Background
Methods
Study population
Clinical data collection and laboratory analyses
Definition of metabolic syndrome
Statistical analysis
Results
Baseline clinical characteristics of subjects according to the presence of metabolic syndrome
Total (N = 1754) | Subjects without MS (n = 636) | Subjects with MS (n = 1118) | P–value | |
---|---|---|---|---|
Age (years) | 54.9 ± 12.1 | 52.3 ± 12.8 | 56.3 ± 11.4 | < 0.001 |
Sex, male, n (%) | 1110 (63.3) | 387 (60.8) | 723 (64.7) | 0.111 |
SBP (mmHg) | 128.5 ± 17.0 | 124.9 ± 16.4 | 130.6 ± 17.0 | < 0.001 |
DBP (mmHg) | 76.0 ± 11.2 | 75.5 ± 10.9 | 76.5 ± 11.4 | 0.059 |
BMI (kg/m2) | 24.7 ± 3.4 | 22.9 ± 2.9 | 25.8 ± 3.2 | < 0.001 |
Waist circumference (cm) | 88.1 ± 9.8 | 81.4 ± 8.4 | 91.7 ± 8.5 | < 0.001 |
DM, n (%) | 700 (39.9) | 110 (17.3) | 590 (52.8) | < 0.001 |
Hypertension, n (%) | 1719 (98.0) | 606 (95.3) | 1113 (99.6) | < 0.001 |
Preexisting CV disease, n (%) | 298 (17.0) | 72 (11.3) | 226 (20.2) | < 0.001 |
CAD, n (%) | 110 (6.3) | 21 (3.3) | 89 (8.0) | < 0.001 |
PVD, n (%) | 76 (4.3) | 22 (3.5) | 54 (4.8) | 0.175 |
Cerebrovascular disease, n (%) | 110 (6.3) | 24 (3.8) | 86 (7.7) | 0.001 |
HF, n (%) | 28 (1.6) | 9 (1.4) | 19 (1.7) | 0.648 |
Arrhythmia, n (%) | 52 (3.0) | 19 (3.0) | 33 (3.0) | 0.966 |
Cause of CKD, n (%) | < 0.001 | |||
GN, n (%) | 746 (42.5) | 387 (60.8) | 359 (32.1) | |
Diabetic nephropathy, n (%) | 491 (28.0) | 72 (11.3) | 419 (37.5) | |
Hypertension, n (%) | 389 (22.2) | 142 (22.3) | 247 (22.1) | |
Others, n (%) | 128 (7.3) | 35 (5.5) | 93 (8.3) | |
Laboratory findings | ||||
eGFR (mL/min/1.73m2) | 49.1 ± 28.6 | 53.1 ± 29.6 | 46.8 ± 27.9 | < 0.001 |
Hemoglobin (g/dL) | 12.7 ± 2.1 | 12.8 ± 2.0 | 12.7 ± 2.1 | 0.798 |
Albumin (g/dL) | 4.1 ± 0.4 | 4.1 ± 0.4 | 4.1 ± 0.5 | 0.357 |
Uric acid (mg/dL) | 7.2 ± 1.9 | 7.1 ± 1.9 | 7.3 ± 1.9 | 0.025 |
Creatinine (mg/dL) | 1.9 ± 1.2 | 1.8 ± 1.1 | 2.0 ± 1.2 | 0.002 |
hsCRP, median, (IQR) (mg/dL) | 0.07 (0.03, 0.17) | 0.04 (0.02, 0.11) | 0.08 (0.03, 0.21) | 0.005 |
Fasting blood sugar (mg/dL) | 113.9 ± 42.7 | 100.4 ± 28.5 | 121.5 ± 47.2 | < 0.001 |
Total cholesterol (mg/dL) | 173.4 ± 40.4 | 173.5 ± 36.2 | 173.3 ± 42.5 | 0.917 |
Triglyceride (mg/dL) | 164.1 ± 103.1 | 106.3 ± 52.0 | 196.0 ± 110.2 | < 0.001 |
LDL cholesterol (mg/dL) | 95.0 ± 32.7 | 96.5 ± 30.1 | 95.7 ± 34.1 | 0.609 |
HDL cholesterol (mg/dL) | 48.2 ± 15.5 | 56.5 ± 15.0 | 43.7 ± 13.8 | < 0.001 |
Overt proteinuriaa, n (%) | 942 (61.0) | 319 (58.3) | 623 (62.5) | 0.108 |
Medication, n (%) | ||||
ACEi or ARB, n (%) | 1521 (86.9) | 526 (83.0) | 995 (89.1) | < 0.001 |
Diuretics, n (%) | 443 (25.3) | 99 (15.6) | 344 (25.3) | < 0.001 |
Statin, n (%) | 998 (56.9) | 323 (50.8) | 675 (60.4) | < 0.001 |
Ca-based P binders, n (%) | 161 (9.2) | 67 (10.5) | 94 (8.4) | 0.179 |
Clinical characteristics of subjects stratified by serum klotho level
Klotho groups | P–value | ||
---|---|---|---|
