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IGF-1 levels link estimated glomerular filtration rate to insulin resistance in obesity: a study in obese, but metabolically healthy, subjects and obese, insulin-resistant subjects.
Nutr Metab Cardiovasc Dis. 2011 Dec; 21(12):933-40.NM

Abstract

BACKGROUND AND AIMS

Metabolically healthy but obese (MHO) subjects have a favourable cardio-metabolic risk profile, but whether they are also at lower risk for kidney dysfunction is still questionable.

METHODS AND RESULTS

A total of 106 MHO, 122 normal-weight and 212 insulin-resistant obese (IRO) subjects were stratified on the basis of their insulin sensitivity and body mass index (BMI). The CKD-EPI equation was used to estimate glomerular filtration rate (eGFR) and ISI index was used to estimate insulin sensitivity. eGFR was significantly lower in IRO as compared to MHO subjects after adjusting for age, gender and BMI (P = 0.008). In a logistic regression model adjusted for age, gender and BMI, IRO subjects showed an increased risk of having eGFR in the lowest quartile (odds ratio (OR) 1.91, 95% confidence interval (CI) 1.01-3.58; P = 0.04) as compared with MHO subjects. This association was maintained when waist, lean body mass, blood pressure, HDL cholesterol, triglyceride, fasting glucose and insulin levels were additionally included into the model (OR 2.49, 95%CI 1.17-5.27; P = 0.01), but its independence was not retained with further inclusion of insulin-like growth factor-1 (IGF-1) levels (OR 2.16, 95%CI 0.93-5.04; P = 0.07) No differences in eGFR were observed between non-obese and MHO individuals.

CONCLUSIONS

These results indicate that heterogeneity in obese phenotypes may account for conflicting evidence regarding the significance of obesity as a risk factor for chronic kidney disease. Our findings suggest that obesity is associated with lower kidney function only when insulin sensitivity is reduced, and that plasma IGF-1 is likely to be an important mechanism linking the IRO phenotype with reduced eGFR.

Authors+Show Affiliations

Department of Experimental and Clinical Medicine, University Magna-Græcia of Catanzaro, Catanzaro, Italy. sesti@unicz.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20685093

Citation

Sesti, G, et al. "IGF-1 Levels Link Estimated Glomerular Filtration Rate to Insulin Resistance in Obesity: a Study in Obese, but Metabolically Healthy, Subjects and Obese, Insulin-resistant Subjects." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 21, no. 12, 2011, pp. 933-40.
Sesti G, Succurro E, Arturi F, et al. IGF-1 levels link estimated glomerular filtration rate to insulin resistance in obesity: a study in obese, but metabolically healthy, subjects and obese, insulin-resistant subjects. Nutr Metab Cardiovasc Dis. 2011;21(12):933-40.
Sesti, G., Succurro, E., Arturi, F., Andreozzi, F., Laino, I., Perticone, M., Sciacqua, A., Hribal, M. L., & Perticone, F. (2011). IGF-1 levels link estimated glomerular filtration rate to insulin resistance in obesity: a study in obese, but metabolically healthy, subjects and obese, insulin-resistant subjects. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 21(12), 933-40. https://doi.org/10.1016/j.numecd.2010.02.008
Sesti G, et al. IGF-1 Levels Link Estimated Glomerular Filtration Rate to Insulin Resistance in Obesity: a Study in Obese, but Metabolically Healthy, Subjects and Obese, Insulin-resistant Subjects. Nutr Metab Cardiovasc Dis. 2011;21(12):933-40. PubMed PMID: 20685093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - IGF-1 levels link estimated glomerular filtration rate to insulin resistance in obesity: a study in obese, but metabolically healthy, subjects and obese, insulin-resistant subjects. AU - Sesti,G, AU - Succurro,E, AU - Arturi,F, AU - Andreozzi,F, AU - Laino,I, AU - Perticone,M, AU - Sciacqua,A, AU - Hribal,M L, AU - Perticone,F, Y1 - 2010/08/03/ PY - 2009/11/23/received PY - 2010/02/09/revised PY - 2010/02/10/accepted PY - 2010/8/6/entrez PY - 2010/8/6/pubmed PY - 2012/3/22/medline SP - 933 EP - 40 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 21 IS - 12 N2 - BACKGROUND AND AIMS: Metabolically healthy but obese (MHO) subjects have a favourable cardio-metabolic risk profile, but whether they are also at lower risk for kidney dysfunction is still questionable. METHODS AND RESULTS: A total of 106 MHO, 122 normal-weight and 212 insulin-resistant obese (IRO) subjects were stratified on the basis of their insulin sensitivity and body mass index (BMI). The CKD-EPI equation was used to estimate glomerular filtration rate (eGFR) and ISI index was used to estimate insulin sensitivity. eGFR was significantly lower in IRO as compared to MHO subjects after adjusting for age, gender and BMI (P = 0.008). In a logistic regression model adjusted for age, gender and BMI, IRO subjects showed an increased risk of having eGFR in the lowest quartile (odds ratio (OR) 1.91, 95% confidence interval (CI) 1.01-3.58; P = 0.04) as compared with MHO subjects. This association was maintained when waist, lean body mass, blood pressure, HDL cholesterol, triglyceride, fasting glucose and insulin levels were additionally included into the model (OR 2.49, 95%CI 1.17-5.27; P = 0.01), but its independence was not retained with further inclusion of insulin-like growth factor-1 (IGF-1) levels (OR 2.16, 95%CI 0.93-5.04; P = 0.07) No differences in eGFR were observed between non-obese and MHO individuals. CONCLUSIONS: These results indicate that heterogeneity in obese phenotypes may account for conflicting evidence regarding the significance of obesity as a risk factor for chronic kidney disease. Our findings suggest that obesity is associated with lower kidney function only when insulin sensitivity is reduced, and that plasma IGF-1 is likely to be an important mechanism linking the IRO phenotype with reduced eGFR. SN - 1590-3729 UR - https://www.unboundmedicine.com/medline/citation/20685093/IGF_1_levels_link_estimated_glomerular_filtration_rate_to_insulin_resistance_in_obesity:_a_study_in_obese_but_metabolically_healthy_subjects_and_obese_insulin_resistant_subjects_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(10)00043-8 DB - PRIME DP - Unbound Medicine ER -