No direct link between albumin excretion rate and insulin resistance--a study in type 1 diabetes patients with mild nephropathy.
OBJECTIVE
Albuminuria is thought to be associated with insulin resistance in patients with type 1 and type 2 diabetes as well as in non-diabetic subjects. The aim of this study was to find out about any direct correlation between the albumin excretion rate (AER) and insulin resistance; this was investigated in patients with type 1 diabetes.


METHODS
Euglycemic hyperinsulinemic clamps were performed in 18 patients with type 1 diabetes and incipient nephropathy-elevated albumin excretion rate (AER > 20 microg/min) but normal glomerular filtration rate (GFR) (81 - 135 ml/min/1.73 m (2)).


RESULTS
AER, determined as mean of two overnight urine collections, was 137 +/- 157 (mean +/- S.D.) microg/min (range 24 - 447). Insulin sensitivity, expressed as the M-value, was 6.8 +/- 2.9 mg/kg/min, insulin sensitivity index (ISI = 100 x M/plasma insulin) 7.9 +/- 3.4 and insulin clearance (MCR ins ) 17.0 +/- 4.0 ml/kg/min. Simple regression analyses showed no direct association between AER and M, ISI or MCR ins. GFR was not associated with M, ISI or MCR ins in this group, either. AER was, however, positively associated with poor glucose control (high HbAlc) and tobacco use.


CONCLUSIONS
These results suggest that the degree of albuminuria is not directly linked to insulin resistance. This was shown in type 1 diabetics, but could possibly be applicable in other subjects as well.
Svensson
Maria
M
Dept. of Medicine, Umeå University Hospital, 901 85 Umea, Sweden. Maria.Svensson@medicin.umu.se
Eriksson
J W
JW
D000328:Adult; D000419:Albuminuria / Q000652:urine*; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D002851:Chromatography, High Pressure Liquid; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D015309:Glucose Clamp Technique; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged
D006442:Glycated Hemoglobin; D007328:Insulin