Association between insulin resistance and development of microalbuminuria in type 2 diabetes: a prospective cohort study.
Association between insulin resistance and development of microalbuminuria in type 2 diabetes: a prospective cohort study.
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DOI：
10.2337/dc10-1718
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发表时间：
2011-04
期刊：
影响因子：
16.2
通讯作者：
Kuo KN
中科院分区：
文献类型：
--
作者：
Hsu CC;Chang HY;Huang MC;Hwang SJ;Yang YC;Tai TY;Yang HJ;Chang CT;Chang CJ;Li YS;Shin SJ;Kuo KN
在横断面研究中经常发现2型糖尿病患者胰岛素抵抗和微量白蛋白尿之间存在关联。我们的目的是在台湾2型糖尿病受试者的前瞻性队列中重新评估这种关系。我们在2003年至2005年期间招募了738名正常白蛋白尿的2型糖尿病受试者，年龄为56.6 ± 9.0岁，并随访至2009年底。平均随访时间为5.2 ± 0.8年。我们用尿白蛋白/肌酐比值来定义微量白蛋白尿，用胰岛素抵抗稳态模型评估（HOMA-IR）来评估胰岛素抵抗。采用发生率比值和考克斯比例风险模型评价HOMA-IR与微量白蛋白尿发生的关系。我们发现HOMA-IR最低至最高四分位数的微量白蛋白尿发生率分别为64.8、83.5、93.3和99.0/1000人年，与HOMA-IR最低四分位数相比，第2、3和最高四分位数的发生率比值为1.28（95% CI 0.88-1.87）、1.44（0.99-2.08）和1.52（1.06-2.20）（趋势检验：P < 0.001）。与最低四分位数的患者相比，第2、3和最高HOMA-IR四分位数的患者的校正风险比分别为1.37（0.93-2.02）、1.66（1.12-2.47）和1.76（1.20-2.59）。根据本研究中HOMA-IR的剂量反应效应，我们认为胰岛素抵抗可以显著预测2型糖尿病患者微量白蛋白尿的发生。
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. 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. 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. 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.
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影响因子：
16.2
作者：
Kramer H;Reboussin D;Bertoni AG;Marcovina S;Lipkin E;Greenway FL 3rd;Brancati FL;Look Ahead Research Group
通讯作者：
Look Ahead Research Group
影响因子：
5.1
作者：
Rachmani, R;Levi, Z;Ravid, M
通讯作者：
Ravid, M
影响因子：
--
作者：
COHEN, AJ;MCCARTHY, DM;STOFF, JS
通讯作者：
STOFF, JS
DOI：
10.1111/j.1365-2362.2007.01865.x
发表时间：
2007-10-01
影响因子：
5.5
作者：
Lin, C.-C.;Liu, C.-S.;Lin, W.-Y.
通讯作者：
Lin, W.-Y.
影响因子：
8.2
作者：
MATTHEWS, DR;HOSKER, JP;TURNER, RC
通讯作者：
TURNER, RC