Association of insulin resistance with chronic kidney disease in non-diabetic subjects with normal weight.
OBJECTIVE
To the best of our knowledge, the association of insulin resistance (IR) with chronic kidney disease (CKD) has not been well studied in normal-weight individuals. The aim of this study is to examine whether IR is associated with CKD in non-diabetic subjects with normal weight. We also examine whether the presence of obesity modifies the association of IR with CKD.


METHODS
Data were drawn from a cross-sectional survey in China. Both estimated glomerular filtration rate and urinary albumin to creatinine ratio were used as markers of CKD. Logistic regression models and the quartiles of homeostatic model assessment of insulin resistance were used to explore the associations of IR with CKD in entire cohort, normal-weight and overweight/obese subpopulations.


RESULTS
In normal-weight subpopulation, the prevalence of IR and metabolic syndrome were 11.11% and 8.99%, respectively. In the entire cohort, the highest quartile HOMA-insulin resistance had a 70% increased risk for CKD (RR 1.70, 95% CI 1.07, 2.71, P=0.03, comparing the highest to the lowest quartile). However, when adding obesity to the model, the association was abolished. IR was associated with CKD in overweight/obese subpopulation but not in normal-weight subpopulation.


CONCLUSIONS
IR and MetS in normal-weight individuals is common in the Chinese population. IR is associated with CKD in overweight/obese subpopulation but not in normal-weight subpopulation and the presence of obesity modifies the association of IR with CKD.
Department of Nephrology, Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China ; Department of Nephrology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, Fujian, China.
Shanying
S
Chen
Youming
Y
Chen
Xinyu
X
Liu
Mi
M
Li
Bide
B
Wu
Yongqiang
Y
Li
Yan
Y
Liang
Xiaofei
X
Shao
Harry
H
Holthöfer
Hequn
H
Zou
D000328:Adult; D001835:Body Weight; D002681:China / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D012709:Serum Albumin / Q000378:metabolism
D012709:Serum Albumin; D003404:Creatinine