Risk Factors for Metabolic Syndrome Independently Predict Arterial Stiffness and Endothelial Dysfunction in Patients With Chronic Kidney Disease and Minimal Comorbidity
- Pajaree Lilitkarntakul, MD1,
- Neeraj Dhaun, MBCHB, PHD1,2,
- Vanessa Melville, BSC1,
- Debbie Kerr, BSC1,
- David J. Webb, MD, FRCP1 and
- Jane Goddard, MBCHB, PHD2⇓
- 1Clinical Pharmacology Unit, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, U.K.
- 2Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, U.K.
- Corresponding author: Jane Goddard, .
OBJECTIVE Metabolic syndrome (MS) is common in patients with chronic kidney disease (CKD), but its contribution to arterial stiffness and endothelial dysfunction in CKD is not well defined. We hypothesized that risk factors for MS would independently predict arterial stiffness and endothelial dysfunction in CKD patients.
RESEARCH DESIGN AND METHODS Risk factors for MS, carotid-femoral pulse wave velocity (CF-PWV) and flow-mediated dilation (FMD) as measures of arterial stiffness and endothelial dysfunction, respectively, were assessed in 113 minimally comorbid CKD patients and in 23 matched control subjects.
RESULTS CF-PWV correlated with systolic blood pressure (SBP), waist circumference, and plasma glucose (r2 = 0.25, 0.09, and 0.09; P < 0.01 for all). FMD correlated with SBP (r2 = 0.09; P < 0.01) and waist circumference (r2 = 0.03; P < 0.05). CF-PWV increased progressively (r2 = 0.07; P < 0.01) with increasing number of risk factors for MS. In multiple linear regression, SBP and waist circumference were independent determinants of CF-PWV, whereas only SBP predicted FMD.
CONCLUSIONS The number of MS risk factors is an important determinant of arterial stiffness in CKD patients irrespective of the degree of renal impairment. Although BP remains the major determinant of arterial stiffness and endothelial dysfunction, waist circumference independently predicts arterial stiffness. MS risk factors, particularly abdominal girth, are potential targets for future interventional studies in patients with CKD.
- Received December 2, 2011.
- Accepted March 14, 2012.
- © 2012 by the American Diabetes Association.
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