Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes
Objective To explore the association between insulin resistance （IR） and diabetic kidney disease （DKD） among adults with type 1 diabetes mellitus （T1DM） and compare multiple surrogate parameters of IR for their associations with DKD in this population. Methods For this cross-sectional study， 556 adu...
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Editorial Department of Journal of Clinical Nephrology
2024-10-01
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| Series: | Linchuang shenzangbing zazhi |
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| Online Access: | http://www.lcszb.com/cn/article/doi/10.3969/j.issn.1671-2390.2024.10.001 |
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| author | Tao Liu Yan Zhou Jie Zhou Jian-fang Fu Li Wang Ying Xing Li-jun Ren Qiu-he Ji |
| author_facet | Tao Liu Yan Zhou Jie Zhou Jian-fang Fu Li Wang Ying Xing Li-jun Ren Qiu-he Ji |
| author_sort | Tao Liu |
| collection | DOAJ |
| description | Objective To explore the association between insulin resistance （IR） and diabetic kidney disease （DKD） among adults with type 1 diabetes mellitus （T1DM） and compare multiple surrogate parameters of IR for their associations with DKD in this population. Methods For this cross-sectional study， 556 adults with classic T1DM admitted into Xijing Hospital between October 2008 and June 2021 were enrolled. Demographic， anthropometric and laboratory data were collected. IR-related parameters of estimated glucose disposal rate （eGDR）， metabolic score for insulin resistance （METS-IR） and triglyceride-glucose index （TyG） were calculated. They were categorized into two groups of DKD and non-DKD. The relationship between IR and DKD was explored by binary Logistic regression and restricted cubic spline （RCS） models. Receiver operating characteristic （ROC） curves were plotted for comparing the discriminatory performance of all parameters. Results Median age was 31.0（24.8，44.0） year and median disease duration 6.0（2.0，12.0） year. The prevalence of DKD was 20.14%. Lower eGDR was associated with a high prevalence of DKD. In multivariable analysis， as compared to quartile 1 （Q1）， odds ratios （OR， 95%CI） of DKD for participants in eGDR calculated with body mass index （eGDRBMI） Q2-Q4 were 1.08（0.40-2.92）， 0.13（0.03-0.45） and 0.26（0.07-0.83）， respectively. The corresponding risk in eGDR calculated with waist-to-hip ratio （eGDRWHR） Q2-Q4 was 0.68（0.20-2.23）， 0.51（0.15-1.66） and 0.16（0.03-0.72）， respectively. TyG， eGDR calculated with waist circumference （eGDRWC）， METS-IR， body mass index， waist-to-height ratio and waist-to-hip ratio were not significantly associated with the prevalence of DKD. Subgroup analyses indicated that the association between eGDRBMI and DKD was consistent with overall population in six subgroups of females， age 28-＜40 years and ≥40 years， disease duration ≥5 years， non-smokers and individuals with a family history of diabetes. RCS hinted at a linear and negative correlation between eGDRBMI， eGDRWHR and the prevalence of DKD. ROC analyses indicated that the cutoff values for identifying DKD were 8.23 mg·kg−1·min−1， 7.22 mg·kg−1·min−1 and 7.92 mg·kg−1·min−1 for eGDRBMI， eGDRWHR and eGDRWC， respectively. After adding into a basic model， all three eGDRs demonstrated incremental discriminatory performance. Conclusion IR， reflected by a declining eGDR， is associated with the prevalence of DKD among adults with classic T1DM. And eGDR has demonstrated some potential in identifying DKD in adult classic T1DM and its clinical implication should be validated by more studies. |
| format | Article |
| id | doaj-art-79ef0f09d6f34f5dbcea276c55d43146 |
| institution | OA Journals |
| issn | 1671-2390 |
| language | zho |
| publishDate | 2024-10-01 |
| publisher | Editorial Department of Journal of Clinical Nephrology |
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| series | Linchuang shenzangbing zazhi |
