title: Association of urinary albumin excretion with insulin resistance in Japanese subjects: impact of gender difference on insulin resistance.
abstract: OBJECTIVE
  To investigate the relationship between homeostasis model assessment for insulin resistance (HOMA-R) and urinary albumin excretion in Japanese and clarify gender difference in albuminuria-related insulin resistance.
  
  
  METHODS
  The subject group consisted of 752 Japanese who had no history of diabetes, hypertension or dyslipidemia. After anthropometric examination, fasting blood samples were obtained to determine plasma glucose (FPG), lipids and HOMA-R. The urinary excretion of albumin in the first void urine was expressed as the creatinine ratio (ACR, mg/gCr). Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the formula for Japanese.
  
  
  RESULTS
  HOMA-R showed a significant correlation with ACR, and the correlation between HOMA-R and ACR was evident in the subjects with central obesity, whereas no significant correlation was found in the non-obese subjects. There was no correlation between HOMA-R and eGFR. HOMA-R increased according to the quintile of ACR and followed a significant trend. This association was obvious in males; however, in females there was no significant trend. Multiple regression analysis revealed that HOMA-R showed a significant correlation with age, waist circumference, blood pressure and serum triglyceride. In addition, ACR exhibited an independent association with HOMA-R. The association of HOMA-R and ACR was observed only in males, and was not present in females.
  
  
  CONCLUSIONS
  Microalbuminuria is associated with insulin resistance in Japanese, where central obesity might play an essential role. This association is gender-specific suggesting the involvement of sex hormones in the pathogenesis of albuminuria-related insulin resistance.
authors.affiliation: Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan. kazu-utsunomiya@jikei.ac.jp
authors.forename: Kazunori
authors.initials: K
authors.lastname: Utsunomiya
authors.forename: Keita
authors.initials: K
authors.lastname: Takamatsu
authors.forename: Isao
authors.initials: I
authors.lastname: Fukuta
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Sho
authors.initials: S
authors.lastname: Ishizawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kanazawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Gojo
authors.forename: Kanta
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Yokota
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kurata
authors.forename: Kouji
authors.initials: K
authors.lastname: Nomura
authors.forename: Naoko
authors.initials: N
authors.lastname: Tajima
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000503:physiopathology*; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D003928:Diabetic Nephropathies / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007564:Japan; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D056128:Obesity, Abdominal / Q000503:physiopathology; D012307:Risk Factors; D012727:Sex Characteristics
chemical_list: D001786:Blood Glucose; D008055:Lipids; D003404:Creatinine