197 Official Journal of the Turkish Society of Nephrology / Türk Nefroloji Diyaliz ve Transplantasyon Dergisi ÖZGÜN ARAfiTIRMA Türk Eriflkinlerinde Hafif Böbrek Fonksiyon Bozuklu¤u: Yayg›nl›¤› ve ‹nsülin Direnci ile Yak›n ‹liflkisi Mild Renal Dysfunction Among Turkish Adults: Prevalence and Its Association With Insulin Resistance Altan Onat 1,2 , Mehmet Yaz›c› 3 , Gülay Hergenç 4 , Hüseyin Uyarel 5 , A. Metin Esen 6 , Ahmet Karabulut 5 , Günay Can 2 1 Türk Kardiyoloji Derne¤i, ‹stanbul 2 ‹stanbul Üniversitesi Cerrahpafla T›p Fakültesi, ‹stanbul 3 ‹. Baysal Üniversitesi Düzce T›p Fakültesi, Kardiyoloji Bölümü, Düzce 4 Y›ld›z Teknik Üniversitesi, Biyoloji Bölümü, ‹stanbul 5 S. Ersek Kalp-Damar Cerrahisi Merkezi, ‹stanbul 6 Kofluyolu Kalp Hastanesi, ‹stanbul ÖZET Amaç: Halkmzda serum kreatininde hafif bozukluun ve bu- nun yanstt bbrek fonksiyon bozukluunun yaygnl ve bunun inslin direnci (IR), metabolik sendrom (MS) veya bileenleri ile arasndaki ilikinin aratrlmas. Yöntem: Serum kreatinin konsantrasyonlar 1048 erkek ve ka- dnda lld. Diyabet hastalar dlandktan sonra geri kalan 933 kiide glomerler filtrasyon hz da (GFR) Renal Hastalkta Diyet Modifikasyonu frml esas alnarak kreatinin deerlerine gre tahmin edildi. GFR deerlerine gre bireyler evre 2 ve evre ‡3 kro- nik bbrek hastal olanlar da ierecek ekilde  kategoriye ayrld. MS tanm modifiye Adult Treatment Panel-III (ATP-III) kri- terlerine gre yapld. Bulgular: Kohortun %38.7inde MS mevcuttu. Hafif renal fonksi- yon bozukluu (MRD) varl (tahmini GFR: 60-89.9 mL/dak/1.73 m 2 olanlar) her iki cinsiyet iin geerli olmak zere alma poplasyonu- nun %50sinde saptand. Normal GFRli grupla karlatrldnda grup IIde, yaa gre ayarlanm vcut kitle indeksi (VK), homeostatik model deerlendirme (HOMA) indeksi, kan basnlar, total, HDL- kolesterol, LDL-kolesterol ve serum proteinleri her iki cinsiyet iin, apo B ve log TSH deerleri ise yalnz kadnlarda anlaml olarak yksekti. stelik belirtilen deikenler ile GFR arasnda anlaml ve ters bir iliki de mevcuttu. okdeikenli analizde MS varl ile ne GFR gruplar arasnda, ne de HOMA iin kontroll azalm GFR olasl arasnda anlaml bir iliki vard. Oysa cinsiyet, ya ve sistolik kan basnc yan ABSTRACT Objectives: To investigate the prevalence of mild renal dysfunction and its association with insulin resistance (IR), meta- bolic syndrome (MS) or its components among Turkish adults. Methods: Serum creatinine concentrations were measured in 1048 male and female subjects. After excluding cases with diabe- tes mellitus, 933 participants of a representative cohort were studi- ed cross-sectionally. Glomerular filtration rate (GFR) was estimated based on serum creatinine concentrations using the Modification of Diet in Renal Disease formula. GFR was divided into 3 categori- es constituting chronic kidney disease stages 2 and ‡3. MS was identified by modified criteria of the Adult Treatment Panel-III. Results: MS existed in 38.7% of the cohort. Mild renal dysfunc- tion (estimated GFR 60 to 89.9 mL/min/1.73 m 2 ) existed in 50% of the study sample in both genders. Compared to the group with normal GFR, in category II, age-adjusted estimates of body mass index, homeostatic model assessment (HOMA) index, blood pres- sures, total, HDL-, LDL-cholesterol and serum proteins were all sig- nificantly elevated in both genders, as were apo B and log TSH in women alone. Stated variables were also significantly and inver- sely correlated with GFR. Whereas MS was not significantly asso- ciated with GFR categories, nor with reduced GFR when controlled for HOMA, HOMA —adjusted for MS as well as for sex, age and systolic BP- was significantly associated with likelihood for redu- ced GFR. Prof. Dr. Altan Onat Nisbetiye Cad. 37/24, Etiler 34335 ‹stanbul Tel : 0 (212) 351 62 17 Faks : 0 (212) 351 42 35 E-posta : alt_onat@yahoo.com.tr