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

Year 2015, Volume: 15 Issue: 4, - , 15.09.2015

Uğur Bilge , Gözde Gültekin Muzaffer Bilgin , İlhami Ünlüoğlu

https://doi.org/10.17098/amj.18395

Cited By: 2

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

Abstract

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. 

Keywords

İnsülin direnci, glomerüler filtrasyon hızı

References

• Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function measured and estimated glomerular filtration rate. N Engl J Med 2006;354(23):2473-83.
• Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS. Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003;41(1):1-12.
• Lindeman RD, Tobin JD, Shock NW. Association between blood pressure and the rate of decline in renal function with age. Kidney Int 1984;26(6):861-8.
• DeFronzo RA, Goldberg M, Agus ZS. The effects of glucose and insulin on renal electrolyte transport. J Clin Invest. 1976;58(1):83-90.
• DeFronzo RA. The effect of insulin on renal sodium metabolism. A review with clinical implications. Diabetologia 1981;21(3):165-71.
• Afsar B, Ay M. The relationships between cortisol levels, insulin levels, and thyroid hormones with 24-h urinary sodium excretion in never treated essential hypertensive patients. ARYA Atheroscler 2014;10(3):159-63.
• Ascaso JF, Pardo S, Real JT et al. Diagnosing insulin resistance by simple quantitative methods in subjects with normal glucose metabolism. Diabetes Care 2003;26:3320-5.
• Topsakal S, Yerlikaya E, Akin F, Kaptanoglu B, Erürker T. Relation with HOMA-IR and thyroid hormones in obese Turkish women with metabolic syndrome. Eat Weight Disord 2012;17(1):e57-61.
• Barra S, Providência R, Faustino C, Paiva L, Fernandes A, Marques AL. Performance of the Cockcroft-Gault, MDRD and CKD-EPI Formulae in Non-Valvular Atrial Fibrillation: Which one Should be Used for Risk Stratification? J Atr Fibrillatio 2003;6(3):36-45.
• Kim HJ, Ryu J, Ahn SY, Kim S, Lim S, Na KY, Kim KW, Jang HC, Chae DW, Chin HJ. Association of insulin resistance with lower glomerular filtration rate and all-cause mortality in the Korean elderly population: a community-based prospective cohort study. Tohoku J Exp Med 2013;231(4):271-9.
• Michels WM, Grootendorst DC, Verduijn M, Elliott EG, Dekker FW, Krediet RT. Performance of the Cockcroft-Gault, MDRD, and new CKD-EPI formulas in relation to GFR, age, and body size. Clin J Am Soc Nephrol 2010;5(6):1003-9.
• Gupta D, Krueger CB, Lastra G. Over-nutrition, obesity and insulin resistance in the development of β-cell dysfunction. Curr Diabetes Rev 2012;8(2):76-83.
• Moller DE, Flier JS. Insulin resistance--mechanisms, syndromes, and implications.N Engl J Med 1991;325(13):938-48.
• Esteghamati A, Ashraf H, Khalilzadeh O etal. Optimal cut-off of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolicsyndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007). NutrMetab (Lond) 2010;7:26. (doi: 10.1186/1743-7075-7-26).
• Satman I, Omer B, Tutuncu Y etal. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013;28(2):169-80. (doi: 10.1007/s10654-013-9771-5).