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

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    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
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    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
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    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
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