The dose response effect of insulin sensitivity on albuminuria in children according to diabetes type
Published Date:Jan 11 2016
Source:Pediatr Nephrol. 31(6):933-940.
Pubmed Central ID:PMC4841707
Funding:1U18DP002709/DP/NCCDPHP CDC HHS/United States
8 UL1 TR000077/TR/NCATS NIH HHS/United States
DP-05-069/DP/NCCDPHP CDC HHS/United States
DP-10-001/DP/NCCDPHP CDC HHS/United States
K23 DK093804/DK/NIDDK NIH HHS/United States
P30 DK57516/DK/NIDDK NIH HHS/United States
PA 00097/PHS HHS/United States
U01 DP000244/DP/NCCDPHP CDC HHS/United States
U01 DP000246/DP/NCCDPHP CDC HHS/United States
U01 DP000247/DP/NCCDPHP CDC HHS/United States
U01 DP000248/DP/NCCDPHP CDC HHS/United States
U01 DP000250/DP/NCCDPHP CDC HHS/United States
U01 DP000254/DP/NCCDPHP CDC HHS/United States
U18DP000247-06A1/DP/NCCDPHP CDC HHS/United States
U18DP002708/DP/NCCDPHP CDC HHS/United States
U18DP002710-01/DP/NCCDPHP CDC HHS/United States
U18DP002714/DP/NCCDPHP CDC HHS/United States
U48/CCU419249/PHS HHS/United States
U48/CCU519239/PHS HHS/United States
U48/CCU819241-3/PHS HHS/United States
U48/CCU919219/PHS HHS/United States
U58/CCU019235-4/PHS HHS/United States
UL1 TR000154/TR/NCATS NIH HHS/United States
UL1 TR00423/TR/NCATS NIH HHS/United States
UL1RR029882/RR/NCRR NIH HHS/United States
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.
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.
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).
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.
Supporting Files:No Additional Files
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