一项关于韩国男性中微量白蛋白尿发病与胰岛素抵抗稳态模型评估（HOMA-IR）关系的队列研究。

A cohort study of incident microalbuminuria in relation to HOMA-IR in Korean men.

作者信息

Park Sung Keun, Chun Hyejin, Ryoo Jae-Hong, Lee Sang Wha, Lee Hong Soo, Shim Kyung Won, Cho Choo Yon, Ryu Dong-Ryeol, Ko Taeg Su, Kim Eugene, Park Se-Jin, Park Jai Hyung, Hong Seok Jin, Hong Hyun Pyo

机构信息

Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.

Health Promotion Center, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Republic of Korea.

出版信息

Clin Chim Acta. 2015 Jun 15;446:111-6. doi: 10.1016/j.cca.2015.03.043. Epub 2015 Apr 17.

DOI:10.1016/j.cca.2015.03.043

PMID:25896961

Abstract

BACKGROUND

Despite the previous studies showing the relationship between microalbuminuria and insulin resistance, longitudinal effect of insulin resistance on development of microalbuminuria is not clearly identified in non-diabetic population.

METHODS

One thousand six hundred three non-diabetic Korean men without microalbuminuria in 2005 had been followed up for the development of microalbuminuria until 2010. Microalbuminuria was evaluated by urine-albumin creatinine ration, and insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). Cox proportional hazards model was used to estimate the risk for microalbuminuria according to the tertile of HOMA-IR.

RESULTS

During 5465.8 person-y of average follow-up, microalbuminuria developed in 76 (4.7%) participants. Incidence of microalbuminuria increased in proportion to the level of HOMA-IR (tertile 1: 3.0%, tertile 2: 4.1%, tertile 3: 7.1%, P<0.001). When the 1st tertile of HOMA-IR was set as reference, hazard ratios and 95% confidence interval were 1.15 (0.56-2.35) and 2.07 (1.05-4.09) for those in the 2nd and 3rd tertiles of HOMA-IR, even after adjusting multiple covariates, respectively (P for linear trend=0.054).

CONCLUSIONS

Increased insulin resistance was a predictor of microalbuminuria in Korean men.

摘要

背景

尽管先前的研究表明微量白蛋白尿与胰岛素抵抗之间存在关联，但在非糖尿病人群中，胰岛素抵抗对微量白蛋白尿发展的纵向影响尚未明确。

方法

对2005年1603名无微量白蛋白尿的非糖尿病韩国男性进行随访，直至2010年观察微量白蛋白尿的发生情况。通过尿白蛋白肌酐比值评估微量白蛋白尿，通过胰岛素抵抗稳态模型评估（HOMA-IR）评估胰岛素抵抗。采用Cox比例风险模型根据HOMA-IR三分位数估计微量白蛋白尿的风险。

结果

在平均5465.8人年的随访期间，76名（4.7%）参与者出现了微量白蛋白尿。微量白蛋白尿的发生率与HOMA-IR水平成比例增加（三分位数1：3.0%，三分位数2：4.1%，三分位数3：7.1%，P<0.001）。即使在调整多个协变量后，将HOMA-IR的第一三分位数作为参考，HOMA-IR第二和第三三分位数人群的风险比及95%置信区间分别为1.15（0.56 - 2.35）和2.07（1.05 - 4.09）（线性趋势P = 0.054）。