Gender-specific and age-specific associations of the homoeostasis model assessment for IR (HOMA-IR) with albuminuria and renal function impairment: a retrospective cross-sectional study in Southeast China

OBJECTIVES: The study aimed to investigate the association of insulin resistance (IR), which was estimated by the homoeostasis model assessment for IR (HOMA-IR), with albuminuria and renal function impairment in a general Chinese population. DESIGN: A retrospective cross-sectional study. SETTING AND PARTICIPANTS: A total of 13 742 adults (age: ≥18 years) who underwent a health check-up at a hospital in Southeast China during 2013–2014 were enrolled. 216 subjects were excluded due to lack of enough fasting time, be pregnant, have chronic diseases influencing metabolic functions or have glomerulonephritis, renal cancer, kidney transplant. Eventually, 7552 men and 5974 women were included for the present analysis. PRIMARY OUTCOME MEASURES: The association of HOMA-IR with albuminuria and renal function impairment were analysed. The HOMA-IR cut-off value for detecting albuminuria and renal function impairment were determined. RESULTS: An increase in the HOMA-IR quartile was significantly associated with the prevalence of albuminuria and renal function impairment in all men and women aged >45 years. The multivariable logistic regression analyses revealed a significant association of the HOMA-IR with albuminuria and renal function impairment in subjects aged >45 years of the fourth quartiles compared with those of the first quartile after adjusting for potential confounders (albuminuria: men OR, 2.39; 95% CI 1.51 to 3.79, p<0.001; women OR, 2.40; 95% CI 1.44 to 4.01; p=0.001; renal function impairment: men OR, 2.30; 95% CI 1.50 to 3.51; p<0.001; women OR, 2.20; 95% CI 1.35 to 3.58; p=0.002). The optimal cut-off value of HOMA-IR for detecting albuminuria and renal function impairment was 2.69 in men aged ≤45 years, 1.60 in men aged >45 years and 1.86 in women aged >45 years. CONCLUSIONS: Our study revealed that HOMA-IR was significantly associated with albuminuria and renal function impairment in individuals aged >45 years.