URINARY ALBUMIN EXCRETION RATE IS RELATED TO INSULIN-RESISTANCE IN NORMOTENSIVE SUBJECTS WITH IMPAIRED GLUCOSE-TOLERANCE

Microalbuminuria has been reported to precede the development of NIDDM and to be a risk marker for cardiovascular disease. Therefore, the pr esent study investigated the relationship between urinary albumin excr etion rate (UAER) and the degree of insulin resistance in Japanese sub jects with impaired glucose tolerance (IGT). Thirty-three normotensive IGT subjects were divided into three groups and twenty hypertensive I GT subjects were divided into two groups according to the degree of in sulin resistance (GIR value) estimated by the euglycemic hyperinsuline mic clamp method. UAER was significantly higher in the lower GIR group in normotensive subjects (highest GIR group, 6.6 +/- 0.9 mg/24 h; int ermediate group, 10.5 +/- 3.0 mg/24 h; lowest group, 21.3 +/- 3.8 mg/2 4 h; P < 0.01 between highest and both of the other groups), but not i n hypertensive subjects. The lowest GIR was associated with higher fas ting plasma insulin, increased insulin response to glucose, higher pla sma triglyceride and uric acid, and lower high-density-lipoprotein cho lesterol, but not with increased creatinine clearance rate in normoten sive subjects. A similar tendency was also found in hypertensive subje cts. It is concluded that UAER is related to insulin resistance in nor motensive subjects with IGT through a mechanism other than glomerular hyperfiltration. (C) 1997 Elsevier Science Ireland Ltd.