{
    "abstract": "Reduced renal insulin signalling is implicated in the pathogenesis of albuminuria. We sought to investigate whether insulin action and secretion, measured before diabetes onset, are associated with the development of albuminuria after diabetes onset.\nBaseline body composition, insulin sensitivity by hyperinsulinaemic-euglycaemic clamp at submaximal and maximal insulin stimulation (240 and 2400\u2009pmol/m\nParticipants who developed albuminuria were of similar age (26.4\u2009\u00b1\u20095.4 vs. 27.5\u2009\u00b1\u20096.1\u2009years), sex (46% vs. 48% male), body fat (36.4\u2009\u00b1\u20097.5 vs. 35.7\u2009\u00b1\u20097.9%) and AIR [2.3\u2009\u00b1\u20090.3 vs. 2.3\u2009\u00b1\u20090.3, pmol/L (log)] as those who did not develop albuminuria but had lower insulin sensitivity [M-low: 0.33\u2009\u00b1\u20090.08 vs. 0.36\u2009\u00b1\u20090.12, p\u2009=\u2009.03; M-high: 0.87\u2009\u00b1\u20090.11 vs. 0.91\u2009\u00b1\u20090.12, p\u2009=\u2009.02; mg/kg-metabolic body size/min (log)]. In separate adjusted models, lower M-low and M-high were both associated with an increased risk for albuminuria [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.14, 2.00, p\u2009=\u2009.004; HR 1.31, 95% CI 1.06, 1.63, p\u2009=\u2009.01), whereas AIR was not (HR 1.15, 95% CI 0.87, 1.56, p\u2009=\u2009.3).\nLower insulin sensitivity is associated with the development of albuminuria, suggesting a role for insulin signalling in the pathogenesis of proteinuria.",
    "authors": [
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Meeah R",
            "initials": "MR",
            "lastname": "Willig"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Emma J",
            "initials": "EJ",
            "lastname": "Stinson"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Helen C",
            "initials": "HC",
            "lastname": "Looker"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Paolo",
            "initials": "P",
            "lastname": "Piaggi"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Cassie M",
            "initials": "CM",
            "lastname": "Mitchell"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Robert L",
            "initials": "RL",
            "lastname": "Hanson"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Robert G",
            "initials": "RG",
            "lastname": "Nelson"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Jonathan",
            "initials": "J",
            "lastname": "Krakoff"
        },
        {
            "affiliation": "Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona, USA.",
            "firstname": "Douglas C",
            "initials": "DC",
            "lastname": "Chang"
        }
    ],
    "conclusions": null,
    "copyrights": "Published 2024. This article is a U.S. Government work and is in the public domain in the USA. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.",
    "doi": "10.1111/dom.15505\n10.1016/S0140-6736(10)60674-5\n10.2337/dc08-s249\n10.1007/s11906-012-0270-y\n10.3389/fcell.2020.00519\n10.2337/diacare.28.1.164\n10.1007/978-1-4939-9841-8\n10.1056/NEJMcibr1008395\n10.1016/j.cmet.2010.08.015\n10.1007/s00125-017-4394-0\n10.1038/ki.2012.234\n10.1056/NEJM199312303292703\n10.1172/JCI7231\n10.2337/dbi20-0043\n10.2337/diacare.16.1.335\n10.2337/dc13-2573\n10.1253/circj.CJ-14-0689\n10.2337/dc10-1718\n10.1093/oxfordjournals.aje.a112648\n10.1093/ajcn/53.6.1368\n10.2337/diacare.26.11.3160\n10.1093/ajcn/62.4.730\n10.1038/oby.2004.241\n10.1007/s00125-020-05348-5\n10.1111/j.1749-6632.1959.tb44923.x\n10.1210/jcem-25-10-1375\n10.1002/j.1550-8528.1996.tb00274.x\n10.1007/BF00281119\n10.1152/ajpendo.00645.2007\n10.1016/S2213-8587(18)30051-2\n10.1016/s0168-8227(01)00241-8\n10.1111/j.1464-5491.2004.01290.x\n10.3389/fendo.2018.00693\n10.2337/diabetes.54.11.3095\n10.1038/sj.ki.5001882\n10.1681/ASN.2018111166\n10.1038/s41467-021-26900-w\n10.1053/j.ajkd.2009.11.013\n10.1210/jc.2003-030861\n10.1038/sj.ki.5002516\n10.2337/diabetes.54.7.2206\n10.1152/ajpendo.00247.2020\n10.1016/j.biopha.2021.111454\n10.3390/biomedicines9010003\n10.3390/ijms23073651",
    "journal": "Diabetes, obesity & metabolism",
    "keywords": [
        "albuminuria",
        "hyperinsulinaemic\u2010euglycaemic clamp",
        "insulin resistance",
        "proteinuria",
        "type 2 diabetes"
    ],
    "methods": null,
    "publication_date": "2024-02-29",
    "pubmed_id": "38419421\n20483451\n18227485\n22569647\n32850773\n15616252\n31701441\n21083394\n20889126\n28852804\n22718189\n8247074\n10491414\n34285119\n8422805\n24623021\n25391257\n21335369\n736028\n2035463\n14578255\n1888242\n7572700\n15687392\n33404681\n13833973\n5320561\n8946445\n6714534\n13692569\n17957034\n29503172\n11403858\n15384955\n30524379\n16249431\n17003816\n31152118\n34764278\n20110146\n15579760\n17805239\n15983223\n32776829\n33714781\n33375185\n35409011",
    "results": "Participants who developed albuminuria were of similar age (26.4\u2009\u00b1\u20095.4 vs. 27.5\u2009\u00b1\u20096.1\u2009years), sex (46% vs. 48% male), body fat (36.4\u2009\u00b1\u20097.5 vs. 35.7\u2009\u00b1\u20097.9%) and AIR [2.3\u2009\u00b1\u20090.3 vs. 2.3\u2009\u00b1\u20090.3, pmol/L (log)] as those who did not develop albuminuria but had lower insulin sensitivity [M-low: 0.33\u2009\u00b1\u20090.08 vs. 0.36\u2009\u00b1\u20090.12, p\u2009=\u2009.03; M-high: 0.87\u2009\u00b1\u20090.11 vs. 0.91\u2009\u00b1\u20090.12, p\u2009=\u2009.02; mg/kg-metabolic body size/min (log)]. In separate adjusted models, lower M-low and M-high were both associated with an increased risk for albuminuria [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.14, 2.00, p\u2009=\u2009.004; HR 1.31, 95% CI 1.06, 1.63, p\u2009=\u2009.01), whereas AIR was not (HR 1.15, 95% CI 0.87, 1.56, p\u2009=\u2009.3).",
    "title": "Insulin resistance before type 2 diabetes onset is associated with increased risk of albuminuria after diabetes onset: A prospective cohort study.",
    "xml": "<Element 'PubmedArticle' at 0x7885033e4a40>"
}