Metabolic Syndrome-Associated Risk Factors and High-Sensitivity C-Reactive Protein Independently Predict Arterial stiffness in 9903 Subjects With and Without Chronic Kidney Disease

Medicine (Baltimore). 2015 Sep;94(36):e1419. doi: 10.1097/MD.0000000000001419.

Abstract

Metabolic syndrome (MS), high-sensitivity C-reactive protein (hs-CRP), and chronic kidney disease (CKD) are related to cardiovascular diseases. Although MS is common in CKD subjects, the contribution of MS-associated risk factors and hs-CRP to arterial stiffness in CKD has not been well studied.In this cross-sectional cohort study, we enrolled 9903 subjects who underwent brachial-ankle pulse wave velocity (baPWV) measurements from our database of Health Care Center. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m. Comparing those grouped with and without CKD, multivariate linear regression analyses were used.Overall, baPWV was found to have an inverse relationship with eGFR (P for trend <0.001), which increased progressively with the presence of CKD, increasing number of MS-associated risk factors and hs-CRP (P for trend <0.001). In the non-CKD group, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, triglyceride, high-density lipoprotein cholesterol, and hs-CRP independently predicted baPWV, whereas in CKD, eGFR, age, gender, body mass index, SBP, DBP, and fasting glucose remained predictors.The number of MS-associated risk factors and hs-CRP remains a determinant of arterial stiffness in both CKD and non-CKD groups. The decline of renal function contributes to arterial stiffness only in CKD but not in non-CKD. Our findings suggest that for CKD subjects, renal function, BP, and glycemic control are potential targets for further interventional studies of arterial stiffness.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Ankle Brachial Index / methods
  • Blood Flow Velocity / physiology
  • Blood Pressure / physiology
  • C-Reactive Protein / analysis*
  • Cardiovascular Diseases* / blood
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / physiopathology
  • Cohort Studies
  • Cross-Sectional Studies
  • Disease Progression
  • Female
  • Glomerular Filtration Rate / physiology
  • Humans
  • Male
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Predictive Value of Tests
  • Prognosis
  • Renal Insufficiency, Chronic* / epidemiology
  • Renal Insufficiency, Chronic* / physiopathology
  • Risk Factors
  • Taiwan / epidemiology
  • Vascular Stiffness / physiology*

Substances

  • C-Reactive Protein