Insulin resistance precedes the appearance of albuminuria in non-diabetic subjects: 6 years follow up study.
Microalbuminuria is a marker of increased risk of cardiovascular mortality in type 1 and type 2 diabetes, and in non-diabetic subjects. Little is known about the association between prospective changes of microalbuminuria and the risk factors of atherosclerosis, or gene polymorphism in non-diabetic subjects. We conducted a 6-year prospective study of risk factors for progression of albuminuria in non-diabetic subjects. The participants were 116 non-diabetic subjects who consecutively underwent medical examinations for Japanese-Americans living in Hawaii. In the baseline examination in 1992, normoalbuminuria was found in all subjects. After 6 years, 101 subjects remained normoalbuminuria (non-progressors), 15 subjects changing from normoalbuminuria to microalbuminuria or proteinuria and were defined as progressors. In progressors, compared with non-progressors, the fasting insulin level and HOMA-R were significantly higher at 3 years follow-up, and the systolic and diastolic pressure and Sigma insulin level were significantly higher at 6 years follow-up. Insulin resistance appeared earlier than the appearance of hypertension and albuminuria. In progressors, there was no significant correlation with angiotensin-converting enzyme (ACE) genotype or angiotensinogen (AGT) genotype compared with non-progressors. Therefore, the appearance of insulin resistance should be regarded as a remarkable mediator of albuminuria.
Fujikawa
R
R
Second Department of Internal Medicine, Hiroshima University School of Medicine, 1-2-3 Kasumi, Minami-ku, 734-8551, Hiroshima, Japan. frumi@mcai.med.hiroshima-u.ac.jp
Okubo
M
M
Egusa
G
G
Kohno
N
N
D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000503:physiopathology*; D001213:Asian; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006254:Hawaii; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan / Q000208:ethnology; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D013997:Time Factors
D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D003404:Creatinine