Metabolic Syndrome and Socioeconomic Status in Association with Chronic Kidney Disease: A Cross-Sectional Study in Ningbo, China

Shichun Huang,1,2 Xuejie Yao,2 Xueqin Chen,2 Xiuli Chen,3 Yanxia Li,3 Yashpal Kanwar,4 Faith Ka Shun Chan,5 Ping Ye,2 Ming Zhan2,6 1School of Medicine, Ningbo University, Ningbo, 315211, People’s Republic of China; 2Department of Medicine, The First Affiliated Hospital, Ningbo University, Ningbo, 315000, People’s Republic of China; 3Department of Medicine, Ningbo Baiyun Community Healthcare Center, Ningbo, 315000, People’s Republic of China; 4Department of Pathology and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611, USA; 5School of Geographical Sciences, University of Nottingham Ningbo China, Ningbo, 315100, People’s Republic of China; 6China Health Institute, University of Nottingham Ningbo China, Ningbo, 315100, People’s Republic of ChinaCorrespondence: Ming Zhan, Department of Medicine, The First Affiliated Hospital, Ningbo University, 59 Liuting Street, Ningbo, Zhejiang Province, 315000, People’s Republic of China, Email [email protected]: Metabolic syndrome (MS) and low socioeconomic status (SES) may increase the risk for chronic kidney disease (CKD). This study aimed to investigate the prevalence of MS and CKD and the association between MS, SES, and CKD among adults in Ningbo, a city in Eastern China.Methods: A cross-sectional survey of 3212 adults was conducted between July 2019 and February 2021 in Ningbo. MS was defined as the presence of three or more risk factors: elevated blood pressure, reduced high-density lipoprotein (HDL) cholesterol, elevated triglycerides, elevated plasma glucose, and abdominal obesity. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or the occurrence of albuminuria. SES was stratified according to personal education and income levels. Multivariate logistic regression was used to analyze the relationships among MS, sociodemographic factors, and CKD.Results: The age- and sex-adjusted prevalence of CKD was 9.1% (95% CI: 8.3– 10.0), the prevalence of eGFR less than 60 mL/min/per 1· 73 m² was 2.5% (95% CI 2.0– 3.0) and that of albuminuria was 7.9% (95% CI 7.0– 8.7), and the adjusted prevalence of MS was 23.1% (95% CI 21.7– 24.4). MS components, including elevated blood pressure, elevated fasting glucose, abdominal obesity, elevated serum triglyceride, or reduced serum HDL-C, were independent risk factors for CKD, and the adjusted prevalence of CKD proportionally increased with the number of MS-defined parameters. Participants with MS had 2.43-fold increased odds of developing CKD compared with those without MS. In addition, age, female sex, low SES including low educational level and low income were associated with increased odds of occurrence of albuminuria and CKD.Conclusion: The prevalence of metabolic syndrome and chronic kidney disease is high among adults in Ningbo. Metabolic syndrome and low socioeconomic status are associated with the high risk of developing chronic kidney disease.Keywords: chronic kidney disease, metabolic syndrome, socioeconomic status, prevalence, risk factors