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Estimated Glucose Disposal Rate in Assessment of Renal Function in Patients with Type 1 Diabetes

Utjecaj inzulinske rezistencije na parametre bubrežne funkcije u šećernoj bolesti tipa 1
Authors: Bulum, Tomislav; Duvnjak, Lea; Prkačin, Ingrid;

Estimated Glucose Disposal Rate in Assessment of Renal Function in Patients with Type 1 Diabetes

Abstract

Insulin resistance has been documented in type 1 diabetes and may contribute to the high risk for cardiovascular disease in this population and progression of nephropathy. We investigated associations of renal parameters, including urinary albumin excretion rate (UAE), serum creatinine and creatinine clearance, with surrogate measure of insulin sensitivity calculated using a formula derived from euglycemic-hyperinsulinemic clamp studies (estimated glucose disposal rate, eGDR). Study included 353 patients with type 1 diabetes, none showed signs of adrenal, thyroid, renal, or cardiovascular diseases. Insulin sensitivity was measured with eGDR calculated with the equation: 24.31-(12.22xWHR)-(3.29xHT)-(0.57xHbA1c). The units were mgkg(-1)min(-1); WHR=waist to hip ratio; HT=hypertension. Correlations and logistic regression analysis were performed to identify relationships between renal parameters and eGDR, individual components of insulin resistance and risk of insulin resistance. UAE and serum creatinine significantly correlated with insulin resistance measured by eGDR (r=-0.13, and -0.17, all p<0.05), and its components disorders, WHR and HbA1c. After stratifying patients in quartiles of eGDR, those in the upper quartile of the eGDR had significantly reduced levels of UAE and serum creatinine, compared to subjects in lowest quartile. In a logistic regression analysis risk for development of insulin resistance in our subjects were independently predicted only by UAE (odds ratio = 1.01, p<0.01). Our results provide evidence of associations between insulin resistance and its components disorders with renal parameters, such as UAE and serum creatinine. Insulin resistance, measured with eGDR, predicts the increment in UAE in subjects with type 1 diabetes. Since progression to microalbuminuria is likely to occur in majority of diabetic patients, there is a need to further explore the role of risk factors such as insulin resistance.

Country
Croatia
Keywords

Adult, Blood Glucose, Male, diabetes mellitus type 1, Diabetic Nephropathies/epidemiology, Adolescent, Young Adult, diabetes mellitus type 1; estimated glucose disposal rate; urinary albumin excretion; insulin resistance, Risk Factors, insulin resistance, Clinical Medical Sciences, Albuminuria/epidemiology, Diabetes Mellitus, Type 1/metabolism, Albuminuria, Humans, Diabetic Nephropathies, Biomedicine and Health Sciences, Albuminuria/metabolism, Aged, Blood Glucose/metabolism, Middle Aged, Diabetic Nephropathies/metabolism, Kliničke medicinske znanosti, Diabetes Mellitus, Type 1, Biomedicina i zdravstvo, Diabetes Mellitus, Type 1/epidemiology, urinary albumin excretion, Female, Insulin Resistance, estimated glucose disposal rate

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Average
Average
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