Sex-specific Trajectories of Insulin Resistance Markers and Reduced Renal Function During 18 Years of Follow-up: TLGS
Abstract Context The evidence suggest that insulin resistance (IR) complicates chronic kidney disease (CKD); however, the longitudinal association of IR with development of CKD is unknown. Objective This work aimed to investigate the association between the dynamic course of insulin resistance and C...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2023-06, Vol.108 (6), p.e230-e239 |
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| creator | Amouzegar, Atieh Honarvar, Mohammadjavad Masoumi, Safdar Tohidi, Maryam Mehran, Ladan Azizi, Fereidoun |
| description | Abstract
Context
The evidence suggest that insulin resistance (IR) complicates chronic kidney disease (CKD); however, the longitudinal association of IR with development of CKD is unknown.
Objective
This work aimed to investigate the association between the dynamic course of insulin resistance and CKD.
Methods
In the longitudinal, population-based Tehran Lipid and Glucose Study, 3071 eligible participants aged 20 years or older were followed for 18 years at 3-year intervals. Homeostatic model assessment of insulin resistance (HOMA-IR) and clinical surrogate markers of IR, including triglyceride-glucose index (TyG), visceral adiposity index (VAI), and lipid accumulation product (LAP), were calculated. Using latent variable mixture modeling, sex-specific trajectories were plotted for each IR marker. Trajectory group association of the IR markers with CKD was determined using the multivariable Cox proportional-hazards regression model.
Results
For HOMA-IR, 2 distinct trajectory patterns (stable and increasing), and for TyG, VAI, and LAP, 3 trajectories (low, moderate, and high) were identified. The participants with an increasing HOMA-IR trajectory had a significantly increased risk of CKD in men (hazard ratio [HR]: 1.72; 95% CI, 1.06-2.79) and women (HR: 1.37; 95% CI, 1.00-1.89) after adjusting for confounding variables. The high TyG and VAI trajectory classes were associated with a higher risk of CKD than the low TyG and VAI trajectory classes both in men (TyG: HR: 1.97; 95% CI, 1.12-3.46; VAI: HR:1.66; 95% CI, 1.06-2.62) and women (TyG: HR: 1.50; 95% CI, 1.06-2.12; VAI: HR:1.66; 95% CI, 1.20-2.31). In contrast, the high LAP (HR: 3.38; 95% CI, 2.08-5.48) trajectory was associated with incident CKD only in women.
Conclusion
An increasing trend of HOMA-IR is associated with a higher risk of CKD in men and women. Among clinical IR surrogate markers, abnormal trajectory patterns of LAP in women and TyG and VAI in both sexes are associated with a higher risk of CKD. |
| doi_str_mv | 10.1210/clinem/dgac735 |
| format | Article |
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Context
The evidence suggest that insulin resistance (IR) complicates chronic kidney disease (CKD); however, the longitudinal association of IR with development of CKD is unknown.
Objective
This work aimed to investigate the association between the dynamic course of insulin resistance and CKD.
Methods
In the longitudinal, population-based Tehran Lipid and Glucose Study, 3071 eligible participants aged 20 years or older were followed for 18 years at 3-year intervals. Homeostatic model assessment of insulin resistance (HOMA-IR) and clinical surrogate markers of IR, including triglyceride-glucose index (TyG), visceral adiposity index (VAI), and lipid accumulation product (LAP), were calculated. Using latent variable mixture modeling, sex-specific trajectories were plotted for each IR marker. Trajectory group association of the IR markers with CKD was determined using the multivariable Cox proportional-hazards regression model.
