021: 34 · 2020: 44 · 2019: 39 · 2018: 37 · 2017: 41 · 2016: 27 · 2015: 37 · 2014: 36 · 2013: 47 · 2012: 22
- FWCI
- 4.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Journal of the American Society of Nephrology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5kl2rr024990-05)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK089547)
- National Center for Research Resources (KL2-RR-024990, RR024990)
- National Institute on Minority Health and Health Disparities (P60MD002265)
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- metabolic syndrome, chronic kidney disease, microalbuminuria, proteinuria, estimated glomerular filtration rate, elevated blood pressure, hypertriglyceridemia, low HDL cholesterol, abdominal obesity, impaired fasting glucose, risk factors
- MeSH terms
- Adult, Aged, Albuminuria, Female, Glomerular Filtration Rate, Humans, Kidney Diseases, Male, Middle Aged, Prognosis, Proteinuria, Risk Factors, Chi-Square Distribution, Odds Ratio, Risk Assessment, Metabolic Syndrome
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