Correlation between glomerular filtration rate and insulin resistance index in patients with type 2 diabetes mellitus and chronic kidney disease

Abstract

Objective: To investigate the changes of insulin resistance index^{[Homa-IR (CP)]} in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at different stages of glomerular filtration rate (eGFR), and to analyze the relationship between them. Methods: From January 2015 to June 2019, 1013 patients with T2DM and CKD were admitted to Mudanjiang Cardiovascular Disease Hospital Diabetes Branch Hospital (grade three grade a hospital). The general conditions of the patients were collected, and the biochemical indexes were measured by the laboratory department of our hospital. After calculating the HOMA IR (CP) and EGFR values according to the obtained data, the patients were divided into five groups according to the CKD grouping criteria: 0 ~ 15 ml·(min·1. 73m²)^-1 for group A, 15 ~ 30 ml·(min·1. 73m²)^-1 for group B, 30 ~ 45 ml·(min·1. 73m²)^-1 for group C, 45 ~ 60 ml·(min·1. 73m²)^-1 for group D and 60 ~ 90 mL·(min·1. 73m²)^-1 for group E. The relevant data were statistically analyzed by SPSS software. Results: (1) There was a negative correlation between EGFR and HOMA IR (CP) in T2DM patients with CKD (r = - 0.25, P = 0.000). (2) The comparison results between HOMA IR (CP) groups showed that there was significant difference between group A and group B and other groups, and there was significant difference between group C and group D and other groups (P0.05). (3) The pairwise comparison between fasting blood glucose groups showed that there was significant difference between group A and group B (LSD-t = -1.74, P = 0.034). There was significant difference in insulin dosage between group A and other groups (P0.05), and there was significant difference between group D and group E (LSD-t = 0.06, P = 0.005). (4) Logistic analysis of EGFR showed that age, serum creatinine and HOMA IR (CP) were the main influencing factors of EGFR (P0.05). Conclusion: there is a significant negative correlation between EGFR and HOMA IR (CP) in T2DM patients with CKD. In the process of aggravating insulin resistance, EGFR increased more significantly in the two stages of 45 ~ 60 ml·(min·1. 73m²)^-1 and 15 ~ 30 ml·(min·1. 73m²)^-1.