Results
For HOMA-IR, 2 distinct trajectory patterns (stable and increasing), and for TyG, VAI, and LAP, 3 trajectories (low, moderate, and high) were identified. The participants with an increasing HOMA-IR trajectory had a significantly increased risk of CKD in men (hazard ratio [HR]: 1.72; 95% CI, 1.06-2.79) and women (HR: 1.37; 95% CI, 1.00-1.89) after adjusting for confounding variables. The high TyG and VAI trajectory classes were associated with a higher risk of CKD than the low TyG and VAI trajectory classes both in men (TyG: HR: 1.97; 95% CI, 1.12-3.46; VAI: HR:1.66; 95% CI, 1.06-2.62) and women (TyG: HR: 1.50; 95% CI, 1.06-2.12; VAI: HR:1.66; 95% CI, 1.20-2.31). In contrast, the high LAP (HR: 3.38; 95% CI, 2.08-5.48) trajectory was associated with incident CKD only in women.
Conclusion
An increasing trend of HOMA-IR is associated with a higher risk of CKD in men and women. Among clinical IR surrogate markers, abnormal trajectory patterns of LAP in women and TyG and VAI in both sexes are associated with a higher risk of CKD.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/clinem/dgac735</identifier><identifier>PMID: 36546593</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Adipose tissue ; Adipose tissues ; Biomarkers ; Blood Glucose ; Chronic kidney failure ; Dextrose ; Female ; Glucose ; Humans ; Hyperinsulinism ; Hypoglycemic agents ; Insulin Resistance ; Iran - epidemiology ; Kidney - physiology ; Kidney diseases ; Male ; Renal function ; Renal Insufficiency, Chronic - epidemiology ; Triglycerides ; Type 2 diabetes ; Women</subject><ispartof>The journal of clinical endocrinology and metabolism, 2023-06, Vol.108 (6), p.e230-e239</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2023 Oxford University Press</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-d1a61abacead3115ed3f1a80ecd65f0a41c07c9f31b3a4c1643020b3505e80543</citedby><cites>FETCH-LOGICAL-c424t-d1a61abacead3115ed3f1a80ecd65f0a41c07c9f31b3a4c1643020b3505e80543</cites><orcidid>0000-0002-3650-4951 ; 0000-0001-8568-7419 ; 0000-0001-9433-9408</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36546593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amouzegar, Atieh</creatorcontrib><creatorcontrib>Honarvar, Mohammadjavad</creatorcontrib><creatorcontrib>Masoumi, Safdar</creatorcontrib><creatorcontrib>Tohidi, Maryam</creatorcontrib><creatorcontrib>Mehran, Ladan</creatorcontrib><creatorcontrib>Azizi, Fereidoun</creatorcontrib><title>Sex-specific Trajectories of Insulin Resistance Markers and Reduced Renal Function During 18 Years of Follow-up: TLGS</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Abstract
Context
The evidence suggest that insulin resistance (IR) complicates chronic kidney disease (CKD); however, the longitudinal association of IR with development of CKD is unknown.
Objective
This work aimed to investigate the association between the dynamic course of insulin resistance and CKD.
Methods
In the longitudinal, population-based Tehran Lipid and Glucose Study, 3071 eligible participants aged 20 years or older were followed for 18 years at 3-year intervals. Homeostatic model assessment of insulin resistance (HOMA-IR) and clinical surrogate markers of IR, including triglyceride-glucose index (TyG), visceral adiposity index (VAI), and lipid accumulation product (LAP), were calculated. Using latent variable mixture modeling, sex-specific trajectories were plotted for each IR marker. Trajectory group association of the IR markers with CKD was determined using the multivariable Cox proportional-hazards regression model.
Results
For HOMA-IR, 2 distinct trajectory patterns (stable and increasing), and for TyG, VAI, and LAP, 3 trajectories (low, moderate, and high) were identified. The participants with an increasing HOMA-IR trajectory had a significantly increased risk of CKD in men (hazard ratio [HR]: 1.72; 95% CI, 1.06-2.79) and women (HR: 1.37; 95% CI, 1.00-1.89) after adjusting for confounding variables. The high TyG and VAI trajectory classes were associated with a higher risk of CKD than the low TyG and VAI trajectory classes both in men (TyG: HR: 1.97; 95% CI, 1.12-3.46; VAI: HR:1.66; 95% CI, 1.06-2.62) and women (TyG: HR: 1.50; 95% CI, 1.06-2.12; VAI: HR:1.66; 95% CI, 1.20-2.31). In contrast, the high LAP (HR: 3.38; 95% CI, 2.08-5.48) trajectory was associated with incident CKD only in women.
