Insulin resistance is associated with urinary albumin‐creatinine ratio in normal weight individuals with hypertension and diabetes: The REACTION study

Gu, Shi; Wang, Anping; Ning, Guang; Zhang, Linxi; Mu, Yiming

doi:10.1111/1753-0407.13010

Cited by 22 publications

(15 citation statements)

References 29 publications

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“…Furthermore, a study from a sub-center of the REACTION study found that TG/HDL-C showed a more powerful association with elevated UACR compared with other lipid parameters Table 4 The logistic regression analyses evaluating the correlation between TG/HDL-C and increased UACR in subgroups [22]. However, the study did not carry out fully adjustments for confounders, including HOMA-IR, which was found to be closely related to both UACR [28] and TG/ HDL-C [17,18]. It is noteworthy that compared with the abovementioned studies, this study involved a larger general population from 7 regions of China and adjusted for extensive confounders, which ensured a preferable representation of the general population in China.…”

Section: Discussionmentioning

confidence: 99%

Triglycerides to high-density lipoprotein cholesterol ratio is superior to triglycerides and other lipid ratios as an indicator of increased urinary albumin-to-creatinine ratio in the general population of China: a cross-sectional study

Xue

Wang

et al. 2021

Lipids Health Dis

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Background Dyslipidemia contributes to the pathogenesis of renal dysfunction. Previous research demonstrated that triglycerides (TG), instead of other individual lipid indexes, has a significant link with elevated urinary albumin-to-creatinine ratio (UACR). However, it is unclear whether lipid ratios are superior indicators of increased UACR compared with TG. This research is to determine whether there are close relationships of lipid ratios with UACR in a general population. Methods 35,751 participants from seven centers across China were enrolled. UACR equal or higher than 30 mg/g was recognized as increased albuminuria. The associations of TG, low-density lipoprotein cholesterol (LDL-C)/ high-density lipoprotein cholesterol (HDL-C), TG/HDL-C and non-high-density lipoprotein cholesterol (non-HDL-C)/HDL-C with increased UACR were evaluated by linear and logistic regression analyses in females and males separately. Results There were 3692 (14.8%) female subjects, and 1307 (12.0%) male subjects characterized as having increased UACR. There were significantly differences in TG/HDL-C and non-HDL-C/HDL-C between the normal UACR group and the increased UACR group, while LDL-C/HDL-C was not. Furthermore, linear regression analysis was implemented and showed that TG and TG/HDL-C were both positively related to UACR even after a variety of potential confounders were adjusted regardless of sexes, while the correlation between non-HDL-C/HDL-C and elevated UACR were only significant in females. Further analyses utilizing logistic regression demonstrated that compared with non-HDL-C/HDL-C and TG, TG/HDL-C showed the strongest association with increased UACR (quartile 1 of TG/HDL-C as a reference; OR [95% CI] of quartile 4: 1.28 [1.13–1.44] in women, 1.24 [1.02–1.50] in men) after fully adjusting for potential confounding factors. Stratified analyses revealed that in males who were overweight and in females who were overweight or over 55 years or had prediabetes or prehypertension, TG/HDL-C had significant associations with abnormal UACR. Conclusions Compared with TG and other routine lipid ratios, TG/HDL-C is a superior indicator for increased UACR.

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Section: Discussionmentioning

confidence: 99%

Triglycerides to high-density lipoprotein cholesterol ratio is superior to triglycerides and other lipid ratios as an indicator of increased urinary albumin-to-creatinine ratio in the general population of China: a cross-sectional study

Xue

Wang

et al. 2021

Lipids Health Dis

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“…Most studies have observed that higher UACR levels in patients with hypertension and insulin resistance [ 24 , 25 ]. A study demonstrated that hypertension significantly increased protein excretion in urine and contributed to the development of nephropathy in diabetics [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Dietary Fish and n-3 Unsaturated Fatty Acid Consumption with Diabetic Nephropathy from a District Hospital in Northern Taiwan

