Gender difference and relationship of insulin resistance with microalbuminuria type-2 diabetes.
OBJECTIVE
To determine the relationship of insulin resistance with microalbuminuria in patients of type-2 Diabetes mellitus and observe gender difference if any.


METHODS
A cross-sectional study.


METHODS
Diabetes Clinic of Combined Military Hospital, Malir Cantt, from April to August 2007.


METHODS
One hundred and fifty five patients of type-2 Diabetes mellitus were included in the study who had either microalbuminuria or normoalbuminuria. Body mass index, waist circumference and blood pressure were recorded. Fasting venous blood sample was collected for plasma glucose (FPG), serum insulin, total and HDL cholesterol, triglycerides, creatinine and HbA1c. Urine albumin excretion was determined using urine albumin to creatinine ratio. Insulin resistance was calculated from fasting plasma glucose and serum insulin levels, using homeostatic model assessment of insulin resistance (HOMA-IR). Correlation and association testing was carried out with significance at p<0.05.


RESULTS
Microalbuminuria was found to be significantly correlated with HOMA-IR (r=0.33, p<0.001), serum insulin (r=0.28, p=<0.001), body mass index (r=0.18, p=0.02) and waist circumference (r=0.21, p=0.008). This correlation was more significant in women (n=85, r=0.48, p=<0.0001) as compared to men (n=70, r=0.14, p=0.12). The correlation between HOMA-IR and urine albumin excretion remained highly significant (p=0.001) after controlling for gender, age, duration of diabetes, waist circumference, hypertension, triglycerides and HbA1c.


CONCLUSIONS
Urinary albumin excretion in patients of type-2 diabetes is strongly associated with insulin resistance and related cardiovascular risk factors. This association appears to be stronger in women than the men, in our population.
Ahmed
Shahid
S
Department of Medicine, Combined Military Hospital, Malir Cantt, and Department of Pathology, Baqai Medical University, Karachi. shahidahmed833@hotmail.com
Ahmad
Syed Azhar
SA
D000328:Adult; D000419:Albuminuria / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012737:Sex Factors