Association between insulin resistance and development of microalbuminuria in type 2 diabetes: A prospective cohort study

Chih Cheng Hsu, Hsing Yi Chang, Meng Chuan Huang, Shang Jyh Hwang, Yi Ching Yang, Tong Yuan Tai, Hung Jen Yang, Chwen Tzuei Chang, Chih Jen Chang, Yu Sheng Li, Shyi Jang Shin, Ken N. Kuo

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Abstract

OBJECTIVE - An association between insulin resistance and microalbuminuria in type 2 diabetes has often been found in cross-sectional studies. We aimed to reassess this relationship in a prospective Taiwanese cohort of type 2 diabetic subjects. RESEARCH DESIGN AND METHODS - We enrolled 738 normoalbuminuric type 2 diabetic subjects, aged 56.6 ± 9.0 years, between 2003 and 2005 and followed them through the end of 2009. Average follow-up time was 5.2 ± 0.8 years. We used urine albumin-to-creatinine ratio to define microalbuminuria and the homeostasis model assessment of insulin resistance (HOMA-IR) to assess insulin resistance. The incidence rate ratio and Cox proportional hazards model were used to evaluate the association between HOMA-IR and development of microalbuminuria. RESULTS - We found incidences of microalbuminuria of 64.8, 83.5, 93.3, and 99.0 per 1,000 person-years for the lowest to highest quartiles of HOMA-IR. Compared with those in the lowest quartile of HOMA-IR, the incidence rate ratios for those in the 2nd, 3rd, and highest quartiles were 1.28 (95% CI 0.88-1.87), 1.44 (0.99-2.08), and 1.52 (1.06-2.20), respectively (trend test: P < 0.001). By comparison with those in the lowest quartile, the adjusted hazard ratios were 1.37 (0.93-2.02), 1.66 (1.12-2.47), and 1.76 (1.20-2.59) for those in the 2nd, 3rd, and highest HOMA-IR quartiles, respectively. CONCLUSIONS - According to the dose-response effects of HOMA-IR shown in this prospective study, we conclude that insulin resistance could significantly predict development of microalbuminuria in type 2 diabetic patients.

Original languageEnglish
Pages (from-to)982-987
Number of pages6
JournalDiabetes Care
Volume34
Issue number4
DOIs
Publication statusPublished - 2011 Apr 1

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

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    Hsu, C. C., Chang, H. Y., Huang, M. C., Hwang, S. J., Yang, Y. C., Tai, T. Y., Yang, H. J., Chang, C. T., Chang, C. J., Li, Y. S., Shin, S. J., & Kuo, K. N. (2011). Association between insulin resistance and development of microalbuminuria in type 2 diabetes: A prospective cohort study. Diabetes Care, 34(4), 982-987. https://doi.org/10.2337/dc10-1718