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The dose response effect of insulin sensitivity on albuminuria in children according to diabetes type
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Jan 11 2016
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Source: Pediatr Nephrol. 31(6):933-940.
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Alternative Title:Pediatr Nephrol
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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.
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Pubmed ID:26754041
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Pubmed Central ID:PMC4841707
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