Non-Insulin-Based Indices of Insulin Resistance for Predicting Incident Albuminuria: A Nationwide Population- Based Study
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Studies have shown that incident albuminuria is associated with insulin resistance (IR); however, an IR marker that best predicts the prevalence of albuminuria has not yet been established. This study explored the association between IR and incident albuminuria using various IR indices, including the homeostasis model assessment of IR (HOMA-IR), metabolic score for IR (METS-IR), and triglyceride-glucose (TyG) index, and compared their predictive abilities for the prevalence of albuminuria. Methods: A total of 4,982 Korean adults from the 2019 Korea National Health and Nutritional Examination Survey were analyzed. The odds of albuminuria were determined using the quartiles of the IR indices. Receiver operating characteristic (ROC) curves were used to calculate the area under the ROC curve and predictability. The cutoff values for albuminuria detection were also computed. Results: An increase in the quartiles of all three IR indices was associated with incident albuminuria, even after full adjustment for covariates (HOMA-IR: odds ratio [OR], 1.906; 95% confidence interval [CI], 1.311–2.772; P=0.006; METS-IR: OR, 2.236; 95% CI, 1.353–3.694; P=0.002; TyG index: OR, 1.757; 95% CI, 1.213–2.544; P=0.003). The area under the ROC curve for incident albuminuria based on the HOMA-IR, METS-IR, and TyG indices was 0.594 (95% CI, 0.568–0.619), 0.633 (95% CI, 0.607–0.659), and 0.631 (95% CI, 0.606–0.656), respectively. The optimal cutoff values for predicting albuminuria were 2.38, 35.38, and 8.72 for the HOMA-IR, METS-IR, and TyG indices, respectively. Conclusion: The METS-IR and TyG indices outperformed HOMA-IR in predicting incident albuminuria.
Abstract
Background: Studies have shown that incident albuminuria is associated with insulin resistance (IR); however, an IR marker that best predicts the prevalence of albuminuria has not yet been established. This study explored the association between IR and incident albuminuria using various IR indices, including the homeostasis model assessment of IR (HOMA-IR), metabolic score for IR (METS-IR), and triglyceride-glucose (TyG) index, and compared their predictive abilities for the prevalence of albuminuria. Methods: A total of 4,982 Korean adults from the 2019 Korea National Health and Nutritional Examination Survey were analyzed. The odds of albuminuria were determined using the quartiles of the IR indices. Receiver operating characteristic (ROC) curves were used to calculate the area under the ROC curve and predictability. The cutoff values for albuminuria detection were also computed. Results: An increase in the quartiles of all three IR indices was associated with incident albuminuria, even after full adjustment for covariates (HOMA-IR: odds ratio [OR], 1.906; 95% confidence interval [CI], 1.311–2.772; P=0.006; METS-IR: OR, 2.236; 95% CI, 1.353–3.694; P=0.002; TyG index: OR, 1.757; 95% CI, 1.213–2.544; P=0.003). The area under the ROC curve for incident albuminuria based on the HOMA-IR, METS-IR, and TyG indices was 0.594 (95% CI, 0.568–0.619), 0.633 (95% CI, 0.607–0.659), and 0.631 (95% CI, 0.606–0.656), respectively. The optimal cutoff values for predicting albuminuria were 2.38, 35.38, and 8.72 for the HOMA-IR, METS-IR, and TyG indices, respectively. Conclusion: The METS-IR and TyG indices outperformed HOMA-IR in predicting incident albuminuria.
