Fig. 1Prevalence of metabolic syndrome and its components between reduced kidney function and preserved kidney function by estimated glomerular filtration rate (eGFR) based on creatinine (eGFRcr), cystatin C (eGFRcys), and combined creatinine-cystatin C (eGFRcr-cys). (A) Metabolic syndrome, (B) abdominal obesity, (C) hypertension, (D) high fasting glucose, (E) low high density lipoprotein (HDL), (F) high triglyceride, (G) high insulin resistance, and (H) hepatic steatosis. P value was calculated by chi-square test. aP<0.05 vs. eGFRcr <60 mL/min/1.73 m2; bP<0.05 vs. eGFRcys <60 mL/min/1.73 m2; cP<0.05 vs. eGFRcr-cys <60 mL/min/1.73 m2.
Table 1Clinical Characteristics of the Subjects
Variable |
Total |
Men |
Women |
P value |
Number |
3,154 |
1,871 |
1,283 |
|
Age, yr |
53.2±10.2 |
53.2±10.2 |
53.2±10.3 |
0.961 |
Waist circumference, cm |
85.0±9.2 |
88.4±7.6 |
79.9±8.9 |
<0.001 |
Body mass index, kg/m2
|
23.9±3.0 |
24.5±2.8 |
23.1±3.2 |
<0.001 |
Systolic blood pressure, mm Hg |
117.8±13.9 |
119.2±12.9 |
115.7±14.9 |
<0.001 |
Diastolic blood pressure, mm Hg |
77.4±10.4 |
79.5±10.1 |
74.4±10.2 |
<0.001 |
Fasting blood glucose, mg/dL |
98.3±22.5 |
101.2±24.6 |
93.9±18.3 |
<0.001 |
Insulin, μU/mL |
4.97±3.23 |
5.11±3.47 |
4.77±2.83 |
0.003 |
HOMA-IR |
1.24±1.00 |
1.31±1.09 |
1.14±0.84 |
<0.001 |
Total cholesterol, mg/dL |
210.3±38.6 |
209.7±38.9 |
211.2±38.1 |
0.303 |
LDL, mg/dL |
129.1±34.9 |
130.2±34.6 |
127.4±35.2 |
0.029 |
Triglyceride, mg/dL (median) |
129.1±94.4 (106.0) |
147.0±102.6 (121.0) |
104.6±74.1 (86.0) |
<0.001a
|
HDL, mg/dL |
55.1±13.7 |
51.6±12.3 |
60.1±14.2 |
<0.001 |
AST, IU/L |
28.1±10.9 |
30.0±11.7 |
25.2±9.1 |
<0.001 |
ALT, IU/L |
26.7±16.2 |
30.7±17.1 |
20.9±12.7 |
<0.001 |
GGT, IU/L (median) |
42.5±46.9 (28.0) |
55.2±53.3 (39.0) |
24.0±26.0 (18.0) |
<0.001a
|
BUN, mg/dL |
14.1±3.7 |
14.6±3.7 |
13.4±3.7 |
<0.001 |
Creatinine, mg/dL |
0.86±0.18 |
0.97±0.14 |
0.71±0.13 |
<0.001 |
Uric acid, mg/dL |
5.7±1.5 |
6.4±1.4 |
4.7±1.2 |
<0.001 |
hs-CRP, mg/dL (median) |
0.15±0.35 (0.06) |
0.17±0.35 (0.07) |
0.12±0.35 (0.05) |
<0.001a
|
Cystatin C, mg/L |
0.85±0.17 |
0.89±0.16 |
0.80±0.18 |
<0.001 |
Fatty liver index |
33.3±25.6 |
42.8±24.9 |
19.3±19.4 |
<0.001 |
eGFRcr, mL/min/1.73 m2
|
91.2±13.6 |
88.7±13.3 |
94.9±13.2 |
<0.001 |
eGFRcys, mL/min/1.73 m2
|
96.1±18.2 |
94.9±18.5 |
97.9±17.5 |
<0.001 |
eGFRcr-cys, mL/min/1.73 m2
|
94.5±15.4 |
92.5±15.0 |
97.5±15.5 |
<0.001 |
Metabolic syndrome, n (%) |
