Both genes and environment are responsible for the link between metabolic syndrome and chronic kidney disease (CKD), according to new research published in the Clinical Journal of the American Society of Nephrology.

In a study of 4721 sets of Swedish twins born between 1911 and 1958 (44% male), 34% had metabolic syndrome and 20% CKD stage 3 or higher. Metabolic syndrome and CKD phenotypically correlated by a coefficient of 0.16, according to Xu Chen, MD, of the Institute for Maternal Fetal Medicine in China, and collaborators. Fifty-one percent of the correlation was explained by genes, 34% by nonshared (unique) environment, and 15% by common environment. Genetic and environmental correlations were also positive at 0.29 and 0.27, respectively.

Genetics particularly contributed to the correlation between abdominal obesity (ie, waist circumference exceeding 40 inches for men and 35 inches for women) and estimated glomerular filtration rate (eGFR) determined by cystatin C. This finding suggests “a central role for abdominal obesity in the link between metabolic syndrome and CKD.”

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“Our results indicate that the observed genetic contribution to the correlation between metabolic syndrome and eGFR-defined CKD in our study is compatible with a direct effect of metabolic syndrome on CKD,” Dr Chen’s team concluded.

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Chen X, Bhuiyan I, Kuja-Halkola R, et al. Genetic and environmental influences on the correlation between traits of metabolic syndrome and chronic kidney disease [published online September 10, 2019]. Clin J Am Soc Nephrol. doi:10.2215/011971018