engleski

Insulin resistance , gamma-glutamyltransferase and creatine phosphokinase alongside lgucose regulation as predictors of nephropathy in type 2 diabetes

Our aim was to determine the correlation of albumin/creatinine (A/C) ratio with parameters of metabolic syndrome (MS). A total of 295 patients were divided into 3 groups, a group with type 2 diabetes (DM2), a group with glucose intolerance (GI), and a control group (CG). Insulin resistance (IR) was assessed using homeostatic model assessment (HOMA2). A/C ratio, C-reactive protein (CRP), fibrinogen (FIB), homocysteine (HCY), liver function parameters, lipid values, uric acid (UA), creatine phosphokinase (CPK), glycated hemoglobin (A1c), fasting plasma glucose(fPG) and postprandial PG (ppPG) were determined. ANOVA revealed a significant difference in A/C ratio between DM2, GI and CG (p=0.002). A significant difference in A/C was found between DM2 and GI (2.84&plusmn ; 12.44) (p=0.002), and between DM2 (4.47&plusmn ; 15.57) and CG (2.55&plusmn ; 7.1) (p=0.032). No difference was observed between GI and CG. The A/C ratio in patients with DM2 was increased, correlating significantly (p<0.01) with fPG (r=0.249), ppPG (r=0.254), and A1c (r=0.240). Furthermore, a significant difference in IR (p=0.001), A1c (p=0.012), CPK (p=0.024) and gamma-glutamyltransferase (GGT) (p=0.034) was found between patients with A/C ratios of &#8804; 2.5 mg/mmol and >2.5 mg/mmol. The difference in UA according to the A/C ratio was not statistically significant (p=0.07). IR correlated significantly (p<0.01) with BMI (r=0.298), fPG (r=0.198), high-density lipoprotein (HDL) (-r=0.302), triglycerides (Tg) (r=0.380), GGT (r=0.221) and UA (r=0.334). GGT correlated significantly (p<0.01) with fPG (r=0.243), ppPG (r=0.240), Tg (r=0.209), alanine aminotransferase (ALT) (r=0.475, p<0.001), aspartate aminotransferase (AST) (r=0.348) and UA (r=0.218). CPK correlated significantly (p<0.05) with total cholesterol (TC) (r=0.182), AST (r=0.408), and ALT (r=0.181). Only 3 patients with GI and 3 patients from the CG had A/C ratio >2.5mg/mmol. Patients with DM2 and an A/C ratio above 2.5 mg/mmol have significantly higher values of IR, A1c, GGT and CPK, indicating that IR and glucose regulation together with GGT and CPK values are important predictors of nephropathy in patients with DM2 and MS.

albumin/creatinine ratio; insulin resistance; gamma-glutamyltransferase

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