{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:05:55Z","timestamp":1792098355292,"version":"4.4.0"},"reference-count":36,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":2667,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Accumulating evidence suggests an association between insulin sensitivity and albuminuria, which, even in the normal range, is a risk factor for cardiovascular diseases. We evaluated whether insulin sensitivity is associated with albuminuria in healthy subjects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>We investigated 1,415 healthy, nondiabetic participants (mean age 43.9 \u00b1 8.3 years; 54.3% women) from the RISC (Relationship between Insulin Sensitivity and Cardiovascular Disease) study, of whom 852 participated in a follow-up examination after 3 years. At baseline, insulin sensitivity was assessed by hyperinsulinemic\u2013euglycemic clamps, expressed as the M\/I value. Oral glucose tolerance test\u2013based insulin sensitivity (OGIS), homeostasis model assessment of insulin resistance (HOMA-IR), and urinary albumin-to-creatinine ratio (UACR) were determined at baseline and follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Microalbuminuria (UACR \u226530 mg\/g) was present in fewer than 2% at either study visit. After multivariate adjustments, there was no cross-sectional association between UACR and any measure of insulin sensitivity. Neither OGIS nor HOMA-IR was significantly associated with follow-up UACR, but in a multivariate regression analysis, baseline M\/I emerged as an independent predictor of UACR at follow-up (\u03b2-coefficient \u22120.14; P = 0.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In healthy middle-aged adults, reduced insulin sensitivity, assessed by hyperinsulinemic\u2013euglycemic clamp, is continuously associated with a greater risk of increasing albuminuria. This finding suggests that reduced insulin sensitivity either is simply related to or might causally contribute to the initial pathogenesis of albuminuria.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc13-2573","type":"journal-article","created":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T01:46:07Z","timestamp":1394675167000},"page":"1597-1603","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":56,"title":["Insulin Sensitivity and Albuminuria: The RISC Study"],"prefix":"10.2337","volume":"37","author":[{"given":"Stefan","family":"Pilz","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands"},{"name":"Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"Rutters","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giel","family":"Nijpels","sequence":"additional","affiliation":[{"name":"Department of General Practice, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coen D.A.","family":"Stehouwer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiovascular Research Institute, Maastricht University Medical Centre, Maastricht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"H\u00f8jlund","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Odense University Hospital, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Nolan","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center, Gentofte, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverley","family":"Balkau","sequence":"additional","affiliation":[{"name":"INSERM, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease over the Lifecourse and Determinants of Early Nutrition, Villejuif, France"},{"name":"University of Paris-Sud 11, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline M.","family":"Dekker","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the RISC Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2014,5,10]]},"reference":[{"key":"2022031220075145000_B1","doi-asserted-by":"crossref","first-page":"S194","DOI":"10.2337\/dc08-s249","article-title":"Microalbuminuria in type 2 diabetes and hypertension: a marker, treatment target, or innocent bystander?","volume":"31","author":"Basi","year":"2008","journal-title":"Diabetes Care"},{"key":"2022031220075145000_B2","doi-asserted-by":"crossref","first-page":"2073","DOI":"10.1016\/S0140-6736(10)60674-5","article-title":"Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis","volume":"375","author":"Matsushita","year":"2010","journal-title":"Lancet"},{"key":"2022031220075145000_B3","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s11906-012-0270-y","article-title":"Microalbuminuria as surrogate endpoint in therapeutic trials","volume":"14","author":"Redon","year":"2012","journal-title":"Curr Hypertens Rep"},{"key":"2022031220075145000_B4","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1038\/sj.jhh.1002143","article-title":"Urinary albumin excretion is associated with impaired flow- and nitroglycerin-mediated brachial artery dilatation in hypertensive adults","volume":"21","author":"Malik","year":"2007","journal-title":"J Hum Hypertens"},{"key":"2022031220075145000_B5","doi-asserted-by":"crossref","first-page":"581","DOI":"10.2215\/CJN.03190906","article-title":"Microalbuminuria and cardiovascular disease","volume":"2","author":"Weir","year":"2007","journal-title":"Clin J Am Soc Nephrol"},{"key":"2022031220075145000_B6","doi-asserted-by":"crossref","first-page":"2751","DOI":"10.1093\/ndt\/13.11.2751","article-title":"How heterogeneous is microalbuminuria in diabetes mellitus? 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