Impaired renal function and the metabolic syndrome are two independent cardiovascular disease (CVD) risk factors. Their relative contributions to CVD risk remain unknown. This prospective study by Chien et al. therefore sought to study renal function, estimated either by creatinine levels or glomerular filtration rate (GFR) as predictors of CVD. In this study conducted at the national Taiwan University Hospital, 11,429 men and 7,472 women were followed for an average of 4.9 years. During follow-up, 106 patients died from CVD as an underlying cause. Based on the c-statistic, the estimated GRF was the best CVD risk predictor (AUC=0.762), followed by creatinine quintiles (AUC=0.756), number of metabolic syndrome components (AUC=0.628), and uric acid quintiles (0.598). Participants with creatinine levels in the top quintile without the metabolic syndrome had a relative CVD death risk of 15.8, whereas participants who had both creatinine levels in the top quintile and the metabolic syndrome had a risk of 30.6. Results of the present study suggest that the metabolic syndrome and impaired renal function might have a joint effect on CVD risk.
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