745 (23.6) |
503 (26.9) |
233 (18.2) |
<0.001b
|
Table 2The Prevalence of Reduced Kidney Function by eGFR Based on Creatinine, Cystatin C, and Combined Creatinine-Cystatin C
Parameter |
No. |
eGFRcr |
eGFRcys |
eGFRcr-cys |
P value |
Sex |
|
|
|
|
|
Men |
1,871 |
39 (2.1) |
66 (3.5) |
39 (2.1) |
0.005 |
Women |
1,283 |
16 (1.2) |
37 (2.9) |
21 (1.6) |
0.006 |
Age, yr |
|
|
|
|
|
20–39 |
349 |
1 (0.3) |
0 |
0 |
0.367 |
40–59 |
2,007 |
15 (0.7) |
26 (1.3) |
14 (0.7) |
0.087 |
≥60 |
798 |
39 (4.9) |
77 (9.6) |
46 (5.8) |
<0.001 |
Metabolic syndrome |
|
|
|
|
|
No |
2,409 |
36 (1.5) |
65 (2.7) |
38 (1.6) |
0.002 |
Yes |
745 |
19 (2.6) |
38 (5.2) |
22 (3.0) |
0.022 |
Abdominal obesity |
|
|
|
|
|
No |
1,711 |
20 (1.2) |
32 (1.9) |
33 (1.5) |
0.153 |
Yes |
1,443 |
35 (2.4) |
71 (4.9) |
27 (2.7) |
<0.001 |
Hypertension |
|
|
|
|
|
No |
2,162 |
31 (1.4) |
59 (2.7) |
33 (1.5) |
0.002 |
Yes |
992 |
24 (2.4) |
44 (4.4) |
27 (2.7) |
<0.001 |
High fasting glucose |
|
|
|
|
|
No |
2,169 |
34 (1.6) |
68 (3.1) |
40 (1.8) |
<0.001 |
Yes |
985 |
21 (2.1) |
35 (3.6) |
20 (2.0) |
0.057 |
High triglyceride |
|
|
|
|
|
No |
2,286 |
36 (1.6) |
67 (2.9) |
40 (1.8) |
0.002 |
Yes |
868 |
19 (2.2) |
36 (4.1) |
20 (2.0) |
0.023 |
Low HDL |
|
|
|
|
|
No |
2,589 |
46 (1.8) |
70 (2.7) |
42 (1.6) |
0.011 |
Yes |
565 |
9 (1.6) |
33 (5.8) |
18 (3.2) |
<0.001 |
High insulin resistance |
|
|
|
|
|
IR ≤75 percentile |
2,366 |
32 (1.4) |
62 (2.6) |
37 (1.6) |
0.002 |
IR >75 percentile |
788 |
23 (2.9) |
41 (5.2) |
23 (2.9) |
0.021 |
Hepatic steatosis |
|
|
|
|
|
FLI <30 |
1,693 |
21 (1.2) |
36 (2.1) |
20 (1.2) |
0.012 |
FLI ≥60 |
574 |
16 (2.8) |
28 (4.9) |
16 (2.8) |
0.083 |
Table 3ORs (95% CI) of Reduced Kidney Function by eGFR Based on Creatinine, Cystatin C, and Combined Creatinine-Cystatin C for the Prevalence of Metabolic Syndrome
eGFR |
Model 1a
|
Model 2b
|
Model 3c
|
OR (95% CI) |
P value |
OR (95% CI) |
P value |
OR (95% CI) |
P value |
eGFRcr ≥60 |
1 (reference) |
|
1 (reference) |
|
1 (reference) |
|
eGFRcr <60 |
1.75 (1.00–3.07) |
0.050 |
1.29 (0.72–2.29) |
0.380 |
1.03 (0.47–2.28) |
0.928 |
eGFRcys ≥60 |
1 (reference) |
|
1 (reference) |
|
1 (reference) |
|
eGFRcys <60 |
1.97 (1.30–2.96) |
0.001 |
1.47 (0.96–2.25) |
0.070 |
1.57 (0.92–2.67) |
0.094 |
eGFRcr-cys ≥60 |
1 (reference) |
|
1 (reference) |
|
1 (reference) |
|
eGFRcr-cys <60 |
1.93 (1.13–3.28) |
0.015 |
1.42 (0.82–2.45) |
0.203 |
1.42 (0.71–2.85) |
0.315 |