Association between mild renal dysfunction and insulin resistance or metabolic syndrome in a random nondiabetic population sample.
OBJECTIVE
The association of mild renal dysfunction (estimated glomerular filtration rate [eGFR] 60-89.9 ml/min/1.73 m(2)) with insulin resistance (IR) or metabolic syndrome (MS) needs be investigated in a population in which MS prevails.


METHODS
After excluding subjects with diabetes mellitus, 1,678 subjects from a representative cohort (median age 52 years) were studied cross-sectionally. eGFR was based on serum creatinine concentrations using the quadratic GFR equation and categorized by 90 and 60 ml/min/1.73 m(2) as limits. MS was identified using the modified criteria of the Adult Treatment Panel-III.


RESULTS
In men, whereas MS was not significantly associated with a reduced eGFR category when controlled for homeostatic model assessment (HOMA), HOMA adjusted for MS or for its components was significantly associated with the likelihood of a reduced eGFR. This likelihood was increased by 14% with a doubling of HOMA in men. Age was the dominant correlate of reduced eGFR in women, whereby an association with HOMA was not significant.


CONCLUSIONS
Mildly impaired kidney function is common in nondiabetic adults among whom MS prevails, and in men it is mainly associated with IR but not with central obesity and MS-related dyslipidemia. The quadratic GFR equation enables an acceptable estimation of GFR in a general population.
Onat
Altan
A
Turkish Society of Cardiology, Istanbul University, Istanbul, Turkey. alt_onat@yahoo.com.tr
Hergenç
Gulay
G
Uyarel
Huseyin
H
Ozhan
Hakan
H
Esen
A Metin
AM
Karabulut
Ahmet
A
Albayrak
Sinan
S
Can
Gunay
G
Keleş
Ibrahim
I
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000209:etiology; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012727:Sex Characteristics; D014421:Turkey
D002097:C-Reactive Protein; D003404:Creatinine