Song Su Hyun, Goo Young Jin, Oh Tae Ryom, Suh Sang Heon, Choi Hong Sang, Kim Chang Seong, Ma Seong Kwon, Kim Soo Wan, Bae Eun Hui
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Kidney Res Clin Pract. 2025 May;44(3):491-499. doi: 10.23876/j.krcp.22.298. Epub 2023 Dec 13.
Insulin resistance is prevalent in chronic kidney disease and may accelerate the progression of chronic kidney disease. This study aimed to investigate whether insulin resistance is associated with the development of incident chronic kidney disease in a population with normal renal function.
A total of 3,331 participants from a community-based cohort with normal renal function were prospectively analyzed. We determined the relationship of insulin resistance indices with the incident chronic kidney disease using the Cox proportional hazard model and Kaplan-Meier survival analysis.
During a mean follow-up of 11.03 ± 4.22 years, incident chronic kidney disease occurred in 414 participants (12.4%). The high homeostasis model assessment-insulin resistance level group had an increased risk of incident chronic kidney disease (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.13-1.74; p = 0.002) compared to the normal group after adjustment for age, sex, history of hypertension, body mass index, total cholesterol, alcohol drinking status, smoking status, and baseline estimated glomerular filtration rate. The risk of incident chronic kidney disease also increased with the lower quantitative insulin sensitivity check index level (HR, 0.62; 95% CI, 0.41-0.92; p = 0.02) and higher leptin-adiponectin ratio level (HR, 1.23; 95% CI, 1.06-1.42; p = 0.006).
Higher insulin resistance indices are associated with the incidence of chronic kidney disease. Our data suggest that increased insulin resistance may be involved in the development of incident chronic kidney disease in a population with normal renal function.
胰岛素抵抗在慢性肾脏病中普遍存在，且可能加速慢性肾脏病的进展。本研究旨在调查在肾功能正常的人群中，胰岛素抵抗是否与新发慢性肾脏病的发生相关。
对来自一个基于社区的肾功能正常队列的3331名参与者进行前瞻性分析。我们使用Cox比例风险模型和Kaplan-Meier生存分析来确定胰岛素抵抗指数与新发慢性肾脏病之间的关系。
在平均11.03±4.22年的随访期间，414名参与者（12.4%）发生了新发慢性肾脏病。在调整年龄、性别、高血压病史、体重指数、总胆固醇、饮酒状况、吸烟状况和基线估计肾小球滤过率后，与正常组相比，高稳态模型评估-胰岛素抵抗水平组发生新发慢性肾脏病的风险增加（风险比[HR]，1.40；95%置信区间[CI]，1.13-1.74；P = 0.002）。新发慢性肾脏病的风险也随着较低的定量胰岛素敏感性检查指数水平（HR，0.62；95%CI，0.41-0.92；P = 0.02）和较高的瘦素-脂联素比值水平（HR，1.23；95%CI，1.06-1.42；P = 0.006）而增加。
较高的胰岛素抵抗指数与慢性肾脏病的发病率相关。我们的数据表明，胰岛素抵抗增加可能参与了肾功能正常人群中新发慢性肾脏病的发生。
