Do albuminuria and hs-CRP add to the International Diabetes Federation definition of the metabolic syndrome in predicting outcome?

Nephrol Dial Transplant. 2012 Jun;27(6):2275-83. doi: 10.1093/ndt/gfr634. Epub 2012 Jan 9.

Abstract

Background: To investigate the added value of elevated urinary albumin excretion (UAE) and high high-sensitive C-reactive protein (hs-CRP) in predicting new-onset type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD) and chronic kidney disease (CKD) in addition to the present metabolic syndrome (MetS) defining criteria.

Methods: The PREVEND Study is a prospective population-based cohort study in the Netherlands, including 8592 participants. The MetS was defined according to the 2004 International Diabetes Federation criteria, elevated UAE as albuminuria ≥ 30 mg/24 h and high hs-CRP as ≥ 3 mg/L.

Results: At follow-up, subjects without MetS when compared to subjects with MetS had a lower incidence of T2DM, CVD as well as CKD (2.5 versus 15.5; 4.1 versus 10.3 and 5.8 versus 11.2%, all P < 0.001). In subjects with MetS, the incidence of all three outcomes was higher among subjects with elevated albuminuria versus subjects with normoalbuminuria (all P < 0.01). The incidence of all outcomes was also higher among subjects with high hs-CRP versus subjects without elevated hs-CRP but only significant for CKD (P = 0.002). Multivariate analysis including elevated UAE, hs-CRP and the variables defining the MetS showed that elevated albuminuria was independently associated with the risk for new-onset T2DM, CVD and CKD, whereas high hs-CRP was only independently associated with new-onset CVD and CKD.

Conclusion: Our data show that elevated UAE has added value to the present MetS defining variables in predicting new-onset T2DM, CVD and CKD, whereas hs-CRP adds to predicting new-onset CVD and CKD, but not T2DM.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albuminuria / diagnosis*
  • Albuminuria / epidemiology
  • Albuminuria / etiology
  • Blood Pressure
  • C-Reactive Protein / metabolism*
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Creatinine / blood
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • International Agencies
  • Kidney Failure, Chronic / diagnosis*
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / etiology
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / metabolism*
  • Middle Aged
  • Netherlands / epidemiology
  • Prognosis
  • Prospective Studies
  • Risk Factors

Substances

  • C-Reactive Protein
  • Creatinine