title: Insulin resistance in non-insulin-dependent diabetes mellitus is associated with microalbuminuria independently of ambulatory blood pressure.
abstract: Microalbuminuria in both insulin-dependent (IDDM) and non-insulin-dependent diabetes mellitus (NIDDM) is a marker for insulin resistance. Microalbuminuria is also associated with hypertension, itself an insulin-resistant state. Therefore, in order to examine the independent relationships of microalbuminuria with blood pressure and insulin resistance, we measured ambulatory blood pressure (Takeda TM-2420), insulin resistance (modified Harano method), and urinary albumin excretion rate (overnight urine collection) in 36 subjects with NIDDM. Albumin excretion correlated with 24-h systolic blood pressure (r = 0.49, p = 0.003), and insulin sensitivity (r = -0.39, p = 0.007). Microalbuminuric subjects had reduced insulin sensitivity compared with normoalbuminuric subjects [Mean (SD) 2.95 (0.33) versus 4.67 (0.56) ml.kg-1.min-1; p = 0.013]. In multivariate analysis including ambulatory blood pressure and insulin resistance, urinary albumin excretion was associated primarily with insulin resistance, with smaller contributions from glycated hemoglobin and male gender. These data suggest that microalbuminuria in NIDDM, although associated with hypertension, is also independently associated with insulin resistance.
authors.affiliation: University College London School of Medicine, Department of Medicine, United Kingdom.
authors.forename: J H
authors.initials: JH
authors.lastname: Pinkney
authors.forename: A E
authors.initials: AE
authors.lastname: Denver
authors.forename: V
authors.initials: V
authors.lastname: Mohamed-Ali
authors.forename: C
authors.initials: C
authors.lastname: Foster
authors.forename: J S
authors.initials: JS
authors.lastname: Yudkin
mesh_terms: D000419:Albuminuria; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012727:Sex Characteristics; D013599:Systole
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin