Insulin resistance precedes the appearance of albuminuria in non-diabetic subjects: 6 years follow up study

Diabetes Res Clin Pract. 2001 Aug;53(2):99-106. doi: 10.1016/s0168-8227(01)00241-8.


Microalbuminuria is a marker of increased risk of cardiovascular mortality in type 1 and type 2 diabetes, and in non-diabetic subjects. Little is known about the association between prospective changes of microalbuminuria and the risk factors of atherosclerosis, or gene polymorphism in non-diabetic subjects. We conducted a 6-year prospective study of risk factors for progression of albuminuria in non-diabetic subjects. The participants were 116 non-diabetic subjects who consecutively underwent medical examinations for Japanese-Americans living in Hawaii. In the baseline examination in 1992, normoalbuminuria was found in all subjects. After 6 years, 101 subjects remained normoalbuminuria (non-progressors), 15 subjects changing from normoalbuminuria to microalbuminuria or proteinuria and were defined as progressors. In progressors, compared with non-progressors, the fasting insulin level and HOMA-R were significantly higher at 3 years follow-up, and the systolic and diastolic pressure and Sigma insulin level were significantly higher at 6 years follow-up. Insulin resistance appeared earlier than the appearance of hypertension and albuminuria. In progressors, there was no significant correlation with angiotensin-converting enzyme (ACE) genotype or angiotensinogen (AGT) genotype compared with non-progressors. Therefore, the appearance of insulin resistance should be regarded as a remarkable mediator of albuminuria.

MeSH terms

  • Aged
  • Albuminuria / blood
  • Albuminuria / physiopathology*
  • Asian Americans
  • Asian Continental Ancestry Group
  • Blood Glucose / metabolism
  • Blood Pressure
  • Creatinine / blood
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glucose Tolerance Test
  • Hawaii
  • Humans
  • Hypertension / epidemiology
  • Insulin / blood
  • Insulin Resistance / physiology*
  • Japan / ethnology
  • Lipids / blood
  • Longitudinal Studies
  • Male
  • Risk Factors
  • Time Factors


  • Blood Glucose
  • Insulin
  • Lipids
  • Creatinine