Kidney injury molecule (KIM)-1 is associated with insulin resistance: results from two community-based studies of elderly individuals

Diabetes Res Clin Pract. 2014 Mar;103(3):516-21. doi: 10.1016/j.diabres.2013.12.008. Epub 2013 Dec 25.

Abstract

Background and objectives: Insulin resistance has been shown to be closely associated with glomerular filtration rate and urinary albumin/creatinine ratio, even prior to the development of diabetes. Urinary kidney injury molecule 1 (KIM-1) is a novel, highly specific marker of kidney tubular damage. The role of insulin resistance in the development of kidney tubular damage is not previously reported. Thus, we aimed to investigate the associations between insulin sensitivity (assessed by HOMA) and urinary KIM-1.

Design, setting, participants and measurements: Two community-based cohorts of elderly individuals were investigated: Prospective Investigation of the vasculature in Uppsala seniors (PIVUS, n=701; mean age 75 years, 52% women); and Uppsala Longitudinal Study of adult men (ULSAM, n=533; mean age 78 years).

Results: Lower insulin sensitivity was associated with higher urinary KIM-1 in both cohorts after adjustments for age, BMI, blood pressure, antihypertensive treatment, glomerular filtration rate, and urinary albumin-creatinine ratio (PIVUS: regression coefficient for 1-SD higher HOMA-IR 0.11, 95% CI 0.03-0.20, p=0.009, and ULSAM: 0.13, 95% CI 0.04-0.22, p=0.007). Results were similar in individuals without diabetes, with normal kidney function and normo-albuminuria.

Conclusions: Our findings in elderly individuals support the notion that the interplay between an impaired glucose metabolism and renal tubular damage is evident even prior to the development of diabetes and overt kidney disease.

Keywords: Blood glucose; Diabetes; Glomerular filtration; Kidney injury; Microalbuminuria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Albuminuria / blood
  • Antihypertensive Agents / administration & dosage
  • Biomarkers / urine*
  • Blood Pressure
  • Community-Based Participatory Research*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Hepatitis A Virus Cellular Receptor 1
  • Humans
  • Insulin Resistance*
  • Kidney Diseases / etiology
  • Kidney Diseases / pathology
  • Kidney Tubules / metabolism
  • Kidney Tubules / pathology
  • Longitudinal Studies
  • Male
  • Membrane Glycoproteins / urine*
  • Middle Aged
  • Prospective Studies
  • Receptors, Virus
  • Residence Characteristics

Substances

  • Antihypertensive Agents
  • Biomarkers
  • HAVCR1 protein, human
  • Hepatitis A Virus Cellular Receptor 1
  • Membrane Glycoproteins
  • Receptors, Virus