et al. 2022

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Nephropathy caused by diabetes mellitus (DM) is the main cause of end-stage renal disease (ESRD). To understand the association of dietary intake with renal function indicators among patients with diabetic nephropathy (DN), this cross-sectional study was conducted at the dietetic consultation clinic of the Taoyuan Armed Forces General Hospital in Taiwan. In total, 317 participants were recruited for this study. Patients with diabetes who had a urinary albumin–creatinine ratio (UACR) of ≥30 mg/g were defined as having DN. The anthropometric characteristics, blood biochemistry, and renal function of the participants were assessed. Furthermore, a semiquantitative food frequency questionnaire (SQFFQ) was administered to investigate the dietary intake of the participants in the DM and DN groups. The result showed that participants in the DN group were older, had longer diabetes duration and poorer glycemic control and renal function than those in the DM group. Logistic regression models revealed that intake of high-fat marine fishes had the lowest odds ratio (OR) for DN risk compared with other fishes (OR: 0.868; 95% CI: 0.781–0.965, p = 0.009). Shellfish, soybean products, and skim milk also provided better protective effects to decrease the risk of DN. A further analysis of polyunsaturated fatty acids revealed that Σn-3 PUFAs significantly reduced DN risk, while Σn-6 PUFAs did not, especially EPA (OR: 0.821; 95% CI: 0.688–0.979, p = 0.029) and DHA (OR: 0.903; 95% CI: 0.823–0.992, p = 0.033) regardless of whether the variables were adjusted, including diabetes duration, age, and HbA1c. Our findings suggest that a diet that incorporates high-fat fish, shellfish, soybean products, and a lower Σn-6/Σn-3 ratio can mitigate DN risk.

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“…A lot of researches have presented that HOMA-IR is strongly associated with the progression of albuminuria. Recently, the REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal) study conducted in China [ 23 ] found that HOMA-IR was positively related to UACR in prediabetes or diabetes groups, but this relationship was not found in the normal glucose tolerance group. Another large prospective study showed that HOMA-IR quintiles were correlated with the incidence of CKD in adults without diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated the associations between the two indexes mentioned above with microalbuminuria or CKD separately in specific populations, such as elderly individuals or those with diabetes [ 14 , 23 ]. However, this study compared the performance of TyG index with HOMA-IR in general population.…”

Section: Discussionmentioning

confidence: 99%

Discordance between the triglyceride glucose index and HOMA-IR in incident albuminuria: a cohort study from China

Gao¹,

Wang

Chen³

et al. 2021

Lipids Health Dis

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Background To date, there have no study comparing the associations between TyG index and HOMA-IR on the risk of incident albuminuria. Accordingly, the objective of the present study is to use discordance analysis to evaluate the diverse associations between TyG index and HOMA-IR on the risk of incident albuminuria. Methods A community-based prospective cohort study was performed with 2446 Chinese adults. We categorized participants into 4 concordance or discordance groups. Discordance was defined as a TyG index equal to or greater than the upper quartile and HOMA-IR less than the upper quartile, or vice versa. Results During a median follow-up period of 3.9 years, 203 of 2446 participants developed incident albuminuria (8.3%). In the multivariable logistic analyses, the high TyG index tertile group was associated with a 1.71-fold (95% confidence interval (CI) 1.07–2.72) higher risk of incident albuminuria, comparing with the low tertile group. Participants in TyG (+) & HOMA-IR (−) group had a greater risk of incident albuminuria compared with those in TyG (−) & HOMA-IR (−) group after multivariate adjustment. Subgroup analyses showed that low HOMA-IR and discordantly high TyG index was closely related to a highest risk of incident albuminuria in cardiovascular metabolic disorder subjects. Conclusions Participants with a discordantly high TyG index had a significantly greater risk of incident albuminuria, especially in metabolic dysfunction subjects. The TyG index might be a better predictor of early stage of chronic kidney disease than HOMA-IR for subjects with metabolic abnormality.

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Insulin resistance is associated with urinary albumin‐creatinine ratio in normal weight individuals with hypertension and diabetes: The REACTION study

Cited by 22 publications

References 29 publications

Triglycerides to high-density lipoprotein cholesterol ratio is superior to triglycerides and other lipid ratios as an indicator of increased urinary albumin-to-creatinine ratio in the general population of China: a cross-sectional study

Triglycerides to high-density lipoprotein cholesterol ratio is superior to triglycerides and other lipid ratios as an indicator of increased urinary albumin-to-creatinine ratio in the general population of China: a cross-sectional study

Association of Dietary Fish and n-3 Unsaturated Fatty Acid Consumption with Diabetic Nephropathy from a District Hospital in Northern Taiwan

Discordance between the triglyceride glucose index and HOMA-IR in incident albuminuria: a cohort study from China

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