Kidney injury molecule (KIM)-1 is associated with insulin resistance: Results from two community-based studies of elderly individuals
Kidney injury molecule (KIM)-1 is associated with insulin resistance: Results from two community-based studies of elderly individuals
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DOI：
10.1016/j.diabres.2013.12.008
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发表时间：
2014-03-01
影响因子：
5.1
通讯作者：
Arnlov, Johan
中科院分区：
文献类型：
--
作者：
Carlsson, Axel C.;Calamia, Michael;Arnlov, Johan
背景和目标：胰岛素抵抗已被证明与肾小球滤过率和尿白蛋白/肌酐比值密切相关，甚至在糖尿病发展之前。尿肾损伤分子1（KIM-1）是一种新的、高度特异性的肾小管损伤标志物。胰岛素抵抗在肾小管损伤发展中的作用以前没有报道。因此，我们旨在研究胰岛素敏感性与设计、设置、参与者和测量：研究了两个以社区为基础的老年人队列：乌普萨拉老年人血管系统的前瞻性研究（PIVUS，n = 701;平均年龄75岁，52%为女性）;和乌普萨拉成年男性纵向研究（ULSAM，n = 533;平均年龄78岁）。在校正年龄、BMI、血压、抗高血压治疗、肾小球滤过率和尿白蛋白-肌酐比值（PIVUS：1-SD高HOMA-IR的回归系数0.11，95% CI 0.03-0.20，p = 0.009，ULSAM：0.13，95% CI 0.04-0.22，p = 0.007）。结果是相似的个人没有糖尿病，肾功能正常，normo-albuminuria.Conclusions：我们的研究结果在老年人支持的概念，即糖代谢受损和肾小管损伤之间的相互作用是显而易见的，甚至在糖尿病和明显的肾脏疾病的发展。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Background and Objectives: Insulin resistance has been shown to be closely associated with glomerular filtration rate and urinary albumin/creatinine ratio, even prior to the development of diabetes. Urinary kidney injury molecule 1 (KIM-1) is a novel, highly specific marker of kidney tubular damage. The role of insulin resistance in the development of kidney tubular damage is not previously reported. Thus, we aimed to investigate the associations between insulin sensitivity (assessed by HOMA) and urinary KIM-1.Design, setting, participants and measurements: Two community-based cohorts of elderly individuals were investigated: Prospective Investigation of the vasculature in Uppsala seniors (PIVUS, n = 701; mean age 75 years, 52% women); and Uppsala Longitudinal Study of adult men (ULSAM, n = 533; mean age 78 years).Results: Lower insulin sensitivity was associated with higher urinary KIM-1 in both cohorts after adjustments for age, BMI, blood pressure, antihypertensive treatment, glomerular filtration rate, and urinary albumin-creatinine ratio (PIVUS: regression coefficient for 1-SD higher HOMA-IR 0.11, 95% CI 0.03-0.20, p = 0.009, and ULSAM: 0.13, 95% CI 0.04-0.22, p = 0.007). Results were similar in individuals without diabetes, with normal kidney function and normo-albuminuria.Conclusions: Our findings in elderly individuals support the notion that the interplay between an impaired glucose metabolism and renal tubular damage is evident even prior to the development of diabetes and overt kidney disease. (C) 2014 Elsevier Ireland Ltd. All rights reserved.