The dose-response effect of insulin sensitivity on albuminuria in children according to diabetes type

SEARCH for Diabetes in Youth Study

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Insulin resistance is associated with microalbuminuria among youth with diabetes mellitus. We sought to determine the dose-response effect of insulin sensitivity (IS) on the magnitude of albuminuria and whether there is a threshold below which urine albumin excretion increases. Methods: These analyses included participants from the SEARCH for Diabetes in Youth Study with incident diabetes who completed a baseline study visit (n=2988).We estimated IS using a validated equation incorporating waist circumference, HbA1C, and fasting serum triglycerides. Multivariate regression analyses were performed to assess the effect of IS on urine albumin creatinine ratio (UACR), stratified by diabetes type. The IS threshold was then determined using segmented regressions within each diabetes type and incorporated into the multivariate model. Results: There was an association between IS and UACR in type 2 diabetes only (beta = -0.39; p < 0.001). There was strong statistical evidence for a threshold effect of IS score on UACR in the group of youth with type 2 (beta = 0.40; p <0.001) but not type 1 diabetes (p=0.3). Conclusions: In cross-sectional analyses, there is a negative association between IS and UACR in youth with type 2 but not type 1 diabetes, and this association likely includes a threshold effect of IS on UACR.

Original languageEnglish (US)
Pages (from-to)933-940
Number of pages8
JournalPediatric Nephrology
Volume31
Issue number6
DOIs
StatePublished - Jan 11 2016

Fingerprint

Albuminuria
Insulin Resistance
Albumins
Urine
Creatinine
Type 1 Diabetes Mellitus
Waist Circumference
Type 2 Diabetes Mellitus
Fasting
Diabetes Mellitus
Triglycerides
Multivariate Analysis
Cross-Sectional Studies
Regression Analysis

Keywords

  • Insulin resistance
  • Metabolic syndrome
  • Microalbuminuria
  • Nephropathy
  • Urine:albumin creatinine ratio

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The dose-response effect of insulin sensitivity on albuminuria in children according to diabetes type. / SEARCH for Diabetes in Youth Study.

In: Pediatric Nephrology, Vol. 31, No. 6, 11.01.2016, p. 933-940.

Research output: Contribution to journalArticle

SEARCH for Diabetes in Youth Study. / The dose-response effect of insulin sensitivity on albuminuria in children according to diabetes type. In: Pediatric Nephrology. 2016 ; Vol. 31, No. 6. pp. 933-940.
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abstract = "Background: Insulin resistance is associated with microalbuminuria among youth with diabetes mellitus. We sought to determine the dose-response effect of insulin sensitivity (IS) on the magnitude of albuminuria and whether there is a threshold below which urine albumin excretion increases. Methods: These analyses included participants from the SEARCH for Diabetes in Youth Study with incident diabetes who completed a baseline study visit (n=2988).We estimated IS using a validated equation incorporating waist circumference, HbA1C, and fasting serum triglycerides. Multivariate regression analyses were performed to assess the effect of IS on urine albumin creatinine ratio (UACR), stratified by diabetes type. The IS threshold was then determined using segmented regressions within each diabetes type and incorporated into the multivariate model. Results: There was an association between IS and UACR in type 2 diabetes only (beta = -0.39; p < 0.001). There was strong statistical evidence for a threshold effect of IS score on UACR in the group of youth with type 2 (beta = 0.40; p <0.001) but not type 1 diabetes (p=0.3). Conclusions: In cross-sectional analyses, there is a negative association between IS and UACR in youth with type 2 but not type 1 diabetes, and this association likely includes a threshold effect of IS on UACR.",
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author = "{SEARCH for Diabetes in Youth Study} and Mottl, {Amy K.} and Jasmin Divers and Dana Dabelea and Maahs, {David M.} and Lawrence Dolan and David Pettitt and Santica Marcovina and Giuseppina Imperatore and Catherine Pihoker and Michael Mauer and Mayer-Davis, {Elizabeth J.}",
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AU - Maahs, David M.

AU - Dolan, Lawrence

AU - Pettitt, David

AU - Marcovina, Santica

AU - Imperatore, Giuseppina

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AU - Mayer-Davis, Elizabeth J.

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N2 - Background: Insulin resistance is associated with microalbuminuria among youth with diabetes mellitus. We sought to determine the dose-response effect of insulin sensitivity (IS) on the magnitude of albuminuria and whether there is a threshold below which urine albumin excretion increases. Methods: These analyses included participants from the SEARCH for Diabetes in Youth Study with incident diabetes who completed a baseline study visit (n=2988).We estimated IS using a validated equation incorporating waist circumference, HbA1C, and fasting serum triglycerides. Multivariate regression analyses were performed to assess the effect of IS on urine albumin creatinine ratio (UACR), stratified by diabetes type. The IS threshold was then determined using segmented regressions within each diabetes type and incorporated into the multivariate model. Results: There was an association between IS and UACR in type 2 diabetes only (beta = -0.39; p < 0.001). There was strong statistical evidence for a threshold effect of IS score on UACR in the group of youth with type 2 (beta = 0.40; p <0.001) but not type 1 diabetes (p=0.3). Conclusions: In cross-sectional analyses, there is a negative association between IS and UACR in youth with type 2 but not type 1 diabetes, and this association likely includes a threshold effect of IS on UACR.

AB - Background: Insulin resistance is associated with microalbuminuria among youth with diabetes mellitus. We sought to determine the dose-response effect of insulin sensitivity (IS) on the magnitude of albuminuria and whether there is a threshold below which urine albumin excretion increases. Methods: These analyses included participants from the SEARCH for Diabetes in Youth Study with incident diabetes who completed a baseline study visit (n=2988).We estimated IS using a validated equation incorporating waist circumference, HbA1C, and fasting serum triglycerides. Multivariate regression analyses were performed to assess the effect of IS on urine albumin creatinine ratio (UACR), stratified by diabetes type. The IS threshold was then determined using segmented regressions within each diabetes type and incorporated into the multivariate model. Results: There was an association between IS and UACR in type 2 diabetes only (beta = -0.39; p < 0.001). There was strong statistical evidence for a threshold effect of IS score on UACR in the group of youth with type 2 (beta = 0.40; p <0.001) but not type 1 diabetes (p=0.3). Conclusions: In cross-sectional analyses, there is a negative association between IS and UACR in youth with type 2 but not type 1 diabetes, and this association likely includes a threshold effect of IS on UACR.

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