Abstract
PURPOSE: This study aimed to determine the relationship between the metabolic syndrome (MetS) and rapid estimated glomerular filtration rate (eGFR) decline in a Chinese community-based population. PATIENTS AND METHODS: A total of 3108 participants were recruited between December 2011 and July 2014 from an observational study cohort designed for the study of atherosclerotic diseases in Beijing, China. The outcome was a rapid eGFR decline. Subgroup and interaction analyses were performed with respect to a number of covariates. RESULTS: Over a median follow-up period of 2.34 (IQR: 2.29-2.41) years, the overall incidence of rapid eGFR decline was 7.24%. We found that the MetS was significantly associated with the risk of rapid eGFR decline (odds ratio [OR]=1.69, 95% confidence interval [CI]: 1.28-2.23, p<0.001) in a model adjusted for age, sex, and eGFR, and this relationship remained significant after adjustment for smoking, drinking, and low-density lipoprotein-cholesterol (OR=1.78, 95% CI: 1.34-2.35, p<0.001). Waist circumference (OR=1.38, 95% CI: 1.04-1.83, p=0.027), triglycerides (OR=1.40, 95% CI: 1.05-1.86, p=0.022), blood pressure (OR=2.05, 95% CI: 1.49-2.82, p<0.001), and fasting plasma glucose (OR=2.12, 95% CI: 1.57-2.85, p<0.001), but not high-density lipoprotein-cholesterol (OR=1.26, 95% CI: 0.94-1.69, p=0.117), were positively associated with the risk of rapid eGFR decline. Similarly, an increase in the number of MetS components present was associated with an increase in the risk of rapid eGFR decline. Furthermore, this association was modified by smoking status (OR=3.78, 95% CI: 1.68-8.49, p-interaction=0.030). CONCLUSION: The MetS independently predicted rapid eGFR decline in a Chinese community-based cohort recruited for the study of atherosclerosis. The relationship between the MetS and the risk of rapid eGFR decline was modified by smoking status.