Renal function markers and insulin sensitivity after 3 years in a healthy cohort, the EGIR-RISC study

Siméon, S., Massy, Z., Højlund, K., Lalic, K., Porcellati, F., Dekker, J., Petrie, J. , Currie, G. and Balkau, B. (2018) Renal function markers and insulin sensitivity after 3 years in a healthy cohort, the EGIR-RISC study. BMC Nephrology, 19, 124. (doi: 10.1186/s12882-018-0918-1) (PMID:29855339) (PMCID:PMC5984396)

Abstract

Background: People with chronic renal disease are insulin resistant. We hypothesized that in a healthy population, baseline renal function is associated with insulin sensitivity three years later. Methods: We studied 405 men and 528 women from the European Group for the study of Insulin Resistance - Relationship between Insulin Sensitivity and Cardiovascular disease cohort. Renal function was characterized by the estimated glomerular filtration rate (eGFR) and by the urinary albumin-creatinine ratio (UACR). At baseline only, insulin sensitivity was quantified using a hyperinsulinaemic-euglycaemic clamp; at baseline and three years, we used surrogate measures: the Matsuda insulin sensitivity index (ISI), the HOmeostasis Model Assessment of Insulin Sensitivity (HOMA-IS). Associations between renal function and insulin sensitivity were studied cross-sectionally and longitudinally. Results: In men at baseline, no associations were seen with eGFR, but there was some evidence of a positive association with UACR. In women, all insulin sensitivity indices showed the same negative trend across eGFR classes, albeit not always statistically significant; for UACR, women with values above the limit of detection, had higher clamp measured insulin sensitivity than other women. After three years, in men only, ISI and HOMA-IS showed a U-shaped relation with baseline eGFR; women with eGFR> 105 ml/min/1.73m2 had a significantly higher insulin sensitivity than the reference group (eGFR: 90–105 ml/min/1.73m2). For both men and women, year-3 insulin sensitivity was higher in those with higher baseline UACR. All associations were attenuated after adjusting on significant covariates. Conclusions: There was no evidence to support our hypothesis that markers of poorer renal function are associated with declining insulin sensitivity in our healthy population.

• Item Type: Articles
• Additional Information: The EGIR-RISC Study was supported by EU grant QLG1-CT-2001-01252 additionally by AstraZeneca (Sweden).
• Keywords: Albuminuria, cohort, epidemiology, glomerular filtration rate, insulin sensitivity, renal function, sex.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Currie, Dr Gemma and Petrie, Professor John
• Authors: Siméon, S., Massy, Z., Højlund, K., Lalic, K., Porcellati, F., Dekker, J., Petrie, J., Currie, G., and Balkau, B.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: BMC Nephrology
• Publisher: BioMed Central
• ISSN: 1471-2369
• ISSN (Online): 1471-2369
• Copyright Holders: Copyright © 2018 The Authors
• First Published: First published in BMC Nephrology 19: 124
• Publisher Policy: Reproduced under a Creative Commons License