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[Relationship of metabolic syndrome and insulin resistance with microalbuminuria in senior citizens of rural communities in Japan --the Tanno and Sobetsu study--].

AIM
We investigated the relationship of metabolic syndrome (MetS) and insulin resistance (IR) with microalbuminuria in senior citizens of rural communities in Japan.


METHOD
The subjects were 338 senior citizens (age 65 or older) who underwent medical examinations in the towns of Tanno and Sobetsu, Hokkaido in 2005. The following participants were excluded: those with missing data, those with type 2 diabetes (fasting plasma glucose >or=126 mg/dl and/or those who were on medication for diabetes), those who were on medication for hypertension and those with macroalbuminuria (urinary albumin creatinine ratio (ACR) >or=300 mg/g.Cr). The subjects were divided into two groups according to the Japanese criteria of MetS: a MetS group and a non-MetS group. The percentages of subjects with microalbuminuria (ACR >or=30 mg/g.Cr) in the two groups were compared. We also investigated the relationship between IR and microalbuminuria using homeostasis model assessment (HOMA-R).


RESULT
The percentage of subjects with microalbuminuria was significantly higher in the MetS group than in the non-MetS group. Multiple logistic regression analysis showed that there was a significant relationship between MetS and microalbuminuria (relative risk: 3.09, 95%CI: 1.18-8.07) and that there was also a significant relationship between HOMA-R and microalbuminuria (relative risk: 1.91, 95%CI: 1.14-3.20).


CONCLUSION
It may be important for prevention of microalbuminuria in patients with MetS not only to manage blood pressure and blood glucose but also to manage IR, which is part of the background of accumulation of these risk factors.