Microalbuminuria and insulin resistance in patients with type 2 diabetes mellitus : association with cardiovascular risk factors in men and women

الملخص EN

Background In patients with type 2 diabetes mellitus (DM), micro albuminuria (MA) is an early indicator of renal disease.

The relationship between MA and insulin resistance (IR) in these patients is not clear and conflicting data have been reported for the association between gender and MA. Aim: the objective of the present study was to evaluate the relationship between MA and IR in patients with type 2 DM and to correlate this association with gender and the cardiovascular (CV) risk factors: hypertension, dyslipidemia, impaired glycemic control and obesity. Methods : this study included 60 diabetic patients (33 men and 27 women, with a mean age 55.3 ± 4.8 and 55.3 ± 8.3 years, respectively) divided into two equal groups: Group I with norm albuminuria (NA), and Group II with MA.

All patients were subjected to medical and laboratory check-up including, arterial blood pressure (BP), body mass index (BMI), fasting blood glucose (FBG), glycated hemoglobin (HbA1c ), serum lipids, serum insulin, and urinary albumin to creatinine ratio(ACR). Results : Diabetes duration, systolic blood pressure (SBP), diastolic blood pressure (DBP), FBG, serum insulin, HOMA-IR, were significantly higher for Group II than for Group I (P<0.05).

HOMA-IR, was significantly higher for men with MA than that for men with NA (P = 0.001).

However, there was no significant difference (P>0.05) between women with NA and MA with regard to FBG, and HOMA-IR, despite increase in serum insulin.

As a whole, MA was significantly correlated with patients´ age duration of DM, SBP, DBP, HbA1c, serum insulin, and HOMA-IR.

However, a significant correlation between MA and HOMA-IR, was observed for men .(r= 0.67), but not for women (r = 0.02) Conclusions : in patients with type 2 DM, MA is associated with IR, and most related CV risk factors (male gender, increased patients´ age, diabetes duration, poor glycemic control, and hypertension).

This association seems to be stronger in men than in age-matched women, suggesting different pathophysiological mechanisms in both genders.