Metabolic syndrome is associated with better nutritional status, but not with cardiovascular disease or all-cause mortality in patients on haemodialysis

• Published in: Archives of cardiovascular diseases 2012-04, Vol.105 (4), p.211-217
• Main Authors: Xie, Qian, Zhang, Ai-Hua, Chen, Shao-Yan, Lai, Xuan, Zhang, Feng, He, Lian, Zhuang, Zhen, Zhu, Ning, Fan, Min-Hua, Wang, Tao
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; All-cause mortality; Analysis of Variance; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - mortality; Cause of Death; Chi-Square Distribution; China - epidemiology; Emergency and intensive care: renal failure. Dialysis management; Facteurs de risque; Female; Humans; Hypoalbuminemia - mortality; Intensive care medicine; Internal Medicine; Kaplan-Meier Estimate; Maladie cardiovasculaire; Male; Malnutrition - diagnosis; Malnutrition - mortality; Medical sciences; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - diagnosis; Metabolic Syndrome - mortality; Middle Aged; Miscellaneous; Mortalité totale; Nutrition; Nutritional Status; Other metabolic disorders; Proportional Hazards Models; Prospective Studies; Renal Dialysis - mortality; Risk Assessment; Risk Factors; Syndrome métabolique; Time Factors
• ISSN: 1875-2136; 1875-2128
• DOI: 10.1016/j.acvd.2012.01.012

Summary Background Metabolic syndrome increases the risk of cardiovascular disease (CVD) and all-cause mortality in the general population. Aims To investigate whether metabolic syndrome affects CVD and all-cause mortality in chronic haemodialysis patients. Methods This prospective, observational cohort study was carried out at Peking university third hospital from June 2006 to June 2010. Baseline anthropometric and laboratory parameters were evaluated, and causes and times of mortality were documented. Nutritional status of the patients was assessed using subject global assessment (SGA) and serum albumin levels. Results Of 162 haemodialysis patients recruited, five were lost to follow-up, leaving 157 in the final cohort, who were followed for 36−42 months. Mean age was 62 ± 11 years and 55.4% were men. Forty-six patients (30%) had metabolic syndrome. In the metabolic syndrome versus the non-metabolic syndrome group, there were fewer patients with malnutrition (by SGA) (15.2% vs. 55.0%; P < 0.001), but there were no significant differences in CVD mortality (8.7% vs. 10.8%; P = 0.9) or all-cause mortality (15.2% vs. 22.5%; P = 0.39), nor in mean observed survival time (30.8 ± 7.3 vs. 29.8 ± 8.5 months; P = 0.49) or total survival time (67 ± 43 vs. 78 ± 48 months; P = 0.20). Cox regression analysis showed that independent mortality risk factors were pre-existing CVD, age more than or equal to 66 years and serum albumin less than 37 g/L (indicating malnutrition). Conclusion Metabolic syndrome was associated with a better nutritional status, but not with CVD or all-cause mortality in the haemodialysis patients in this prospective cohort study.