Relationship between urinary albumin excretion, body composition, and hyperinsulinemia in normotensive glucose-tolerant adults

Søren Nielsen, Michael Dennis Jensen

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVE - Elevated urinary albumin excretion (UAE) has been associated with insulin resistance and is suggested to be elevated in prediabetic individuals. Upper body obesity, especially visceral obesity, predicts insulin resistance and development of type 2 diabetes. We examined whether UAE clusters with obesity-associated insulin resistance traits in healthy glucose-tolerant normotensive subjects. RESEARCH DESIGN AND METHODS - There were 49 volunteers with a wide range of body fat and body fat distribution studied. All had normal blood pressure and glucose tolerance and were maintained on a controlled diet for 2 weeks. UAE was assessed from three overnight urine collections, and body composition was assessed by whole-body dual-energy X-ray absorptiometry scanning and abdominal computed tomography scanning. RESULTS - Fasting insulin and insulin responses to oral glucose were significantly increased in obese subjects, who also tended to have more dyslipidemia, greater blood pressure, and more visceral fat than lean subjects. These differences were more apparent in upper body obese subjects. UAE was normal in obese and upper body obese subjects and not different from that of lean subjects. UAE ranged from 0.3 to 8.3 μg/min in lean subjects and from 0.2 to 7.2 μg/min in obese subjects. UAE was not significantly correlated with body composition, plasma insulin, glucose, or lipids. CONCLUSIONS - Obese subjects (even upper body obese subjects) with increased visceral and total body fat, high plasma insulin and triglycerides, and low HDL cholesterol concentrations do not have elevated UAE. This suggests that UAE is not closely associated with these characteristics and implies a later onset of abnormal albuminuria in the course of the insulin resistance syndrome.

Original languageEnglish (US)
Pages (from-to)1728-1733
Number of pages6
JournalDiabetes Care
Volume22
Issue number10
DOIs
StatePublished - Oct 1999

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Hyperinsulinism
Body Composition
Albumins
Glucose
Insulin Resistance
Insulin
Adipose Tissue
Obesity
Blood Pressure
Body Fat Distribution
Urine Specimen Collection
Albuminuria
Fat Body
Intra-Abdominal Fat
Abdominal Obesity
Photon Absorptiometry
Dyslipidemias
Type 2 Diabetes Mellitus
HDL Cholesterol
Blood Glucose

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Relationship between urinary albumin excretion, body composition, and hyperinsulinemia in normotensive glucose-tolerant adults. / Nielsen, Søren; Jensen, Michael Dennis.

In: Diabetes Care, Vol. 22, No. 10, 10.1999, p. 1728-1733.

Research output: Contribution to journalArticle

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N2 - OBJECTIVE - Elevated urinary albumin excretion (UAE) has been associated with insulin resistance and is suggested to be elevated in prediabetic individuals. Upper body obesity, especially visceral obesity, predicts insulin resistance and development of type 2 diabetes. We examined whether UAE clusters with obesity-associated insulin resistance traits in healthy glucose-tolerant normotensive subjects. RESEARCH DESIGN AND METHODS - There were 49 volunteers with a wide range of body fat and body fat distribution studied. All had normal blood pressure and glucose tolerance and were maintained on a controlled diet for 2 weeks. UAE was assessed from three overnight urine collections, and body composition was assessed by whole-body dual-energy X-ray absorptiometry scanning and abdominal computed tomography scanning. RESULTS - Fasting insulin and insulin responses to oral glucose were significantly increased in obese subjects, who also tended to have more dyslipidemia, greater blood pressure, and more visceral fat than lean subjects. These differences were more apparent in upper body obese subjects. UAE was normal in obese and upper body obese subjects and not different from that of lean subjects. UAE ranged from 0.3 to 8.3 μg/min in lean subjects and from 0.2 to 7.2 μg/min in obese subjects. UAE was not significantly correlated with body composition, plasma insulin, glucose, or lipids. CONCLUSIONS - Obese subjects (even upper body obese subjects) with increased visceral and total body fat, high plasma insulin and triglycerides, and low HDL cholesterol concentrations do not have elevated UAE. This suggests that UAE is not closely associated with these characteristics and implies a later onset of abnormal albuminuria in the course of the insulin resistance syndrome.

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