HOMA-IR ve eGFR Değerleri Arasındaki Korelasyon

Öz

Amaç: Bu çalışmada amaç, bir eğitim ve araştırma hastanesinin farklı polikliniklerine farklı şikayetlerle başvuran bireylerin insülin direncinin homeostatik model değerlendirmesi (HOMA-IR) değerleri ile tahmini glomerüler filtrasyon hızı değerleri (eGFR) arasındaki korelasyonu belirlemektir. Gereç ve Yöntem: Çalışmada farklı polikliniklere başvuran 7815 (1740 erkek ve 6075 kadın) hastanın verileri analiz edildi. Çalışma kriterlerini karşılayan ve HOMA-IR ile eGFR talep eden yetişkin hastalar hastane bilgi yönetim sistemi tarafından belirlendi. Tüm hastaların yaş ve cinsiyetleri tespit edildi. Veriler istatistiksel olarak değerlendirildi. İnsülin direnci; homeostatik model değerlendirme yöntemi ile ölçüldü. Bulgular: Hastaların ortalama HOMA-IR ve eGFR değerleri sırasıyla 3.28±0.52 ve 111.35±22.91 olarak hesaplandı. 7815 hastanın %60’ının HOMA-IR değerleri normalden yüksek bulunurken, aynı hastaların eGFR değerleri normalden düşük olarak bulundu. HOMA-IR ile eGFR arasında negatif bir korelasyon tespit edildi (r = -0.48). Sonuç: HOMA-IR ve eGFR arasındaki korelasyon (p<0.01) istatistiksel olarak anlamlı bulundu. Ancak, bu bilgilerin daha kapsamlı bir çalışma ile klinisyenler tarafından kullanılabilir hale getirilmesi önem arz edecektir. İnsulin direnci ve böbrek rahatsızlıklarının gelişimi ve takibinde HOMO_IR ve eGFR seviyelerinin değerlendirilmesi erken teşhis bakımından yardımcı olabilir.

Anahtar Kelimeler

• HOMA-IR
• eGFR
• Korelasyon

Correlation Between HOMA-IR and eGFR Values

Öz

Objective: The aim of this study is to determine the correlation between the homeostatic model assessment of insulin resistance (HOMA-IR) values and the estimated glomerular filtration rate (eGFR) values of individuals who applied to different polyclinics of a training and research hospital with different complaints. Materials and Methods: In the study, the data of 7815 (1740 men and 6075 women) patients who applied to different polyclinics were analyzed. Adult patients who met the study criteria and requested HOMA-IR and eGFR were identified by the hospital information management system. Age and gender of all patients were determined. The data were evaluated statistically. Insulin resistance; was measured by the homeostatic model evaluation method. Results: The mean HOMA-IR and eGFR values of the patients were 3.28±0.52 and 111.35±22.91, respectively. While HOMA-IR values were found to be higher than normal in 60% of 7815 patients, the eGFR values of the same patients were found to be lower than normal. There was a moderate negative correlation between HOMA-IR and eGFR (r = -0.48). In other words, it was determined that patients with increased HOMA-IR values had a moderate decrease in eGFR values. Conclusion: There was a moderate negative correlation between HOMA-IR and eGFR However, it will be important to make this information available to clinicians with a more detailed study. Evaluation of HOMO-IR and eGFR levels can be utility for early diagnosis in the development and follow up of insulin resistance and kidney disorders.

