Association of insulin resistance with chronic kidney disease in non-diabetic subjects with normal weight

PLoS One. 2013 Sep 13;8(9):e74058. doi: 10.1371/journal.pone.0074058. eCollection 2013.

Abstract

Objective: To the best of our knowledge, the association of insulin resistance (IR) with chronic kidney disease (CKD) has not been well studied in normal-weight individuals. The aim of this study is to examine whether IR is associated with CKD in non-diabetic subjects with normal weight. We also examine whether the presence of obesity modifies the association of IR with CKD.

Methods: Data were drawn from a cross-sectional survey in China. Both estimated glomerular filtration rate and urinary albumin to creatinine ratio were used as markers of CKD. Logistic regression models and the quartiles of homeostatic model assessment of insulin resistance were used to explore the associations of IR with CKD in entire cohort, normal-weight and overweight/obese subpopulations.

Results: In normal-weight subpopulation, the prevalence of IR and metabolic syndrome were 11.11% and 8.99%, respectively. In the entire cohort, the highest quartile HOMA-insulin resistance had a 70% increased risk for CKD (RR 1.70, 95% CI 1.07, 2.71, P=0.03, comparing the highest to the lowest quartile). However, when adding obesity to the model, the association was abolished. IR was associated with CKD in overweight/obese subpopulation but not in normal-weight subpopulation.

Conclusion: IR and MetS in normal-weight individuals is common in the Chinese population. IR is associated with CKD in overweight/obese subpopulation but not in normal-weight subpopulation and the presence of obesity modifies the association of IR with CKD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Weight
  • China / epidemiology
  • Creatinine / blood
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Insulin Resistance*
  • Logistic Models
  • Male
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / pathology
  • Middle Aged
  • Obesity / complications
  • Obesity / epidemiology*
  • Obesity / pathology
  • Prevalence
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / pathology
  • Serum Albumin / metabolism

Substances

  • Serum Albumin
  • Creatinine

Grants and funding

This study was supported by the following science foundation: 1. EU FP7 Program, UroSense, 2011; 2. ISN Research Committee grant, 2007; 3. ISN Research Committee grant, 2004; 4. Guangdong Provincial Science and Technique Program (No. 2011B031800386), 2011. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.