Research On Relationship Between Insulin Resistance And Urinary Albumin To Creatinine Ratio

Objective: Our study is exploring the correlation the relationship of insulin resistance and the urine albumin.Methods: Baseline date choice: A total of 10207 community residents 40-year-old or older who relying on the endocrine society of Chinese medical association launched RECATION research from August 16 th, 2011 to December 10 th, 2011. There were 10133 cases elected according to the selection and exclusion criteria. Follow-up data choice: in the baseline population excluded non-diabetic participants and diabetes participants were diagnosed as having baseline micro-/macroalbuminuria initial examination, a total of 1061 cases, from July 1st, 2014 follow-up survey. We excluded a further 645 participants and death cases. Accordingly, 584 participants were included. Waist-to-hip ratio, BMI and blood pressure were measured; fasting plasma glucose(FPG), postprandial 2 hours blood glucose(2h PG), glycosylated hemoglobin(Hb AIc), high-density lipoprotein cholesterol(HLD-C), low density lipoprotein cholesterol(LDL-C), total cholesterol(TC), triglycerides(TG), fasting insulin examination(FINS) and UACR were tested. Assess the statues of insulin resistance(HOMA-IR), according to the level of HOMA-IR quartiles, is divided into Q1, Q2, Q3 and Q4 four groups, comparison of the UACR in four groups were analyzed. The relationship between UACR and HOMA-IR was investigated. Follow-up data were divided into two groups UACR < 30 mg/g, UACR≥30 mg/g,UACR normal and UACR abnormal group, with baseline study affected UACR is known risk factors and clinically risk factors as covariate, analyze the influencing factors of UACR follow-up three years later.Results: 1. HOMA-IR quartiles group of Q1, Q2, Q3 and Q4, higher HOMA-IR, and higher UACR(P = 0.000); Relative to the 1st of HOMA-IR quartiles, the 2th、3th、4th of HOMA-IR quartiles,higher HOMA-IR, and higher UACR(P = 0.001, P = 0.000, P = 0.000). Compared to 2th of HOMA-IR quartiles, 3th, 4th of HOMA-IR quartiles, higher HOMA-IR, and higher UACR(P= 0.000, P= 0.000); 3th and 4th of HOMA-IR quartiles compared to the difference was statistically significant(P=0.000).2. In Q1 group, micro-/macroalbuminuria morbidity rates respectively were 106(4.2%). In Q2 group, micro-/macroalbuminuria morbidity respectively rates were 154(6%/0. In Q3 groups, micro-/macroalbuminuria morbidity rates respectively were 198(7.8%). In Q4 groups, micro-/macroalbuminuria morbidity rates respectively were 378(14.8%). There was significant difference between HOMA-IR quartiles groups considering the incidence rate of UACR(χ2 = 216.873,P = 0.000).3. Pearson correlation coefficient showed that UACR and HOMA-IR, Hb A1 c, FPG, 2h PG were significant positive correlation(r = 0.199, r = 0.432, r = 0.545, r = 0.474, P = 0.000).4. Multiple stepwise regression showed that the gender, BMI、Hb Alc、TG、2h PG、HOMA-IR were positive correlation with UACR(β = 0.166, β = 0.013, β = 0.846, β = 0.068, β = 0,168, β = 0.104, P < 0.05), LDL-C were negative correlation with UACR(β =-0.083, P < 0.05).Follow-up results: Cox regression analysis showed that 2th, 3th and 4th of HOMA-IR quartiles HRs and 95%CI were 1.971(95%CI: 1.034-3.758), 2.644(95%CI: 1.413-4.949) and 1.939(95%CI: 1.030-3.649), with statistically significant(P < 0.05).Conclusion:1. In the overall population cross-sectional study, as the IR aggravating, the level of UACR increased, IR is the independent risk factors with UACR.A prospective cohort study: in Type 2 diabetes patient, IR can predict the occurrence of UACR.