참고문헌 (29)
- Carney EF, "The impact of chronic kidney disease on global health", Nat Rev Nephrol, 16, pp.251~ (2020)
- Stevens PE, "Evaluation and management of chronic kidney disease : synopsis of the kidney disease : improving global outcomes 2012 clinical practice guideline", Ann Intern Med, 158, pp.825~830 (2013)
- Wachtell K, "Albuminuria and cardiovascular risk in hypertensive patients with left ventricular hypertrophy : the LIFE study", Ann Intern Med, 139, pp.901~906 (2003)
- Tseng CH, "Differential dyslipidemia associated with albuminuria in type 2 diabetic patients in Taiwan", Clin Biochem, 42, pp.1019~1024 (2009)
- Pilz S, "Insulin sensitivity and albuminuria : the RISC study", Diabetes Care, 37, pp.1597~1603 (2014)
- Jang CM, "Insulin resistance is associated with the development of albuminuria in Korean subjects without diabetes", Endocrine, 48, pp.203~210 (2015)
- De Souza AL, "Assessment of insulin sensitivity by the hyperinsulinemic euglycemic clamp : comparison with the spectral analysis of photoplethysmography", J Diabetes Complications, 31, pp.128~133 (2017)
- Kang ES, "Limitation of the validity of the homeostasis model assessment as an index of insulin resistance in Korea", Metabolism, 54, pp.206~211 (2005)
- Bello-Chavolla OY, "METS-IR, a novel score to evaluate insulin sensitivity, is predictive of visceral adiposity and incident type 2 diabetes", Eur J Endocrinol, 178, pp.533~544 (2018)
- Simental-Mendia LE, "The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects", Metab Syndr Relat Disord, 6, pp.299~304 (2008)
- World Health Organization, "The Asia-Pacific perspective : redefining obesity and its treatment" (2000), World Health Organization
- Seliger SL, "Microvascular endothelial dysfunction is associated with albuminuria and CKD in older adults", BMC Nephrol, 17, pp.82~ (2016)
- Spoto B, "Insulin resistance in chronic kidney disease : a systematic review", Am J Physiol Renal Physiol, 311, pp.F1087~F1108 (2016)
- Tejada T, "Failure to phosphorylate AKT in podocytes from mice with early diabetic nephropathy promotes cell death", Kidney Int, 73, pp.1385~1393 (2008)
- Baron AD, "Role of blood flow in the regulation of muscle glucose uptake", Annu Rev Nutr, 17, pp.487~499 (1997)
- Hsu CC, "Association between insulin resistance and development of microalbuminuria in type 2 diabetes : a prospective cohort study", Diabetes Care, 34, pp.982~987 (2011)
- Lee SH, "Relationship between dyslipidemia and albuminuria in hypertensive adults: a nationwide population-based study", Medicine(Baltimore), 95, pp.e3224~ (2016)
- Tien KJ, "Triglycerides are independently associated with albuminuria in Taiwanese Type 2 diabetic patients", J Endocrinol Invest, 35, pp.800~803 (2012)
- Molitch ME, "Higher levels of HDL cholesterol are associated with a decreased likelihood of albuminuria in patients with long-standing type 1 diabetes", Diabetes Care, 29, pp.78~82 (2006)
- Sharma K, "The link between obesity and albuminuria : adiponectin and podocyte dysfunction", Kidney Int, 76, pp.145~148 (2009)
- Park HM, "The triglyceride-glucose index is a more powerful surrogate marker for predicting the prevalence and incidence of type 2 diabetes mellitus than the homeostatic model assessment of insulin resistance", Diabetes Res Clin Pract, 180, pp.109042~ (2021)
- Son DH, "Comparison of triglycerideglucose index and HOMA-IR for predicting prevalence and incidence of metabolic syndrome", Nutr Metab Cardiovasc Dis, 32, pp.596~604 (2022)
- Wang S, "Stronger association of triglyceride glucose index than the HOMA-IR with arterial stiffness in patients with type 2 diabetes : a real-world single-centre study", Cardiovasc Diabetol, 20, pp.82~ (2021)
- Cai XT, "Associations between the metabolic score for insulin resistance index and the risk of type 2 diabetes mellitus among non-obese adults : insights from a population-based cohort study", Int J Gen Med, 14, pp.7729~7740 (2021)
- Liu XZ, "METS-IR, a novel simple insulin resistance indexes, is associated with hypertension in normal-weight Chinese adults", J Clin Hypertens(Greenwich), 21, pp.1075~1081 (2019)
- Yoon J, "The metabolic score for insulin resistance(METS-IR)as a predictor of incident ischemic heart disease : a longitudinal study among Korean without diabetes", J Pers Med, 11, pp.742~ (2021)
- Gao W, "Discordance between the triglyceride glucose index and HOMA-IR in incident albuminuria : a cohort study from China", Lipids Health Dis, 20, pp.176~ (2021)
- Wang P, "Usefulness of metabolic score for insulin resistance index in estimating the risk of mildly reduced estimate glomerular filtration rate : a cross-sectional study of rural population in China", BMJ Open, 11, pp.e050907~ (2021)
- Su W, "Metabolic Score for Insulin Resistance, a novel score to evaluate insulin sensitivity, is associated with the urinary albumin-to-creatinine ratio in Chinese adults : a cross-sectional REACTION study", J Diabetes Investig, 13, pp.1222~1234 (2022)