Decreased estimated glomerular filtration rate is not directly related to increased insulin resistance

Aims: Insulin resistance (IR) is associated with chronic kidney disease (CKD) but little is known about the possible causal relationship and differences in IR based on estimated glomerular filtration rate (eGFR) groups. The objective of this study was to identify a possible association between the level of renal dysfunction and IR.

Methods: We measured eGFR and calculated the Homeostasis Model Assessment IR (HOMA-IR) index value. The study included 17,157 subjects ≥20years old without diabetes who underwent voluntary health check-ups. We classified subjects into four groups according to eGFR: Group 1, eGFR ≥90; Group 2, eGFR 75-89; Group 3, eGFR 60-74; Group 4, eGFR <60mL/min/1.73m(2).

Results: While HOMA-IR index values were higher in lower eGFR groups compared with higher eGFR groups (P<0.001), multivariate analysis revealed that the relationship was not significant. HOMA-IR index values in eGFR groups estimated by analysis of covariance (ANCOVA) adjusted for related factors were not significantly higher in lower eGFR groups. When we stratified the subjects by the number of MS components, there were no meaningful differences in HOMA-IR values according to eGFR group. The frequency of high HOMA-IR index (≥2.5) among eGFR groups stratified with number of MS components was not significantly different.

Conclusion: Decreased kidney function is not associated with IR.