Conclusion
An increasing trend of HOMA-IR is associated with a higher risk of CKD in men and women. Among clinical IR surrogate markers, abnormal trajectory patterns of LAP in women and TyG and VAI in both sexes are associated with a higher risk of CKD.</description><subject>Adipose tissue</subject><subject>Adipose tissues</subject><subject>Biomarkers</subject><subject>Blood Glucose</subject><subject>Chronic kidney failure</subject><subject>Dextrose</subject><subject>Female</subject><subject>Glucose</subject><subject>Humans</subject><subject>Hyperinsulinism</subject><subject>Hypoglycemic agents</subject><subject>Insulin Resistance</subject><subject>Iran - epidemiology</subject><subject>Kidney - physiology</subject><subject>Kidney diseases</subject><subject>Male</subject><subject>Renal function</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Triglycerides</subject><subject>Type 2 diabetes</subject><subject>Women</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2LFDEQhoMo7jh69SgBL3ro3aSTdLq9LauzLowI7gh6CjXp6iFjd9ImHdR_b48zKsiC1KGgeOqtj5eQp5yd85KzC9s7j8NFuwOrhbpHFryRqtC80ffJgrGSF40uP52RRyntGeNSKvGQnIlKyUo1YkHyLX4v0ojWdc7STYQ92ilEh4mGjt74lOcB9AMmlybwFuk7iF8wJgq-nctttnjIHnq6yt5OLnj6Okfnd5TX9DNC_CW0Cn0fvhV5fEU36-vbx-RBB33CJ6e8JB9XbzZXb4v1--ubq8t1YWUpp6LlUHHYgkVoBecKW9FxqBnatlIdA8kt07bpBN8KkJZXUrCSbYViCmumpFiSF0fdMYavGdNkBpcs9j14DDmZUivNlGJlOaPP_0H3Icf5rmQEU1zXZcX4X2oHPRrnuzBFsAdRc6m1apSu57cuyfkd1BwtDs4Gj52b63c12BhSitiZMboB4g_DmTn4bI4-m5PPc8Oz07Z5O2D7B_9t7Ay8PAIhj_8T-wkKtbGd</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Amouzegar, Atieh</creator><creator>Honarvar, Mohammadjavad</creator><creator>Masoumi, Safdar</creator><creator>Tohidi, Maryam</creator><creator>Mehran, Ladan</creator><creator>Azizi, Fereidoun</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3650-4951</orcidid><orcidid>https://orcid.org/0000-0001-8568-7419</orcidid><orcidid>https://orcid.org/0000-0001-9433-9408</orcidid></search><sort><creationdate>20230601</creationdate><title>Sex-specific Trajectories of Insulin Resistance Markers and Reduced Renal Function During 18 Years of Follow-up: TLGS</title><author>Amouzegar, Atieh ; Honarvar, Mohammadjavad ; Masoumi, Safdar ; Tohidi, Maryam ; Mehran, Ladan ; Azizi, Fereidoun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-d1a61abacead3115ed3f1a80ecd65f0a41c07c9f31b3a4c1643020b3505e80543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adipose tissue</topic><topic>Adipose tissues</topic><topic>Biomarkers</topic><topic>Blood Glucose</topic><topic>Chronic kidney failure</topic><topic>Dextrose</topic><topic>Female</topic><topic>Glucose</topic><topic>Humans</topic><topic>Hyperinsulinism</topic><topic>Hypoglycemic agents</topic><topic>Insulin Resistance</topic><topic>Iran - epidemiology</topic><topic>Kidney - physiology</topic><topic>Kidney diseases</topic><topic>Male</topic><topic>Renal function</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Triglycerides</topic><topic>Type 2 diabetes</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amouzegar, Atieh</creatorcontrib><creatorcontrib>Honarvar, Mohammadjavad</creatorcontrib><creatorcontrib>Masoumi, Safdar</creatorcontrib><creatorcontrib>Tohidi, Maryam</creatorcontrib><creatorcontrib>Mehran, Ladan</creatorcontrib><creatorcontrib>Azizi, Fereidoun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amouzegar, Atieh</au><au>Honarvar, Mohammadjavad</au><au>Masoumi, Safdar</au><au>Tohidi, Maryam</au><au>Mehran, Ladan</au><au>Azizi, Fereidoun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex-specific Trajectories of Insulin Resistance Markers and Reduced Renal Function During 18 Years of Follow-up: TLGS</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>108</volume><issue>6</issue><spage>e230</spage><epage>e239</epage><pages>e230-e239</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><abstract>Abstract
Context
The evidence suggest that insulin resistance (IR) complicates chronic kidney disease (CKD); however, the longitudinal association of IR with development of CKD is unknown.