Lower than median (n = 877) (99–526 pg/mL) | Equal to or higher than median (n = 877) (527–2909 pg/mL) | ||
Age (years) | 55.3 ± 11.9 | 54.5 ± 12.3 | 0.152 |
Sex, male, n (%) | 556 (63.4) | 554 (63.2) | 0.921 |
SBP (mmHg) | 128.9 ± 16.7 | 128.2 ± 17.2 | 0.387 |
DBP (mmHg) | 76.3 ± 11.5 | 76.0 ± 10.9 | 0.568 |
BMI (kg/m2) | 24.9 ± 3.4 | 24.6 ± 3.4 | 0.060 |
Waist circumference (cm) | 88.4 ± 9.8 | 87.8 ± 9.8 | 0.203 |
DM, n (%) | 348 (39.7) | 352(40.1) | 0.845 |
Hypertension, n (%) | 866 (98.7) | 853 (97.3) | 0.026 |
Preexisting CV disease, n (%) | 144 (16.4) | 154 (17.6) | 0.525 |
CAD, n (%) | 46 (5.2) | 64 (7.3) | 0.076 |
PVD, n (%) | 40 (4.6) | 36 (4.1) | 0.639 |
Cerebrovascular disease, n (%) | 50 (5.7) | 60 (6.8) | 0.325 |
HF, n (%) | 11 (1.3) | 17 (1.9) | 0.253 |
Arrhythmia, n (%) | 23 (2.6) | 29 (3.3) | 0.398 |
Cause of CKD, n (%) | 0.012 | ||
GN, n (%) | 358 (40.8) | 388 (44.2) | |
Diabetic nephropathy, n (%) | 253 (28.8) | 238 (27.1) | |
Hypertension, n (%) | 214 (24.4) | 175 (20.0) | |
Others, n (%) | 52 (5.9) | 73 (8.7) | |
Laboratory findings | |||
eGFR (mL/min/1.73m2) | 44.9 ± 26.0 | 53.6 ± 30.6 | < 0.001 |
Hemoglobin (g/dL) | 12.5 ± 2.0 | 13.0 ± 2.1 | < 0.001 |
Albumin (g/dL) | 4.1 ± 0.4 | 4.1 ± 0.5 | 0.953 |
Uric acid (mg/dL) | 7.5 ± 1.9 | 7.0 ± 1.9 | < 0.001 |
Creatinine (mg/dL) | 2.0 ± 1.2 | 1.8 ± 1.1 | < 0.001 |
hsCRP, median, (IQR) (mg/dL) | 0.07 (0.03, 0.18) | 0.06 (0.02, 0.15) | 0.005 |
Fasting blood sugar (mg/dL) | 110.9 ± 34.9 | 117.0 ± 49.1 | 0.003 |
Total cholesterol (mg/dL) | 172.8 ± 39.7 | 174.0 ± 41.0 | 0.531 |
Triglyceride (mg/dL) | 168.6 ± 107.0 | 159.7 ± 98.9 | 0.072 |
LDL cholesterol (mg/dL) | 95.0 ± 32.3 | 97.0 ± 33.1 | 0.205 |
HDL cholesterol (mg/dL) | 47.9 ± 15.9 | 48.6 ± 15.1 | 0.356 |
Overt proteinuriaa, n (%) | 475 (61.3) | 467 (60.7) | 0.821 |
Klotho, median, (IQR) (pg/mL) | 418 (337, 475) | 656 (583, 774) | < 0.001 |
Medication, n (%) | |||
ACEi or ARB, n (%) | 773 (88.2) | 748 (85.5) | 0.088 |
Diuretics, n (%) | 342 (39.0) | 295 (33.6) | 0.058 |
Statin, n (%) | 514 (58.6) | 484 (55.2) | 0.309 |
Ca-based P binders, n (%) | 88 (10.0) | 73 (8.3) | 0.396 |
Metabolic syndrome, n (%) | 574 (65.5) | 544 (62.0) | 0.136 |
Associations of metabolic syndrome and each metabolic syndrome component with serum klotho
Variable | Model Aa | Model Bb |
---|---|---|
Adjusted OR (95% CI) | Adjusted OR (95% CI) | |
Log klotho | 0.44 (0.25–0.80)d | 0.44 (0.23–0.82)d |
Age (per year) | 1.03 (1.02–1.04)d | 1.03 (1.02–1.04)d |
Sex (male vs. female) | 1.15 (0.94–1.41) | 1.13 (0.91–1.40) |
eGFR (per mL/min/1.73m2) | 1.00 (0.99–1.00) | |
Overt proteinuriac | 1.26 (1.01–1.58)d |
Variable | Adjusted OR (95% CI) | ||||
---|---|---|---|---|---|
High blood pressure | High fasting glucose | Abdominal obesity | Hypertriglyceridemia | Low HDL-cholesterol | |
Log klotho | 0.05 (0.01–0.29) | 1.32 (0.70–2.51) | 0.68 (0.36–1.28) | 0.48 (0.27–0.87) | 0.71 (0.38–1.31) |
P-value | 0.001 | 0.389 | 0.235 | 0.016 | 0.271 |