Insulin autoantibodies, D-dimer and microalbuminuria: A cross-sectional, case-control study of type 2 diabetes

Table 1 Characteristics of Insulin autoantibodies cases and controls

	IAA-negative (n = 115)	IAA-positive (n = 115)	Total (n = 230)	P value
Age (years)	62.13 ± 10.43	63.23 ± 9.72	62.68 ± 10.07	0.41
Gender (male), n (%)	66 (57.4)	65 (56.5)	131 (57.0)	0.89
BMI (kg/m2)	26.00 ± 3.54	25.81 ± 3.57	25.91 ± 3.55	0.69
Hypertension, n (%)	61 (53.0)	63 (54.8)	124 (53.9)	0.79
Smoking, n (%)	25 (21.74)	32 (27.83)	57 (24.78)	0.29
Uric acid (μmol/L)	327.06 ± 91.31	309.04 ± 111.72	318.05 ± 102.21	0.18
TC (mmol/L)	4.27 ± 1.24	3.99 ± 1.28	4.13 ± 1.26	0.10
LDL-C (mmol/L)	2.26 ± 0.98	2.11 ± 1.01	2.19 ± 1.00	0.24
HDL-C (mmol/L)	1.13 ± 0.35	1.22 ± 0.49	1.18 ± 0.43	0.11
Triglycerides (mmol/L)	2.03 ± 1.55	2.04 ± 2.53	2.03 ± 2.09	0.96
Homocysteine (μmol/L)	11.10 ± 7.86	10.76 ± 7.77	10.93 ± 7.80	0.74
WBC (× 109/L)	6.17 ± 1.66	5.96 ± 1.71	6.06 ± 1.69	0.34
ESR (mm/Hr)	15.92 ± 16.04	18.84 ± 25.31	17.38 ± 21.20	0.29
CRP (mg/L)	4.30 ± 13.89	4.70 ± 22.89	4.50 ± 18.89	0.87
PCT (ng/mL)	0.03 (0.02-0.04)	0.03 (0.02-0.05)	0.03 (0.02-0.05)	0.28
D-dimer (mg/L)	0.21 (0.19-0.33)	0.30 (0.19-0.55)	0.24 (0.19-0.41)	0.008
UACR (mg/g)	12.7 (4.5-103.9)	20.8 (3.9-285.5)	15.8 (4.3-163.0)	0.21
eGFR (mL/min/1.73 m2)	90.16 ± 16.27	87.64 ± 27.20	88.90 ± 22.39	0.39
Diabetes duration (years)	13.03 ± 6.79	14.88 ± 7.76	13.95 ± 7.33	0.056
Insulin dosage (U/day)	32 (24-40)	36 (28-44)	34 (26-44)	0.12
Insulin use duration (years)	5 (1-9)	5 (2-9)	5 (2-9)	0.99
Insulin types
Human insulin, n (%)	41 (35.7)	53 (46.1)	94 (40.9)	0.10
Insulin analogs, n (%)	77 (67.0)	65 (56.5)	142 (61.7)	0.10
Hypoglycemia, n (%)	13 (11.3)	26 (22.6)	39 (17.0)	0.02
HbA1c (%)	8.63 ± 1.70	8.90 ± 1.84	8.77 ± 1.77	0.24
Fructosamine (%)	22.69 ± 6.08	23.02 ± 5.86	22.86 ± 5.96	0.68
FPG (mmol/L)	8.30 ± 2.84	7.86 ± 3.20	8.08 ± 3.02	0.28
Plasma insulin (μU/mL)	9.8 (5.5-17.6)	39.1 (12.0- 102.7)	16.1 (7.6-48.5)	< 0.001
Plasma C-peptide (ng/mL)	1.39 (0.89-2.45)	1.50 (0.94-2.39)	1.46 (0.90-2.40)	0.47

IAA: Insulin autoantibodies; BMI: Body mass index; TC: Total cholesterol; LDL-C: Low-density lipoprotein cholesterol; HDL-C: High-density lipoprotein cholesterol; WBC: White blood cell; ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein; PCT: Procalcitonin; UACR: Urinary albumin-to-creatinine ratio; eGFR: Estimated glomerular filtration rate.

Table 2 Linear regression analysis for the association between urinary albumin-to-creatinine ratio and D-dimer level in insulin autoantibodies positive or negative cases

	Model 1	Model 2	Model 3
Total β, t	0.712a	0.691a	0.701a
	-3.19	-3.05	-3.13
IAA-negative β, t	0.346	0.415	0.897
	-0.38	-0.45	-1.06
IAA-positive β, t	0.708a	0.643a	0.654b
	-3.07	-2.69	-2.56

^aP < 0.01.

^bP < 0.05.

Model 1: Crude model; Model 2: Adjusted for age, gender and body mass index (BMI); Model 3: Adjusted for age, gender, BMI, hemoglobulin A1C, total cholesterol, C-peptide and estimated glomerular filtration rate. IAA: Insulin autoantibodies;

Table 3 Interaction between D-dimer and insulin autoantibodies on abnormal albuminuria

	IAA-negative	IAA-positive	Total	Interaction P value
D-dimer
Model 1	1.24 (0.28-5.49)	2.88 (1.25-6.6)	2.48 (1.26-4.88)	0.334
Model 2	1.32 (0.29-5.97)	2.68 (1.16-6.18)	2.47 (1.25-4.89)	0.439
Model 3	1.82 (0.37-9.01)	3.39 (1.34-8.59)	2.90 (1.36-6.15)	0.494
Elevated D-dimer
Model 1	0.41 (0.13-1.32)	3.20 (1.36-7.53)	1.53 (0.82-2.87)	0.005
Model 2	0.41 (0.13-1.36)	2.94 (1.23-6.99)	1.53 (0.82-2.88)	0.009
Model 3	0.48 (0.14-1.66)	2.88 (1.17-7.07)	1.60 (0.84-3.07)	0.015

Model 1: Crude model; Model 2: Adjusted for age, gender and body mass index (BMI); Model 3: Adjusted for age, gender, BMI, hemoglobulin A1C, total cholesterol, C-peptide and estimated glomerular filtration rate. IAA: Insulin autoantibodies.