Association between metabolic syndrome and coronary heart disease in patients on hemodialysis

Background: The metabolic syndrome (MeS) is a common risk factor for coronary heart disease (CHD) in the general population.

Objectives: We examined the association between MeS and its risk in terms of CHD in patients on hemodialysis (HD).

Patients and methods: This study was conducted on 300 patients on HD in six HD centers during March 2012. Patients were divided in two groups regarding presence of MeS. The rate of CHD were evaluated in each group and compared with each other.

Results: A total of 300 patients on HD, 173 males and 127 females with mean age of 61.7 ± 14.2, were enrolled in the study. Prevalence of MeS was 50.3%; hypertension, 83.7%; diabetes mellitus, 52%; high triglyceride level, 34%, low HDL cholesterol, 48.3%; and abdominal obesity, 41.3%. During the study, the CHD was more frequent in patients with MeS (27.8%) than was in those without MeS (14.1%) (P = 0.004). In addition, stroke happened more frequently in the MeS group than in those without MeS (30.5% vs. 17.4%; P = 0.008). The mean number of criteria for MeS was not significantly associated with mortality causes (CHD, 2.7 ± 1.3; stroke, 2.8 ± 0.9; other causes, 2.9 ± 1.3 P = 0.78). However, hypertension (89.3%) and diabetes mellitus (53.8%) were associated with increased risk for mortality. In the group of MeS, CHD were not significantly associated with serum albumin, calcium, phosphate, blood urea nitrogen, creatinine, ferritin, C-reactive protein, and KT/V; but there was significant association with white blood cells count (P < 0.0002).

Conclusions: These findings suggested MeS might be an important risk factor for CHD, but not for mortality due to CHD in patients on HD.