Relationship Between Homeostatic Model Assessment Insulin Resistance (HOMA-IR) Values And Glomerular Filtration Rates (GFR). A Retrospective Study

Abstract

Aim: Our aim is to evaluate the possible relationships between insulin resistance levels and glomerular filtration rates (GFR) according to Cockcroft-Gault (CG) and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations.

Material and Method: Data of 169 subjects (58 men, 111 women) with a medium age of 39.11±10.29 years were evaluated retrospectively.  The individuals whose body mass index (BMI) value was 30 and over were defined as obese. Homeostatic model assessment insulin resistance (HOMA-IR) value was calculated and the insulin resistance was accepted as positive for patients with HOMA score ≥ 2.7. Glomerular filtration rates were calculated by both Cockcroft-Gault and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations.

Results:  Ninety-four subjects (%55.60) were accepted to be insulin resistant. There were no statistical significance between insulin resistant group and non-resistant group according to age and gender. There was a correlation between HOMA-IR levels and GFR values according to CG equation. There was no correlation between HOMA-IR levels and GFR values according to CKD-EPI equation. According to the GFR values calculated by CG equation, GFR levels were significantly higher in insulin resistant group (152,66±48,90 vs 123,12±34,95 ml/min; p<0.001).

Conclusion: Cockcroft-Gault equation is accepted to be influenced by body weight and also BMI which was a predictor of insülin resistance.  According to our findings CG levels can be effected by presence of insulin resistance but such finding was not present in CKD-EPI levels. We thought that this topic is needed to be studied in future researches.

Keywords

• Insulin resistance, glomerular filtration rate

Homeostatic Model Assessment Insulin Resistance (HOMA-IR) Değerleri ile Glomerüler Filtrasyon Hızları Arasındaki İlişki: Retrospektif Bir Çalışma

Öz

Amaç: Bu çalışmada amacımız insulin direnci seviyesi ile Cockcroft-Gault (CG) ve Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) denklemlerine  göre hesaplanan glomerüler filtrasyon hızları (GFH) arasındaki olası  ilişkiyi ortaya koymaktır.

Materyal Metod: Yaş ortalaması 39,11±10,29 yıl olan 169 kişi  (58 erkek, 111 kadın) retrospektif olarak değerlendirildi. Vücut kitle indeksi 30 ve üzeri olanlar obez olarak kabul edildi. Homeostatic model assessment insulin  resistance (HOMA-IR) skoru ≥ 2,7 olanların insulin direnci olduğu kabul edildi. Cockcroft-Gault (CG) ve Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) denklemlerine göre GFH değerleri hesaplandı.

Sonuçlar: Kişilerin 94’ü (%55,4) insulin dirençli kabul edildi. İnsülin direnci olan ve olmayan grup arasında yaş ve cinsiyet açısından farklılık yoktu. CG formülüne göre hesaplanan GFH değeleri ve HOMA-IR seviyeleri arasında ilişki vardı. CKD-EPI denklemine göre hesaplanan GFH değerleri ve HOMA-IR seviyeleri arasında ilişki yoktu. CG denklemine göre hesaplanan GFH değerleri insulin dirençli grupta anlamlı olarak daha yüksekti (152,66±48,90 vs 123,12±34,95 ml/min; p<0.001).

Tartışma: Cockcroft-Gault denklemi vücut ağırlığı ve insulin direncinin belirteci olan VKİ’den de etkilenir. Bulgularımıza göre CG seviyeleri insulin direnci varlığından etkilenirken bu bulguya CKD-EPİ değerlerinde rastlanmadı. Bu konunun ilerdeki çalışmalarda araştırılması gerektiği düşüncesindeyiz. 

Anahtar Kelimeler

• İnsülin direnci, glomerüler filtrasyon hızı

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