Objective
This work aimed to investigate the association between the dynamic course of insulin resistance and CKD.
Methods
In the longitudinal, population-based Tehran Lipid and Glucose Study, 3071 eligible participants aged 20 years or older were followed for 18 years at 3-year intervals. Homeostatic model assessment of insulin resistance (HOMA-IR) and clinical surrogate markers of IR, including triglyceride-glucose index (TyG), visceral adiposity index (VAI), and lipid accumulation product (LAP), were calculated. Using latent variable mixture modeling, sex-specific trajectories were plotted for each IR marker. Trajectory group association of the IR markers with CKD was determined using the multivariable Cox proportional-hazards regression model.
Results
For HOMA-IR, 2 distinct trajectory patterns (stable and increasing), and for TyG, VAI, and LAP, 3 trajectories (low, moderate, and high) were identified. The participants with an increasing HOMA-IR trajectory had a significantly increased risk of CKD in men (hazard ratio [HR]: 1.72; 95% CI, 1.06-2.79) and women (HR: 1.37; 95% CI, 1.00-1.89) after adjusting for confounding variables. The high TyG and VAI trajectory classes were associated with a higher risk of CKD than the low TyG and VAI trajectory classes both in men (TyG: HR: 1.97; 95% CI, 1.12-3.46; VAI: HR:1.66; 95% CI, 1.06-2.62) and women (TyG: HR: 1.50; 95% CI, 1.06-2.12; VAI: HR:1.66; 95% CI, 1.20-2.31). In contrast, the high LAP (HR: 3.38; 95% CI, 2.08-5.48) trajectory was associated with incident CKD only in women.
Conclusion
An increasing trend of HOMA-IR is associated with a higher risk of CKD in men and women. Among clinical IR surrogate markers, abnormal trajectory patterns of LAP in women and TyG and VAI in both sexes are associated with a higher risk of CKD.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>36546593</pmid><doi>10.1210/clinem/dgac735</doi><orcidid>https://orcid.org/0000-0002-3650-4951</orcidid><orcidid>https://orcid.org/0000-0001-8568-7419</orcidid><orcidid>https://orcid.org/0000-0001-9433-9408</orcidid></addata></record> |
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| ispartof | The journal of clinical endocrinology and metabolism, 2023-06, Vol.108 (6), p.e230-e239 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adipose tissue Adipose tissues Biomarkers Blood Glucose Chronic kidney failure Dextrose Female Glucose Humans Hyperinsulinism Hypoglycemic agents Insulin Resistance Iran - epidemiology Kidney - physiology Kidney diseases Male Renal function Renal Insufficiency, Chronic - epidemiology Triglycerides Type 2 diabetes Women |
| title | Sex-specific Trajectories of Insulin Resistance Markers and Reduced Renal Function During 18 Years of Follow-up: TLGS |
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