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Pilz, S; Rutters, F; Nijpels, G; Stehouwer, CD; Højlund, K; Nolan, JJ; Balkau, B; Dekker, JM; RISC Investigators.
Insulin sensitivity and albuminuria: the RISC study.
Diabetes Care. 2014; 37(6):1597-1603
Doi: 10.2337/dc13-2573
[OPEN ACCESS]
Web of Science
PubMed
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- Führende Autor*innen der Med Uni Graz
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Pilz Stefan
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Accumulating evidence suggests an association between insulin sensitivity and albuminuria, which, even in the normal range, is a risk factor for cardiovascular diseases. We evaluated whether insulin sensitivity is associated with albuminuria in healthy subjects.
We investigated 1,415 healthy, nondiabetic participants (mean age 43.9 ± 8.3 years; 54.3% women) from the RISC (Relationship between Insulin Sensitivity and Cardiovascular Disease) study, of whom 852 participated in a follow-up examination after 3 years. At baseline, insulin sensitivity was assessed by hyperinsulinemic-euglycemic clamps, expressed as the M/I value. Oral glucose tolerance test-based insulin sensitivity (OGIS), homeostasis model assessment of insulin resistance (HOMA-IR), and urinary albumin-to-creatinine ratio (UACR) were determined at baseline and follow-up.
Microalbuminuria (UACR ≥30 mg/g) was present in fewer than 2% at either study visit. After multivariate adjustments, there was no cross-sectional association between UACR and any measure of insulin sensitivity. Neither OGIS nor HOMA-IR was significantly associated with follow-up UACR, but in a multivariate regression analysis, baseline M/I emerged as an independent predictor of UACR at follow-up (β-coefficient -0.14; P = 0.001).
In healthy middle-aged adults, reduced insulin sensitivity, assessed by hyperinsulinemic-euglycemic clamp, is continuously associated with a greater risk of increasing albuminuria. This finding suggests that reduced insulin sensitivity either is simply related to or might causally contribute to the initial pathogenesis of albuminuria.
© 2014 by the American Diabetes Association.
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Adult -
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Albuminuria - epidemiology
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Albuminuria - physiopathology
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Cardiovascular Diseases - epidemiology
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Creatinine - urine
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Cross-Sectional Studies -
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Cross-Sectional Studies - epidemiology
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Female -
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Follow-Up Studies -
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Glucose Clamp Technique -
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Glucose Tolerance Test -
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Humans -
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Hyperinsulinism - diagnosis
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Incidence -
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Insulin - metabolism
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Insulin Resistance -
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Insulin Secretion -
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Middle Aged -
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Multivariate Analysis -
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Prospective Studies -
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Risk Factors -