Kidney Week

Abstract: PUB556

An Application Study of the Simple Insulin Sensitivity Index for the Assessment of the Level of Insulin Resistance in People with Different Kidney Function

Session Information

• Publication Only

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Yang, Guang, Department of Geriatric Nephrology, The Second Medical Centre, Chinese PLA General Hospital, Beijing, Beijing, China

Guang Yang, MD

• Shen, Xin, Department of Geriatric Nephrology, The Second Medical Centre, Chinese PLA General Hospital, Beijing, Beijing, China

Xin Shen, PhD

• Cheng, Bokai, Department of Geriatric Nephrology, The Second Medical Centre, Chinese PLA General Hospital, Beijing, Beijing, China

Bokai Cheng, MD

• Cheng, Qingli, Department of Geriatric Nephrology, The Second Medical Centre, Chinese PLA General Hospital, Beijing, Beijing, China

Qingli Cheng, MD

Background

Chronic Kidney Disease (CKD) has become an important global public health issue, and with the increasing prevalence of metabolic risk factors, the risk of developing CKD also increases. Insulin resistance (IR) is a core pathogenic mechanism of many related risk factors of CKD, making it crucial in the prevention and control of CKD. Therefore, we need to better assess the level of IR in the CKD population.

Methods

The M-value of HECT test was applied to accurately assess the IR level of the subjects and analyse the differences of IR level in people with different blood creatinine levels. Simple insulin sensitivity index (ISI) was calculated based on fasting glucose, insulin, and OGTT results to analyse the test efficacy of ISI for IR level assessment in people with different renal functions.

Results

The subjects exhibited a progressive decline in IR levels (M-values) as their blood creatinine levels increased, and this difference was found to be statistically significant (P=0.016). A correlation regression analysis was conducted to assess the relationship between ISI and M-value. The results indicated that 1/FIN, HOMA-IR, FINS/FBG, QUICKI, McAuley, Matsuda, Gutt, Disposition, Stumvoll, and Avignon were significantly correlated with M-value, with correlation coefficients (r) ranging from 0.325 to 0.577 (p<0.01). However, Insulinogenic and Belfiore showed no significant correlation with M-values (p=0.948, 0.831 respectively). The effectiveness of each ISI was evaluated based on renal function grouping, and ANOVA analysis revealed that Matsuda (p<0.01), INS/GLU, McAuley, Gutt, and Stumvoll (p<0.05) indices could effectively differentiate between groups in terms of IR levels. Among these, McAuley, Matsuda, and Stumvoll indices were particularly responsive to changes in IR levels across different groups.

Conclusion

As kidney function decreases, the level of insulin resistance in subjects increases. The simple ISI-McAuley, Matsuda, and Stumvoll indices show better testing efficiency in identifying trends of insulin resistance compared to the gold standard M value in populations with varying levels of kidney function.

Funding

• Government Support – Non-U.S.