The Analysis On The Prevalence Of Metabolic Syndrome And Its Correlation With Chronic Kidney Disease In The Rural Areas Of Chongming

【Objective】We conducted a population-based cross-sectional study to observe the prevalence of metabolic syndrome(MS)and chronic kidney disease(CKD)in the rural areas of Chongming District.In the present study,we aimed to analyze the association of MS and CKD,and then provide new evidence for preventing the occurrence and development of CKD.【Methods】1.We selected volunteers who participated in the REACTION study using random cluster sampling method.7679 residents who were above 30 years old were selected,after removing 736 cases with incomplete data,a sample of 6943 residents were enrolled in this study finally.We required the information including gender,age,education level,smoking history and previous disease history through unified questionnaire.All the blood and urine samples were collected for biochemical indexes detection.Fatty liver was detected using ultrasonic examination.All the statistical analysis were conducted by SPSS 20.0.2.Different diagnostic criterias including 1999-WHO,2005-NCEP-ATPⅢ,2005-IDF and 2017-CDS were used to diagnose MS.We observed the prevalence of MS in Chongming,and compared the difference among four diagnostic methods.3.We explored the risk factors of estimated glomerular filtration rate(e GFR)and the ratio of urinary albumin to urinary creatinine(ACR)by multivariate logistic regression analysis.4.Through 3 years’ follow up data,the new incidence rate of nonalcoholic fatty liver disease(NAFLD)was collected.We also calculated the new incidence rate ofcardiovascular and cerebrovascular events in diabetic patients,and then analyzed the effects of different diabetes courses,cardiovascular and cerebrovascular events and NAFLD on e GFR.【Results】1.A total of 6943 residents were enrolled in the study including 2195 males(31.61%)and 4748 females(68.39%).According to the criteria of CDS in 2017,the prevalence of MS was 37.61%(2611),respectively 45.74%(1004)in man and 33.85%(1607)in women.According to the criteria of IDF,the prevalence of MS was 45.60%(3166),respectively 37.90%(832)in man and 49.16%(2334)in women.According to the criteria of NCEP-ATPⅢ,the prevalence of MS was 55.31%(3840),respectively52.67%(1156)in man and 56.53%(2684)in women.According to the criteria of WHO,the prevalence of MS was 33.96%(2351),respectively 36.95%(811)in man and 32.43%(1540)in women.2.The prevalence of CKD was 3.24%(225).The prevalence of albuminuria was10.56%(733).Grouped by 2017 CDS diagnostic criteria,the studied population was divided into MS group and non-MS gruop.The ACR,e GFR,age,smoking history,waist circumference,blood glucose,blood pressure,HDL-C and TG in the MS group were significantly higher than those in the non-MS group(P<0.05).3.According to diagnostic criteria of e GFR<60ml/min/1.73m2,there were 81patients(1.19%)with newly diagnosed as CKD after 3 years.The data showed that when diabetic duration less than 5 years,the annual decline rate of e GFR(2.15%)was lower than the normal glucose metabolism group(2.79%).when the diabetic duration between 5-10 years,the annual decline rate of e GFR(2.78%)maintained a similar level with the normal glucose metabolism group.There was a statistical significance between the annual decline rate of e GFR in the diabetic duration more than 10 years group and less than 5 years group(P<0.05).4.After 3 years,The new incidence of diabetes,nonalcoholic fatty liver disease and cardiovascular and cerebrovascular events in diabetic population were(10.7%),(34.70%)and(4.79%)respectively.The decline rate of e GFR indiabetic patients who had newly diagnostic cardiovascular and cerebrovascular events was higher than those without cardiovascular and cerebrovascular events,but there was no statistical significance.The annual decline rate of e GFR of the newly diagnostic NAFLD population was 2.95%,and the annual increase rate of creatinine was 3.08%,extremely higher than these of the non-fatty liver population(P<0.05).【Conclusions】1.Regardless of different diagnostic criteria of MS,the prevalence of MS in the rural in Chongming was high and significant positively correlated with age.2.ACR,e GFR,age,smoking history,waist circumference,blood glucose,blood pressure,HDL-C and TG in the MS group were significantly higher than those in the non-MS group.3.According to multivariate Logistic regression analysis,hypertension and high triglyceride are the risk factors of early renal function injury,while education level is a protective factor.4.In the early stage of diabetes,e GFR was slightly higher.However,with the diabetes duration progression,the e GFR gradually decreased.With the diabetic duration more than 10 years,the decline rate of e GFR was obviously accelerate.There is a close correlation between NAFLD and CKD.NAFLD accelerated the development of CKD.