Gender difference and relationship of insulin resistance with microalbuminuria type-2 diabetes.

OBJECTIVE: To determine the relationship of insulin resistance with microalbuminuria in patients of type-2 Diabetes mellitus and observe gender difference if any. STUDY DESIGN: A cross-sectional study. PLACE AND DURATION OF STUDY: Diabetes Clinic of Combined Military Hospital, Malir Cantt, from April to August 2007. METHODOLOGY: One hundred and fifty five patients of type-2 Diabetes mellitus were included in the study who had either microalbuminuria or normoalbuminuria. Body mass index, waist circumference and blood pressure were recorded. Fasting venous blood sample was collected for plasma glucose (FPG), serum insulin, total and HDL cholesterol, triglycerides, creatinine and HbA1c. Urine albumin excretion was determined using urine albumin to creatinine ratio. Insulin resistance was calculated from fasting plasma glucose and serum insulin levels, using homeostatic model assessment of insulin resistance (HOMA-IR). Correlation and association testing was carried out with significance at p<0.05. RESULTS: Microalbuminuria was found to be significantly correlated with HOMA-IR (r=0.33, p<0.001), serum insulin (r=0.28, p=<0.001), body mass index (r=0.18, p=0.02) and waist circumference (r=0.21, p=0.008). This correlation was more significant in women (n=85, r=0.48, p=<0.0001) as compared to men (n=70, r=0.14, p=0.12). The correlation between HOMA-IR and urine albumin excretion remained highly significant (p=0.001) after controlling for gender, age, duration of diabetes, waist circumference, hypertension, triglycerides and HbA1c. CONCLUSION: Urinary albumin excretion in patients of type-2 diabetes is strongly associated with insulin resistance and related cardiovascular risk factors. This association appears to be stronger in women than the men, in our population.