Insulin resistance before type 2 diabetes onset is associated with increased risk of albuminuria after diabetes onset: A prospective cohort study
Authors' conclusion
Lower insulin sensitivity is associated with the development of albuminuria, suggesting a role for insulin signalling in the pathogenesis of proteinuria.
Study context
- Population
- Southwestern Indigenous American adults who subsequently developed diabetes; insulin sensitivity by hyperinsulinaemic-euglycaemic clamp and insulin secretion by IVGTT measured before diabetes onset
- Participants
- 170 adults
- Exposure
- Developed albuminuria vs did not develop albuminuria; insulin sensitivity (M-low, M-high) and secretion (acute insulin response (AIR)) per 1-SD
- Albuminurian = 81
- Outcome
- Albuminuria (urine albumin-to-creatinine ratio ≥30 mg/g) after diabetes onset
- Follow-up
- Median 13.6 years
Main finding
As reported in the abstract
Risk of albuminuria per 1-SD change (Cox models adjusted for age, sex, body fat)
Lower M-low: HR
1.51
95% CI 1.14, 2.00p = .004
Lower M-high: HR
1.31
95% CI 1.06, 1.63p = .01
AIR: HR (95% CI 0.87, 1.56; p = .3), not associated
1.15
Observational data: associations, not effects.
Further findings
| Outcome | Albuminuria | No albuminuria | P value |
|---|---|---|---|
| Baseline insulin sensitivity, M-low (mg/kg-metabolic body size/min, log) | 0.33 ± 0.08 mg/kg-metabolic body size/min (log) | 0.36 ± 0.12 mg/kg-metabolic body size/min (log) | P = 0.03 |
| Baseline insulin sensitivity, M-high (mg/kg-metabolic body size/min, log) | 0.87 ± 0.11 mg/kg-metabolic body size/min (log) | 0.91 ± 0.12 mg/kg-metabolic body size/min (log) | P = 0.02 |
| Baseline AIR (pmol/L, log) | 2.3 ± 0.3 pmol/L (log) | 2.3 ± 0.3 pmol/L (log) |
Baseline AIR (pmol/L, log)
- Similar in the two groups
Original publication
Insulin resistance before type 2 diabetes onset is associated with increased risk of albuminuria after diabetes onset: A prospective cohort study. Diabetes Obes Metab. Published 28 February 2024. doi:10.
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