Metabolic Syndrome in Chronic Kidney Disease: Prevalence and Risk-Factors Analyses

Abstract

Background: Metabolic syndrome (MS) has been recognised as a risk factor for chronic kidney disease (CKD). Methods: To determine the prevalence of (MS) and adequacy of the National Cholesterol Education Programme/ Adult Treatment Panel III (ATP III) criteria for the diagnosis of MS in Nigerians with CKD, 168 CKD outpatients, (men 86), aged ≥ 35 years recruited from the Nephrology Outpatient Clinics of the University of Nigeria Teaching Hospital, Enugu south-eastern Nigeria, were evaluated. In addition to waist circumference (WC) and blood pressure measurements, fasting plasma glucose and lipid profile were determined by standard laboratory methods. Results: MS prevalence of 40.5% was recorded with more men (46.5%), than women (34%) having the syndrome.  Sex-specific and significant differences were recorded in fasting plasma glucose (FPG) and serum triglycerides (TG) (p < 0.05) but not in waist circumference (WC) of the subjects. WC  cut-off point of  ≥ 93cm recorded higher sensitivity (61.3%), positive predictive value (61.3%) and odd ratio (5.4) than 41.2%, 56% and 2.5% respectively given by the ATP III cut-off point of >102cm. Fasting triglyceridaemia, hypertension and low high density lipoprotein-cholesterol (HDL-C) formed a cluster in majority of the subjects. Conclusions:  The prevalence of the MS in CKD was moderately high with the male patients recording higher values than the females. The ATP III criteria, especially the WC may need adjustments to make them suitable for the diagnosis of MS in Nigerians with CKD. Suggested criteria for MS diagnosis in the study population are as follows: excess WC ≥ 93cm for men and women; fasting hypertriglyceridaemia  ≥ 1.70mmol/l; raised blood pressure ≥ 130/85mmHg, low HDL-C (men ≤ 1.0mmol/l, women ≤ 1.3mmol/l) and FPG ≥ 5.6mmol/l.  More research is needed to fine-tune the diagnostic potentials of HDL-C and FPG for the CKD patients.