The dose response effect of insulin sensitivity on albuminuria in children according to diabetes type

Details

• Alternative Title:
  Pediatr Nephrol
• Personal Author:
  Mottl, Amy K ; Divers, Jasmin ; Dabelea, Dana ; Maahs, David M ; Dolan, Lawrence ; Pettitt, David ; Marcovina, Santica ; Imperatore, Giuseppina ; Pihoker, Catherine ; Mauer, Michael ; Mayer-Davis, Elizabeth J
• Description:
  Background
  
  Insulin resistance is associated with microalbuminuria among youth with diabetes mellitus. We sought to determine the dose-response effect of insulin sensitivity (IS) on the magnitude of albuminuria and whether there is a threshold below which urine albumin excretion increases.
  
  Methods
  
  These analyses included participants from the SEARCH for Diabetes in Youth Study with incident diabetes who completed a baseline study visit (N = 2988). We estimated IS using a validated equation incorporating waist circumference, HbA1C and fasting serum triglycerides. Multivariate regression analyses were performed to assess the effect of IS on urine albumin creatinine ratio (UACR), stratified by diabetes type. The IS threshold was then determined using segmented regressions within each diabetes type and incorporated into the multivariate model.
  
  Results
  
  There was an association between IS and UACR in type 2 diabetes only (beta = −0.39; p <0.001). There was strong statistical evidence for a threshold effect of IS score on UACR in the group of youth with type 2 (beta = 0.40; p <0.001) but not type 1 diabetes (p = 0.3).
  
  Conclusions
  
  In cross-sectional analyses, there is a negative association between IS and UACR in youth with type 2 but not type 1 diabetes, and this association likely includes a threshold effect of IS on UACR.
  
  
• Subjects:
  Adolescent Albuminuria Child Creatinine Cross-Sectional Studies Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetic Nephropathies Dose-Response Relationship, Drug Female Hemoglobin A, Glycosylated Humans Hypoglycemic Agents Insulin Insulin Resistance Kidney Function Tests Male Multivariate Analysis Triglycerides

  More +
• Source:
  Pediatr Nephrol. 31(6):933-940.
• Pubmed ID:
  26754041
• Pubmed Central ID:
  PMC4841707
• Document Type:
  Journal Article
• Funding:
  U18DP002708/DP/NCCDPHP CDC HHS/United States ; P30 DK057516/DK/NIDDK NIH HHS/United States ; 1U18DP002709/DP/NCCDPHP CDC HHS/United States ; U48/CCU819241-3/PHS HHS/United States ; U01 DP000247/DP/NCCDPHP CDC HHS/United States ; 8 UL1 TR000077/TR/NCATS NIH HHS/United States ; U18 DP002710/DP/NCCDPHP CDC HHS/United States ; U18DP002714/DP/NCCDPHP CDC HHS/United States ; DP-05-069/DP/NCCDPHP CDC HHS/United States ; U48/CCU419249/PHS HHS/United States ; UL1 TR000154/TR/NCATS NIH HHS/United States ; U18 DP002714/DP/NCCDPHP CDC HHS/United States ; U01 DP000248/DP/NCCDPHP CDC HHS/United States ; U48/CCU919219/PHS HHS/United States ; DP-10-001/DP/NCCDPHP CDC HHS/United States ; U01 DP000244/DP/NCCDPHP CDC HHS/United States ; P30 DK57516/DK/NIDDK NIH HHS/United States ; U18DP000247-06A1/DP/NCCDPHP CDC HHS/United States ; UL1 TR00423/TR/NCATS NIH HHS/United States ; K23 DK093804/DK/NIDDK NIH HHS/United States ; U48/CCU519239/PHS HHS/United States ; U18DP002710-01/DP/NCCDPHP CDC HHS/United States ; UL1 RR029882/RR/NCRR NIH HHS/United States ; PA 00097/PHS HHS/United States ; U58/CCU019235-4/PHS HHS/United States ; U18 DP002709/DP/NCCDPHP CDC HHS/United States ; UL1 TR001425/TR/NCATS NIH HHS/United States ; UL1 TR000077/TR/NCATS NIH HHS/United States ; UL1 TR000423/TR/NCATS NIH HHS/United States ; U01 DP000250/DP/NCCDPHP CDC HHS/United States ; U01 DP000246/DP/NCCDPHP CDC HHS/United States ; U01 DP000254/DP/NCCDPHP CDC HHS/United States ; U18 DP002708/DP/NCCDPHP CDC HHS/United States ; UL1RR029882/RR/NCRR NIH HHS/United States ; HIR 10-001/HX/HSRD VA/United States
• Volume:
  31
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:fe39b368935f0548ee86f9f056737c53718a98a23b8f31c00a1a3f35b300b421
• Download URL:
  https://stacks.cdc.gov/view/cdc/41075/cdc_41075_DS1.pdf
• File Type:
  [PDF - 281.64 KB ]