title: Association between mild renal dysfunction and insulin resistance or metabolic syndrome in a random nondiabetic population sample.
abstract: 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.
authors.affiliation: Turkish Society of Cardiology, Istanbul University, Istanbul, Turkey. alt_onat@yahoo.com.tr
authors.forename: Altan
authors.initials: A
authors.lastname: Onat
authors.forename: Gulay
authors.initials: G
authors.lastname: Hergenç
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozhan
authors.forename: A Metin
authors.initials: AM
authors.lastname: Esen
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karabulut
authors.forename: Sinan
authors.initials: S
authors.lastname: Albayrak
authors.forename: Gunay
authors.initials: G
authors.lastname: Can
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Keleş
mesh_terms: 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
chemical_list: D002097:C-Reactive Protein; D003404:Creatinine