Albuminuria is thought to be associated with insulin resistance in patients with type 1 and type 2 diabetes as well as in non-diabetic subjects. The aim of this study was to find out about any direct correlation between the albumin excretion rate (AER) and insulin resistance; this was investigated in patients with type 1 diabetes.
Euglycemic hyperinsulinemic clamps were performed in 18 patients with type 1 diabetes and incipient nephropathy - elevated albumin excretion rate (AER > 20 µg/min) but normal glomerular filtration rate (GFR) (81 - 135 ml/min/1.73 m2).
AER, determined as mean of two overnight urine collections, was 137 ± 157 (mean ± S.D.) µg/min (range 24 - 447). Insulin sensitivity, expressed as the M-value, was 6.8 ± 2.9 mg/kg/min, insulin sensitivity index (ISI = 100 × M/plasma insulin) 7.9 ± 3.4 and insulin clearance (MCRins) 17.0 ± 4.0 ml/kg/min. Simple regression analyses showed no direct association between AER and M, ISI or MCRins. GFR was not associated with M, ISI or MCRins in this group, either. AER was, however, positively associated with poor glucose control (high HbAlc) and tobacco use.
These results suggest that the degree of albuminuria is not directly linked to insulin resistance. This was shown in type 1 diabetics, but could possibly be applicable in other subjects as well.
2002. Vol. 34, no 5, 254-259 p.