Anahtar Kelimeler

• Correlation
• eGFR
• HOMA-IR

Kaynakça

1. Alan S, Go AS, Chertow GM. Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization. N Engl J Med, 2004;351,1296-305.
2. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care, 2011;34(1):62-69.
3. Arcidiacono B, Iiritano S, Nocera A. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res,2012;789174. doi: 10.1155/2012/789174.
4. Ascaso JF, Pardo S, Real JT. Diagnosing insulin resistance by simple quantitative methods in subjects with normal glucose metabolism. Diabetes Care, 2003;26(12),3320-5. doi: 10.2337/diacare.26.12.3320.
5. Bilge U, Gültekin G, Bilgin M, Ünlüoğlu İ. Bir aile hekimliği polikliniğine başvuran kırk yaşaltı populasyonda obezite ve insulin direnci oranları. Türk Aile Hek Derg, 2016;20(2),50-53.
6. Bilge U, Gültekin G, Bilgin M, Ünlüoğlu İ. Relationship Between Homeostatic Model Assessment Insulin Resistance (HOMA-IR) Values and Glomerular Filtration Rates (GFR): A Retrospective Study. Ankara Med J, 2015;15(4),220-225.
7. Brown MA, Whithworth JA. Hypertension in human renal disease. J Hypertens,1992;10,701-12.
8. Castro AF, Coresh J. CKD surveillance using laboratory data from the population-based National Health and Nutrition Examination Survey (NHANES). Am J Kidney Dis. March; 2009;53(3),46–55.

9. Coresh J. Chronic Kidney Disease Awareness, Prevalence, and Trends among U.S. Adults, 1999 to 2000. J Am Soc Nephrol, 2005;16,180-188.
10. De Fronzo RA, Goldberg M, Agus ZS. The effects of glucose and insulin on renal electrolyte transport. J Clin Invest, 1976;58(1),83-90.
11. Demir M, Aslan Ö, Atay A, Köseoğlu MH, Barış N, Çuhadar S. Comparison of MDRD Formula with extended-MDRD Which Were Used to Calculate GFR. Türk Klinik Biyokimya Derg 2010;8(3):111-116.
12. Forsblom CM, Eriksson JG, Ekstrand AV, Teppo AM, Taskinen MR, Groop LC. Insulin resistance and abnormal albumin excretion in non-diabetic first-degree relatives of patients with NIDDM. Diabetologia, 1995;38(3),363-369.
13. Gerstein HC, Mann JF, Yi Q, Zinman B, Dinneen SF, Hoogwerf B. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA, 2001;286(4),421-6.
14. Martin BC, Warram JH, Krolewski AS, Bergman RN, Soeldner JS, Kahn CR. Role of glucose and insulin resistance in development of type 2 diabetes mellitus: results of a 25-year follow-up study. Lancet, 1992;340(8825),925-9.
15. Onat A, Hergene G, Uyarel H, Ozhan H, Esen A, Karabulut A. Association between mild renal dysfunction and insulin resistance or metabolic syndrome in a random nondiabetic population sample. Kidney Blood Press Res, 2007;30(2),88-96.
16. Parvanova AI, Trevisan R, Iliev IP, Dimitrov BD, Vedovato M, Tiengo A. Insulin resistance and microalbuminuria: A cross-sectional, casecontrol study of 158 patients with type 2 diabetes and different degrees of urinary albumin excretion. Diabetes, 2006;55(5),1456–1462.
17. Premaratne E, Maclsaac R, Tsalamandris C, Panagiotopoulos S, Smith T, Jerums G. Renal hyperfiltration in type 2 diabetes: effect of age-related decline in glomerular filtration rate. Diabetologia 2005;48(12):2486-93.
18. Ritz E, Mc Clellan WM. Overview: Increased Cardiovascular Risk in Patients with Minor Renal Dysfunction: An Emerging Issue with Far-Reaching Consequences. J Am Soc Nephrol 2004;15,513-516.
19. Shin DI, Seung KB, Yoon HE, Hwang BH, Seo SM, Shin SJ. Microalbuminuria is independently associated with arterial stiffness and vascular inflammation but not with carotid intima–mediathickness in patients with newly diagnosed type 2 diabetes or essential hypertension. J Korean Med Sci, 2013;28(2),252–60.
20. Simmons RK, Alberti KG, Gale EA. The metabolic syndrome: useful concept or clinical tool? Report of a WHO Expert Consultation. Diabetologia, 2010;53(4),600-5.
21. 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.
22. 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),57-61.
23. Viswanathan V, Tilak P, Meerza R, Kumpatla S. Insulin resistance at different stages of diabetic kidney disease in India. J Assoc Physicians India, 2010;58(1),612-5.