Insulin Resistance Contributes to Obesity-Related Proteinuria
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概要
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Objective Proteinuria is a recognized complication of obesity, but the pathogenesis remains unclear. We undertook the present study to clarify the factors contributing to proteinuria associated with obesity.Methods We studied 12 obese patients with proteinuria. Twenty-seven age-matched obese subjects without proteinuria served as controls. A glucose tolerance test and renal biopsy were performed in all patients. Fasting serum insulin and homeostasis model assessment-insulin resistance (HOMA-IR) were regarded as reflecting insulin resistance. To delineate the relation between insulin resistance and proteinuria, troglitazone, which acts an insulin sensitizer was given to 6 of 12 patients with a regular diet for 8 weeks. The 6 others were observed without receiving troglitazone.Results The 12 patients showed the presence of a cluster of insulin resistance factors: higher blood pressure, higher body mass index, higher fasting plasma glucose, higher fasting serum insulin, and higher HOMA-IR than controls. The renal biopsy specimens exhibited no histological abnormalities in 7, focal segmental glomerulosclerosis in 3 and benign nephrosclerosis in 2. Troglitazone attenuated HOMA-IR and ameliorated proteinuria, but did not affect body weight, creatinine clearance, or blood pressure. In contrast, the parameters in the patients not given troglitazone did not change.Conclusion Insulin resistance is a factor contributing to obesity-related proteinuria. The role of insulin resistance as a factor reducing proteinuria remains to be clarified.
- 社団法人 日本内科学会の論文
- 2005-06-01
著者
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Iwasawa Hideaki
Department Of Nephrology Tokyo Medical University
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MATSUMOTO Hiroshi
Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurolo
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NAKAO Toshiyuki
Department of Nephrology and Dialysis, Tokyo Medical University
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Nakao Toshiyuki
Department Of Nephrology Tokyo Medical University
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Nakao Toshiyuki
Department Of Nephrology And Dialysis Tokyo Medical University
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Okada Tomonari
Department of Nephrology, Tokyo Medical University, Japan
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Nagaoka Yume
Department of Nephrology, Tokyo Medical University, Japan
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Tomaru Ryo
Department of Nephrology, Tokyo Medical University, Japan
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Wada Toshikazu
Department of Nephrology, Tokyo Medical University, Japan
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Tomaru Ryo
Department Of Nephrology Tokyo Medical University
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Nagaoka Yume
Department Of Nephrology Tokyo Medical University
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Wada Toshikazu
Department Of Nephrology Tokyo Medical University
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Okada Tomonari
Department Of Nephrology Tokyo Medical University
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Okada Tomonari
Department Of Bioscience And Biotechnology Faculty Of Agriculture Kyushu University
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Wada Toshikazu
Department Of Computer And Communication Science Wakayama University
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Matsumoto Hiroshi
Department Of Materials Science Toyohashi University Of Technology
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Matsumoto Hiroshi
Department Of Nephrology Tokyo Medical University
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Matsumoto Hiroshi
Department Of Architecture And Civil Engineering Toyohashi University Of Technology
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Matsumoto Hiroshi
Department Of Architecture And Civil Engineering Faculty Of Engineering Toyohashi University Of Tech
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