Insulin resistance, low HDL-cholesterol and microalbuminuria are important components of the metabolic syndrome as defined
by WHO. Insulin resistance and low HDL-cholesterol are also common in chronic kidney disease (CKD), but it is not clear whether
they are early or late phenomenons in the development of renal failure. This study examined whether low-grade albuminuria
(microalbuminuria), lipoprotein fractions, and the insulin/glucose ratio (IGR)—a surrogate marker of insulin resistance—were
related to renal function (expressed as serum creatinine) in persons without diabetes and with apparently normal renal function.
The study included 4,131 men and women aged 55–75 years from the cross-sectional Tromsø IV survey (1994–1995). Lifestyle factors,
waist circumference and blood pressure were included in the analyses. Gender stratified multivariate analysis was used to
assess the relationship between serum creatinine and microalbuminuria, lipoprotein fractions and IGR. Serum creatinine was
positively associated with microalbuminuria in men (β = 2.50, 95% confidence interval (CI) 0.66–4.34), but not in women. HDL-cholesterol
and IGR were strongly associated with creatinine in both genders (HDL-cholesterol: Men: β = −4.82, 95% CI −6.27 to −3.37;
women: β = −2.12, 95% CI −3.28 to −0.96. IGR: Second, third and fourth quartile compared with first quartile, men: β = 0.94,
95% CI −0.63 to 2.51; 2.10, 95% CI 0.52–3.69 and 2.40, 95% CI 0.75–4.04; women: β = 1.91, 95% CI 0.59–3.22; 2.61, 95% CI 1.28–3.95
and 3.20, 95% CI 1.80–4.60). These findings suggest that even early impairment of renal function may be associated with insulin
resistance and dyslipidemia, regardless of renal albumin leakage.
Keywords Albuminuria - Creatinine - Cross-sectional studies - HDL-cholesterol - Insulin resistance - Metabolic syndrome