{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:46:18Z","timestamp":1776746778934,"version":"3.51.2"},"reference-count":76,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) affects 8.2% of China\u2019s population and is a major global health concern. While insulin resistance (IR) is linked to CKD, the relationship between insulin resistance (HOMA-IR) and CKD risk remains unclear, especially in diabetic and non-diabetic populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study analyzed data from 32,055 Chinese adults in the REACTION study. Logistic regression and generalized additive models assessed the association between HOMA-IR and CKD risk in diabetic (DM) and non-diabetic (Non-DM) populations, with nonlinear relationships explored using two-piecewise logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall CKD prevalence was 16.09%(95% CI: 15.68%-16.49%). In the Non-DM group, HOMA-IR was positively associated with CKD risk (OR\u00a0=\u00a01.037, 95% CI: 1.010\u20131.066, P\u00a0=\u00a00.008), while no significant association was found in the DM group (OR\u00a0=\u00a00.991, 95% CI: 0.952\u20131.032, P\u00a0=\u00a00.667). Both groups showed an n-shaped relationship, with inflection points at HOMA-IR values of 2.581 (Non-DM) and 2.587 (DM). Below these thresholds, CKD risk increased with HOMA-IR; above them, risk decreased.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated HOMA-IR is independently associated with an increased risk of CKD in non-diabetic individuals, whereas this association is not significant in diabetic patients. These findings strongly highlight the clinical value of HOMA-IR as an early predictor of CKD risk, particularly in non-diabetic populations, emphasizing the importance of monitoring insulin resistance for early risk stratification and tailored management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1707947","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T04:22:30Z","timestamp":1776745350000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Relationship of HOMA-IR with chronic kidney disease in diabetic and non-diabetic Chinese populations: findings from the REACTION study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuheng","family":"Liao","sequence":"first","affiliation":[{"name":"Department of Nephrology, Shenzhen Second People\u2019s Hospital","place":["Shenzhen, Guangdong, China"]},{"name":"School of Medicine Shenzhen 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