Gender-specific association between urinary albumin excretion and insulin resistance in Japanese subjects
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The study aimed to investigate the relationship between homeostasis model assessment of insulin resistance (HOMA-IR) and albumin excretion in 752 Japanese subjects, with no history of diabetes, hypertension or dyslipidaemia. Urinary excretion of albumin in the first void urine was expressed as the creatinine ratio (ACR, mg/g Cr), and estimated glomerular filtration (eGFR) was calculated from serum creatinine using the formula for Japanese. HOMA-IR significantly correlated with ACR, the correlation being evident in subjects with central obesity, with no significant correlation found in non-obese subjects. HOMA-IR did not correlate with eGFR. HOMA-IR increased with increasing quintiles of ACR; this association was obvious in males, whereas in females, no significant trend was found. Multiple regression analysis revealed that ACR was independently associated with HOMA-IR in males but not females. Other factors significantly associated with HOMA-IR were age, waist circumference, blood pressure, and serum triglycerides. In conclusion, microalbuminuria is associated with insulin resistance in Japanese, where central obesity is likely to play an essential role. As the association is gender-specific, sex hormones or other sexually dimorphic traits may also be involved in albuminuria-related insulin resistance.
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