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Association of Longitudinal Trajectories of Insulin Resistance With Adverse Renal Outcomes
DC Field | Value | Language |
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dc.contributor.author | Yang, Seokhun | - |
dc.contributor.author | Kwak, Soongu | - |
dc.contributor.author | Song, You-Hyun | - |
dc.contributor.author | Han, Seung Seok | - |
dc.contributor.author | Lee, Hye Sun | - |
dc.contributor.author | Kang, Shinae | - |
dc.contributor.author | Lee, Seung-Pyo | - |
dc.date.accessioned | 2023-01-09T02:42:19Z | - |
dc.date.available | 2023-01-09T02:42:19Z | - |
dc.date.created | 2022-06-17 | - |
dc.date.issued | 2022-05 | - |
dc.identifier.citation | Diabetes Care, Vol.45 No.5, pp.1268-1275 | - |
dc.identifier.issn | 0149-5992 | - |
dc.identifier.uri | https://hdl.handle.net/10371/188935 | - |
dc.description.abstract | © 2022 by the American Diabetes Association.OBJECTIVE: To analyze the relationship between time-serial changes in insulin resistance and renal outcomes. RESEARCH DESIGN AND METHODS: A prospective cohort of subjects from the general population without chronic kidney disease (CKD) underwent a biennial checkup for 12 years (n = 5,347). The 12-year duration was divided into a 6-year exposure period, where distinct HOMA for insulin resistance (HOMA-IR) trajectories were identified using latent variable mixture modeling, followed by a 6-year event accrual period, from which the renal outcome data were analyzed. The primary end point was adverse renal outcomes, defined as a composite of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 in two or more consecutive checkups or albumin ≥1+ on urine strip. RESULTS: Two distinct groups of HOMA-IR trajectories were identified during the exposure period: stable (n = 4,770) and increasing (n = 577). During the event accrual period, 449 patients (8.4%) developed adverse renal outcomes, and the risk was higher in the increasing HOMA-IR trajectory group than in the stable group (hazard ratio 2.06, 95% CI 1.62-2.60, P < 0.001). The results were similar after adjustment for baseline clinical characteristics, comorbidities, anthropometric and laboratory findings, eGFR, and HOMA-IR. The clinical significance of increasing HOMA-IR trajectory was similar in three or four HOMA-IR trajectories. The increasing tendency of HOMA-IR was persistently associated with a higher incidence of adverse renal outcomes, irrespective of the prevalence of diabetes. CONCLUSIONS: An increasing tendency of insulin resistance was associated with a higher risk of adverse renal outcomes. Time-serial tracking of insulin resistance may help identify patients at high risk for CKD. | - |
dc.language | 영어 | - |
dc.publisher | American Diabetes Association | - |
dc.title | Association of Longitudinal Trajectories of Insulin Resistance With Adverse Renal Outcomes | - |
dc.type | Article | - |
dc.identifier.doi | 10.2337/dc21-2521 | - |
dc.citation.journaltitle | Diabetes Care | - |
dc.identifier.wosid | 000890443700011 | - |
dc.identifier.scopusid | 2-s2.0-85130633409 | - |
dc.citation.endpage | 1275 | - |
dc.citation.number | 5 | - |
dc.citation.startpage | 1268 | - |
dc.citation.volume | 45 | - |
dc.description.isOpenAccess | Y | - |
dc.contributor.affiliatedAuthor | Lee, Seung-Pyo | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
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