[Cardiovascular risk factors and metabolic syndrome associated with subclinical renal failure]. / Factores de riesgo cardiovascular y síndrome metabólico asociados a la disfunción renal subclínica: subanálisis del Registro MESYAS.

BACKGROUND AND OBJECTIVE: The objectives of this study were to describe the prevalence of subclinical renal dysfunction, assessed by glomerular filtration rate (GFR), and identify the associated cardiovascular risk factors in active working subjects of Spain. SUBJECTS AND METHOD: Data were collected in 11,582 active healthy workers (78.5% males), mean age (standard deviation) 40.2 (10.7) years, in their annual health examinations. Renal function was assessed by the GFR estimated by 3 methods: the abbreviated equation of Modification of Diet in Renal Disease (MDRD) study, the Cockroft-Gault (CG) equation and the weight/creatinine ratio. The assessment of the metabolic syndrome was done according to the modified Adult Treatment Panel III criteria. RESULTS: The 3 equations used for the estimation of GFR showed different values. GFR mean values were highest with the CG method (99.0 [25.0]) ml/min/1.73 m2, followed by the results of the MDRD and weigh/creatinine ratio (90.2 [18.5] ml/min/1.73 m2 and 81.2 [18.3] ml/min/1.73 m2, respectively). The prevalence of mild renal dysfunction (GFR: 60-89 ml/min/1.73 m2) ranged between 35.7% and 50.8% depending on the method applied, and the presence of moderate-severe (GFR < 60 ml/min/1.73 m2) ranged between 1.2% and 2.6%. All cardiovascular risk factors were more prevalent in the categories of worst renal function. Multivariant regression analysis showed that hypertriglyceridemia (odds ratio [OR] = 1.2), metabolic syndrome (OR = 1.2), overweight (OR = 1.2) and hypercholesterolemia (OR = 1.5) were associated independently with mild renal dysfunction. Hypercholesterolemia (OR = 1.6), hypertension (OR = 1.6), low HDL (OR = 2.4), and diabetes mellitus (OR = 3.2) were associated with moderate-severe renal dysfunction. CONCLUSIONS: Renal subclinical dysfunction is highly prevalent and is independently associated with classical cardiovascular risk factors and metabolic syndrome.

Factores de riesgo cardiovascular y síndrome metabólico asociados a la disfunción renal subclínica: subanálisis del Registro MESYAS / Cardiovascular risk factors and metabolic syndrome associated with subclinical renal failure

Fundamento y objetivo: Describir la prevalencia de la disfunción renal subclínica, valorada mediante el filtrado glomerular (FG), e identificar a qué factores de riesgo cardiovascular se asocia en una población laboral activa española. Sujetos y método: Se recogieron los datos de 11.582 trabajadores activos (un 78,5% varones), con una edad media (desviación estándar) de 40,2 (10,7) años, mediante las revisiones anuales de las mutuas laborales. La función renal se clasificó según el FG, valorado mediante la fórmula abreviada del estudio Modification of Diet in Renal Disease (MDRD), la fórmula Cockroft-Gault (CG) y el cociente peso/creatinina. El diagnóstico del síndrome metabólico se realizó mediante los criterios del Adult Treatment Panel III modificados. Resultados: Las 3 fórmulas de estimación del FG aportan valores diferentes. Los valores medios de FG fueron mayores con la fórmula CG (99,0 [25,0]) ml/min/1,73 m2, seguidos de los obtenidos por la fórmula MDRD (90,2 [18,5]) ml/min/1,73 m2 y la fórmula peso/creatinina (81,2 [18,3]) ml/min/1,73 m2. La prevalencia de disfunción renal leve (FG: 60-89 ml/min/1,73 m2) varió entre el 35,7 y el 50,8% en función de la ecuación empleada, y moderada-grave (FG < 60 ml/min/1,73 m2) entre un 1,2 y un 2,6%. Todos los factores de riesgo cardiovascular fueron más prevalentes en las categorías de mayor disfunción renal. El análisis de regresión multivariante muestra que la hipertrigliceridemia (odds ratio [OR] = 1,2), el síndrome metabólico (OR = 1,2), el sobrepeso OR = 1,2) y la hipercolesterolemia (OR = 1,5) se asocian independientemente a la disfunción renal leve. La hipercolesterolemia (OR = 1,6), la hipertensión (OR = 1,6), una concentración baja de colesterol unido a lipoproteínas de alta densidad (OR = 2,4) y la diabetes mellitus (OR = 3,2) se asocian con la disfunción renal moderada-grave. Conclusiones: La disfunción renal subclínica es muy prevalente y se asocia independientemente a los factores de riesgo cardiovascular clásicos y el síndrome metabólico

Background and objective: The objectives of this study were to describe the prevalence of subclinical renal dysfunction, assessed by glomerular filtration rate (GFR), and identify the associated cardiovascular risk factors in active working subjects of Spain. Subjects and method: Data were collected in 11,582 active healthy workers (78.5% males), mean age (standard deviation) 40.2 (10.7) years, in their annual health examinations. Renal function was assessed by the GFR estimated by 3 methods: the abbreviated equation of Modification of Diet in Renal Disease (MDRD) study, the Cockroft-Gault (CG) equation and the weight/creatinine ratio. The assessment of the metabolic syndrome was done according to the modified Adult Treatment Panel III criteria. Results: The 3 equations used for the estimation of GFR showed different values. GFR mean values were highest with the CG method (99.0 [25.0]) ml/min/1.73 m2, followed by the results of the MDRD and weigh/creatinine ratio (90.2 [18.5] ml/min/1.73 m2 and 81.2 [18.3] ml/min/1.73 m2, respectively). The prevalence of mild renal dysfunction (GFR: 60-89 ml/min/1.73 m2) ranged between 35.7% and 50.8% depending on the method applied, and the presence of moderate-severe (GFR < 60 ml/min/1.73 m2) ranged between 1.2% and 2.6%. All cardiovascular risk factors were more prevalent in the categories of worst renal function. Multivariant regression analysis showed that hypertriglyceridemia (odds ratio [OR] = 1.2), metabolic syndrome (OR = 1.2), overweight (OR = 1.2) and hypercholesterolemia (OR = 1.5) were associated independently with mild renal dysfunction. Hypercholesterolemia (OR = 1.6), hypertension (OR = 1.6), low HDL (OR = 2.4), and diabetes mellitus (OR = 3.2) were associated with moderate-severe renal dysfunction. Conclusions: Renal subclinical dysfunction is highly prevalent and is independently associated with classical cardiovascular risk factors and metabolic syndrome