Relation of HOMA-IR and UACR in patients with type 2 diabetes within Normoalbuminuric range
| Autor: | Stanislas Galbaud, 高思達 |
|---|---|
| Rok vydání: | 2011 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 99 Type 2 diabetes mellitus remains to date an interna,onal public health issue and its vascular complica,ons s,ll make it an important cause of morbidity and mortality. The literature has proven numerous factors responsible for that pathology but there is s,ll more to cover. Amongst the microvascular complica,ons associated to this disease, the diabe,c nephropathy is the number one cause of end stage renal failure. In early stages, it can be iden,fied by presence of small amounts of albumin in the urine. The factors correlated with urinary albumin excre,on are not well known in pa,ents with normal range of albuminuria, unlike the microalbuminuric type 2 diabe,c pa,ents. This could cons,tute an important aspect to consider especially when we know that high rates of albuminuria are found to be linked to higher renal and cardiovascular risk. Insulin resistance, in which the body cannot use insulin effec,vely, is also associated with microalbuminuria, but liale is known about its varia,on within the normal range of albuminuria. This study used the HOMA-‐IR (homeostasis model of insulin resistance) as an instrument to assess the level of varia,on of insulin resistance, in type 2 diabe,c pa,ents, associated to the urinary albumin crea,nine ra,o in normoalbuminuric pa,ents, which is the main purpose of this survey. The data was collected for 328 pa,ents who aaended the outpa,ent clinic of the Endocrinology and Metabolism Department of Kaohsiung Medical University Hospital with a diagnosis of type 2 diabetes mellitus according to the American Diabe,c Associa,on criteria. The albumin-‐to-‐crea,nine ra,o (ACR) was classified into three groups. The HOMA-‐IR index was measured as fas,ng serum glucose mul,plied by fas,ng serum insulin / 22.5, with lower values indica,ng a higher degree of insulin sensi,vity. This study found that the HOMA-‐IR was an independent predictor of UAR and therefore was correlated to the increase of the ACR. Its value was found to be highly significant only in men with an increasing risk of going in the upper range within the normoalbuminuria value. The risk was 1.337, mes when it was not adjusted and 1.361 when adjusted. The systolic blood pressure (p=0.0038) and triglycerides (p=0.0232) are also the main factors to influence to varia,on of the albumin crea,nine ra,o (ACR). In conclusion, this study demonstrate that HOMA-‐IR is independently associate with the increase of ACR in type 2 diabe,c pa,ents within the normoalbuminuric range. It should therefore, one of the managements targets of the physician to treat insulin resistance and prevent the development of nephropathy along with the blood pressure and triglycerides in diabe,c pa,ne with normoalbuminuria. Relation of HOMA-IR and UACR in patients with type 2 diabetes within Normoalbuminuric range |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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