Metabolic Syndrome and Risk of Chronic Kidney Disease in Us Adults

Chen, J.; Muntner, Paul; Hamm, L. Lee; Jones, Delyth; Batuman, Vecihi; Fonseca, V.; He, June

doi:10.1097/00004872-200402001-00207

Cited by 116 publications

(189 citation statements)

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“…In addition, it was reported that MS was a significant risk factor for the development of chronic kidney disease (CKD; Chen et al 2004, Kurella et al 2005, Tozawa et al 2007. It was also showed that adipocytes were capable of releasing numerous vasoactive factors, as well as other cells that present within fat tissues, leading to CKD and CVD in MS (Chu et al 2001, Yaturu et al 2007.…”

Section: Introductionmentioning

confidence: 99%

Inhibitory effects of adiponectin on platelet-derived growth factor-induced mesangial cell migration

Ishizawa

Dorjsuren²,

Izawa‐Ishizawa³

et al. 2009

Journal of Endocrinology

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Adiponectin, an adipocyte-derived hormone, has been involved in metabolic syndrome, a known risk factor for the development of chronic kidney disease (CKD). Recent studies have demonstrated that plasma adiponectin levels are elevated when kidney function declines in patients with CKD. Excessive mesangial cell (MC) turnover is one of the important features of CKD. The aim of the present study is to elucidate the effects of adiponectin on platelet-derived growth factor (PDGF)-induced cell migration and intracellular signaling pathways, in cultured rat MCs (RMCs). PDGF-induced RMC migration was significantly inhibited by the pretreatment of adiponectin. Adiponectin alone had no effect on RMC migration. Big mitogen-activated protein (MAP) kinase 1 (BMK1), p38 MAP kinase, and Akt were activated by PDGF stimulation in a time-and concentration-dependent manner in RMC. Adiponectin alone did not affect BMK1, p38 MAP kinase, and Akt phosphorylations in RMC. PDGF-induced BMK1 and p38 MAP kinase phosphorylations were significantly attenuated by the pretreatment of adiponectin in RMCs. On the other hand, the phosphorylation of Akt by PDGF was not diminished by the pretreatment of adiponectin. Adiponectin had no effects on PDGF-receptor autophosphorylation by PDGF. We also confirmed that PDGF-induced RMC migration was significantly suppressed by siBMK1 transfection or SB203580, a p38 MAP kinase inhibitor. From these findings, it is implied that the elevated plasma adiponectin levels in patients with CKD might play a compensatory role aimed at counteracting renal dysfunction related to MC disorders.

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Section: Introductionmentioning

confidence: 99%

Inhibitory effects of adiponectin on platelet-derived growth factor-induced mesangial cell migration

Ishizawa

Dorjsuren²,

Izawa‐Ishizawa³

et al. 2009

Journal of Endocrinology

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“…Sodium and uric acid retention are linked to insulin resistance (7)(8)(9), whereas a renal hyperhemodynamic state has been ascribed to obesity (10). Moreover, an association between MS and chronic kidney disease (CKD) was recently described; patients with increasing features of the MS had a greater incidence and prevalence of CKD (11,12).…”

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confidence: 99%

Low Urine pH

Maalouf

Cameron

Moe

et al. 2007

Clinical Journal of the American Society of Nephrology

252

180

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Background and Objectives: The metabolic syndrome is associated with alterations in renal function. An overly acidic urine has been described as a renal manifestation of the metabolic syndrome in patients with kidney stone disease. This study examined the association between the metabolic syndrome and urine pH in individuals without a history of nephrolithiasis.Design, Setting, Participants, & Measurements: A total of 148 adults who were free of kidney stones were evaluated in this outpatient cross-sectional study. Height, weight, BP, fasting blood, and 24-h urine chemistries were obtained. Urine pH was measured by pH electrode. The following features of the metabolic syndrome were evaluated: BP; body mass index; and serum triglyceride, glucose, and HDL cholesterol concentrations. The degree of insulin resistance was assessed by the homeostasis model assessment of insulin resistance.Results: Participants with the metabolic syndrome had a significantly lower 24-h urine pH compared with participants without the metabolic syndrome. Mean 24-h urine pH, adjusted for age, gender, creatinine clearance, and 24-h urine sulfate, decreased from 6.15, 6.10, 5.99, 5.85, to 5.69 with increasing number of metabolic syndrome abnormalities. An association was observed between 24-h urine pH and each metabolic feature. After adjustment for age, gender, creatinine clearance, urine sulfate, and body mass index, a significant inverse relationship was noted between 24-h urine pH and the degree of insulin resistance.Conclusions: An unduly acidic urine is a feature of the metabolic syndrome and is associated with the degree of insulin resistance.

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“…9,18,19,[22][23][24] Albuminuria is a marker of renal and systemic vascular damage 25 that is associated with hypertension, 26 dyslipidemia 27 and obesity. 28 We Figure 4 Hazard ratio of stroke for patients with type 2 diabetes in the multivariate model in six groups classified according to eGFR levels of X60 ml min À1 per 1.73 m 2 or less and the degree of albuminuria. The multivariate model included the aforementioned covariates (see legend for Figure 2), excluding the eGFR and the urinary albumin-to-creatinine ratio.…”

Section: Discussionmentioning

confidence: 99%

Is a reduced estimated glomerular filtration rate a risk factor for stroke in patients with type 2 diabetes?

et al. 2009

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Although chronic kidney disease is a risk factor for cardiovascular disease it is unclear whether diabetic patients with a reduced glomerular filtration rate (GFR), independent of (micro)albuminuria, carry an increased risk of stroke. We therefore investigated the independent effect of estimated GFR (eGFR) on stroke events in patients with type 2 diabetes mellitus (T2DM). We studied T2DM patients with an eGFR X15 ml min À1 per 1.73 m 2 , who had no history of stroke. Patients were divided into four categories by the eGFR at baseline for comparison: X90, 60-89, 30-59 and 15-29 ml min À1 per 1.73 m 2 . The end point was an incident stroke event. The Cox proportional hazard model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI). The study included a total of 1300 T2DM patients (546 women and 754 men) with a mean (±s.d.) age of 63 ± 13 years. During a mean follow-up period of 3.7 ± 1.4 years, 91 patients experienced an incident stroke event. Although a lower eGFR was associated with an increased stroke risk using a univariate model, statistical significance disappeared after adjusting for other risk factors including albuminuria. The HR (95% CI) was 0.75 (0.40-1.41, P¼0.373), 0.99 (0.50-1.95, P¼0.964) and 0.91 (0.36-2.28, P¼0.844) for patients with eGFRs of 60-89, 30-59 and 15-29 ml min À1 per 1.73 m 2 , respectively, compared with patients with an eGFR X90. Clinical albuminuria remained a significant risk factor for stroke, and the adjusted HR compared with normoalbuminuria was 2.40 (1.46-3.95, P¼0.001). In conclusion, the association between reduced GFR and stroke events in patients with T2DM is likely to be mediated by albuminuria.

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Metabolic Syndrome and Risk of Chronic Kidney Disease in Us Adults

Cited by 116 publications

References 0 publications

Inhibitory effects of adiponectin on platelet-derived growth factor-induced mesangial cell migration

Inhibitory effects of adiponectin on platelet-derived growth factor-induced mesangial cell migration

Low Urine pH

Is a reduced estimated glomerular filtration rate a risk factor for stroke in patients with type 2 diabetes?

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