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Kidney injury molecule (KIM)-1 is associated with insulin resistance: results from two community-based studies of elderly individuals
Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden ; Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden.
Landstinget Dalarna, Falun, Sweden.
Department of Public Health and Caring Sciences/Section of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden.
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2014 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 103, no 3, 516-21 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND AND OBJECTIVES: Insulin resistance has been shown to be closely associated with glomerular filtration rate and urinary albumin/creatinine ratio, even prior to the development of diabetes. Urinary kidney injury molecule 1 (KIM-1) is a novel, highly specific marker of kidney tubular damage. The role of insulin resistance in the development of kidney tubular damage is not previously reported. Thus, we aimed to investigate the associations between insulin sensitivity (assessed by HOMA) and urinary KIM-1.

DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: Two community-based cohorts of elderly individuals were investigated: Prospective Investigation of the vasculature in Uppsala seniors (PIVUS, n=701; mean age 75 years, 52% women); and Uppsala Longitudinal Study of adult men (ULSAM, n=533; mean age 78 years).

RESULTS: Lower insulin sensitivity was associated with higher urinary KIM-1 in both cohorts after adjustments for age, BMI, blood pressure, antihypertensive treatment, glomerular filtration rate, and urinary albumin-creatinine ratio (PIVUS: regression coefficient for 1-SD higher HOMA-IR 0.11, 95% CI 0.03-0.20, p=0.009, and ULSAM: 0.13, 95% CI 0.04-0.22, p=0.007). Results were similar in individuals without diabetes, with normal kidney function and normo-albuminuria.

CONCLUSIONS: Our findings in elderly individuals support the notion that the interplay between an impaired glucose metabolism and renal tubular damage is evident even prior to the development of diabetes and overt kidney disease.

Place, publisher, year, edition, pages
Elsevier, 2014. Vol. 103, no 3, 516-21 p.
Keyword [en]
Diabetes; Blood glucose; Microalbuminuria; Glomerular filtration; Kidney injury
National Category
Clinical Medicine
Research subject
Hälsa och välfärd
Identifiers
URN: urn:nbn:se:du-14221DOI: 10.1016/j.diabres.2013.12.008ISI: 000334582700040PubMedID: 24438875OAI: oai:DiVA.org:du-14221DiVA: diva2:723495
Available from: 2014-06-10 Created: 2014-06-10 Last updated: 2015-06-30Bibliographically approved

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CiteExportLink to record
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Citation style
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