Axel C Carlsson1, Michael Calamia2, Ulf Risérus3, Anders Larsson4, Johanna Helmersson-Karlqvist4, Lars Lind4, Johan Arnlöv5. 1. 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. Electronic address: axelcefam@hotmail.com. 2. Landstinget Dalarna, Falun, Sweden. 3. Department of Public Health and Caring Sciences/Section of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden. 4. Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden. 5. Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden. Electronic address: johan.arnlov@pubcare.uu.se.
Abstract
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.
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.
Authors: Sushrut S Waikar; Venkata Sabbisetti; Johan Ärnlöv; Axel C Carlsson; Josef Coresh; Harold I Feldman; Meredith C Foster; Gudeta D Fufaa; Johanna Helmersson-Karlqvist; Chi-Yuan Hsu; Paul L Kimmel; Anders Larsson; Yumin Liu; Lars Lind; Kathleen D Liu; Theodore E Mifflin; Robert G Nelson; Ulf Risérus; Ramachandran S Vasan; Dawei Xie; Xiaoming Zhang; Joseph V Bonventre Journal: Nephrol Dial Transplant Date: 2016-06-07 Impact factor: 5.992
Authors: Axel C Carlsson; Anders Larsson; Johanna Helmersson-Karlqvist; Lars Lind; Erik Ingelsson; Tobias E Larsson; Matteo Bottai; Johan Sundström; Johan Ärnlöv Journal: Clin J Am Soc Nephrol Date: 2014-06-12 Impact factor: 8.237
Authors: Sylwia M Figarska; Stefan Gustafsson; Johan Sundström; Johan Ärnlöv; Anders Mälarstig; Sölve Elmståhl; Tove Fall; Lars Lind; Erik Ingelsson Journal: Arterioscler Thromb Vasc Biol Date: 2018-10 Impact factor: 8.311
Authors: Aleksandra Tonkonogi; Axel C Carlsson; Johanna Helmersson-Karlqvist; Anders Larsson; Johan Ärnlöv Journal: Ups J Med Sci Date: 2016-06-20 Impact factor: 2.384