CARDIOMETABOLIC RISK FACTORS ASSOCIATED WITH RENAL FUNCTION IN APPARENTLY HEALTHY YOUNG STUDENTS: A CROSS-SECTIONAL STUDY.

BACKGROUND: Cardiometabolic risk factors (CMRFs) appear decades before developing chronic kidney disease (CKD) in adulthood. OBJECTIVE: The objective of the study was to identify the prevalence and association between CMRFs and kidney function in apparently healthy young adults (18-25 years old). METHODS: We included 5531 freshman year students. Data collected on CMRFs included central obesity, high body mass index (hBMI >25), blood pressure, glycemia, lipids, uric acid (UA >6.8 mg/dL), and insulin. Glomerular filtration rate (GFR) was estimated by CKD-Epidemiology Collaboration formula. We used logistic regression and a log linear for odds ratio (OR) (95% confidence level) and probabilities. RESULTS: The presence of any CMRF was observed in 78% (4312) of individuals; GFR ≥120/130 mL/min/1.73 m2sc was found in 33%, GFR <90 mL/min/1.73 m2sc in 3%, and proteinuria in 3%. Factors associated with high GFR were hBMI (OR 1.3 [1.14, 1.47]), UA (OR 0.2 [0.15, 0.26]), high-density lipoprotein (HDL) (OR 1.4 [1.2, 1.6]), and insulin resistance (OR 1.3 [1.05, 1.7]). CMRF associated with low GFR was UA (OR 1.8 [1.3, 2.6]), low-density lipoprotein cholesterol (OR 1.66 [1.05, 2.6]), and proteinuria (OR 3.4 [2.07, 5.7]). Proteinuria was associated with high UA (OR 1.59 [1.01, 2.5]) and hypercholesterolemia (OR 1.8 [1.03, 3.18]). The sole presence of hBMI+UA predicted low GFR with p = 0.6 and hBMI+UA+low HDL predicted proteinuria with p = 0.55. CONCLUSIONS: CMRFs were highly prevalent among this freshman student population and were associated with proteinuria and GFR abnormalities. Future studies should focus on public health programs to prevent or delay the development of CKD.

Clinical Significance of Serum Uric Acid Levels in Mexican Young Adults.

BACKGROUND: High serum uric acid concentration (SUA >6 for women [W] or 7 mg/dL for men [M]) in adults is an independent risk factor for causing cardiovascular disease and chronic kidney disease (CKD); the risk of high SUA in young population is still being debated. SUMMARY: We conducted an epidemiological study to determine the association between SUA quartiles with cardiometabolic risk factors (CRF) and renal impairment in apparently healthy young adults. CRF (dyslipidemia, overweight [Ow], obesity [Ob], blood pressure [BP], hyperglycemia, insulin resistance [IR]) and renal impairment were defined as glomerular filtration rate (GFR) by CKD-Epidemiology Collaboration formula >130/120, <90 mL/min/1.73 m2, and proteinuria were measured in 18- to 25-year-old students (total n = 5,531). Adjusted ORs by sex were calculated using logistic regression. RESULTS: The mean SUA was 4.5 ± 1.04 and 6.2 ± 1.2 mg/dL in W and M respectively. High SUA was found in 13.9% (n = 767); prevalence of Ow/Ob 69% (528 of 767), high BP 9% (67), hyperglycemia 15% (112), IR 47% (214), hypertriglyceridemia 35% (269), high LDL-c 16% (120), low HDL-c 52% (399), and metabolic syndrome 33% (249). Prevalence of high GFR was 13% (103), low GFR 8% (62) and proteinuria 5% (37). All risk factors showed a positive relationship with the SUA quartiles with high LDL-c with lowest risk (OR 1.7) and Ow/Ob with highest risk (OR 4.1), independent of sex. Key Messages: High SUA concentrations (M ≥6.2/W ≥4.5 mg/dL) are associated with CRF and renal impairment in young adults. It is necessary to reevaluate the cutoff points for UA in young adults.

Cardiometabolic risk factors associated with renal function in apparently healthy young students: a cross-sectional study

ABSTRACT Background: Cardiometabolic risk factors (CMRFs) appear decades before developing chronic kidney disease (CKD) in adulthood. Objective: The objective of the study was to identify the prevalence and association between CMRFs and kidney function in apparently healthy young adults (18-25 years old). Methods: We included 5531 freshman year students. Data collected on CMRFs included central obesity, high body mass index (hBMI >25), blood pressure, glycemia, lipids, uric acid (UA >6.8 mg/dL), and insulin. Glomerular filtration rate (GFR) was estimated by CKD-Epidemiology Collaboration formula. We used logistic regression and a log linear for odds ratio (OR) (95% confidence level) and probabilities. Results: The presence of any CMRF was observed in 78% (4312) of individuals; GFR ≥120/130 mL/min/1.73 m2sc was found in 33%, GFR <90 mL/min/1.73 m2sc in 3%, and proteinuria in 3%. Factors associated with high GFR were hBMI (OR 1.3 [1.14, 1.47]), UA (OR 0.2 [0.15, 0.26]), high-density lipoprotein (HDL) (OR 1.4 [1.2, 1.6]), and insulin resistance (OR 1.3 [1.05, 1.7]). CMRF associated with low GFR was UA (OR 1.8 [1.3, 2.6]), low-density lipoprotein cholesterol (OR 1.66 [1.05, 2.6]), and proteinuria (OR 3.4 [2.07, 5.7]). Proteinuria was associated with high UA (OR 1.59 [1.01, 2.5]) and hypercholesterolemia (OR 1.8 [1.03, 3.18]). The sole presence of hBMI+UA predicted low GFR with p = 0.6 and hBMI+UA+low HDL predicted proteinuria with p = 0.55. Conclusions: CMRFs were highly prevalent among this freshman student population and were associated with proteinuria and GFR abnormalities. Future studies should focus on public health programs to prevent or delay the development of CKD.