| spelling | doaj-art-79ef0f09d6f34f5dbcea276c55d431462025-08-20T01:47:54ZzhoEditorial Department of Journal of Clinical NephrologyLinchuang shenzangbing zazhi1671-23902024-10-01241079380210.3969/j.issn.1671-2390.2024.10.00120240134Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetesTao Liu0Yan Zhou1Jie Zhou2Jian-fang Fu3Li Wang4Ying Xing5Li-jun Ren6Qiu-he Ji7Department of Endocrinology, Xi’an International Medical Center Hospital, Northwest University, Xi’an 710100, ChinaDepartment of Endocrinology, Xi’an International Medical Center Hospital, Northwest University, Xi’an 710100, ChinaDepartment of Endocrinology, Xijing Hospital, Air Force Medical University, Xi’an 710032, ChinaDepartment of Endocrinology, Xijing Hospital, Air Force Medical University, Xi’an 710032, ChinaDepartment of Endocrinology, Xijing Hospital, Air Force Medical University, Xi’an 710032, ChinaDepartment of Endocrinology, Xi’an Daxing Hospital, Xi’an 710082, ChinaDepartment of Endocrinology, Xi’an International Medical Center Hospital, Northwest University, Xi’an 710100, ChinaDepartment of Endocrinology, Xi’an International Medical Center Hospital, Northwest University, Xi’an 710100, ChinaObjective To explore the association between insulin resistance （IR） and diabetic kidney disease （DKD） among adults with type 1 diabetes mellitus （T1DM） and compare multiple surrogate parameters of IR for their associations with DKD in this population. Methods For this cross-sectional study， 556 adults with classic T1DM admitted into Xijing Hospital between October 2008 and June 2021 were enrolled. Demographic， anthropometric and laboratory data were collected. IR-related parameters of estimated glucose disposal rate （eGDR）， metabolic score for insulin resistance （METS-IR） and triglyceride-glucose index （TyG） were calculated. They were categorized into two groups of DKD and non-DKD. The relationship between IR and DKD was explored by binary Logistic regression and restricted cubic spline （RCS） models. Receiver operating characteristic （ROC） curves were plotted for comparing the discriminatory performance of all parameters. Results Median age was 31.0（24.8，44.0） year and median disease duration 6.0（2.0，12.0） year. The prevalence of DKD was 20.14%. Lower eGDR was associated with a high prevalence of DKD. In multivariable analysis， as compared to quartile 1 （Q1）， odds ratios （OR， 95%CI） of DKD for participants in eGDR calculated with body mass index （eGDRBMI） Q2-Q4 were 1.08（0.40-2.92）， 0.13（0.03-0.45） and 0.26（0.07-0.83）， respectively. The corresponding risk in eGDR calculated with waist-to-hip ratio （eGDRWHR） Q2-Q4 was 0.68（0.20-2.23）， 0.51（0.15-1.66） and 0.16（0.03-0.72）， respectively. TyG， eGDR calculated with waist circumference （eGDRWC）， METS-IR， body mass index， waist-to-height ratio and waist-to-hip ratio were not significantly associated with the prevalence of DKD. Subgroup analyses indicated that the association between eGDRBMI and DKD was consistent with overall population in six subgroups of females， age 28-＜40 years and ≥40 years， disease duration ≥5 years， non-smokers and individuals with a family history of diabetes. RCS hinted at a linear and negative correlation between eGDRBMI， eGDRWHR and the prevalence of DKD. ROC analyses indicated that the cutoff values for identifying DKD were 8.23 mg·kg−1·min−1， 7.22 mg·kg−1·min−1 and 7.92 mg·kg−1·min−1 for eGDRBMI， eGDRWHR and eGDRWC， respectively. After adding into a basic model， all three eGDRs demonstrated incremental discriminatory performance. Conclusion IR， reflected by a declining eGDR， is associated with the prevalence of DKD among adults with classic T1DM. And eGDR has demonstrated some potential in identifying DKD in adult classic T1DM and its clinical implication should be validated by more studies.http://www.lcszb.com/cn/article/doi/10.3969/j.issn.1671-2390.2024.10.001type 1 diabetesdiabetic kidney diseaseinsulin resistanceestimated glucose disposal rate |
| spellingShingle | Tao Liu Yan Zhou Jie Zhou Jian-fang Fu Li Wang Ying Xing Li-jun Ren Qiu-he Ji Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes Linchuang shenzangbing zazhi type 1 diabetes diabetic kidney disease insulin resistance estimated glucose disposal rate |
| title | Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes |
| title_full | Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes |
| title_fullStr | Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes |
| title_full_unstemmed | Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes |
| title_short | Association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes |
| title_sort | association between insulin resistance and diabetic kidney disease among adults with type 1 diabetes |
| topic | type 1 diabetes diabetic kidney disease insulin resistance estimated glucose disposal rate |
| url | http://www.lcszb.com/cn/article/doi/10.3969/j.issn.1671-2390.2024.10.001 |
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