Abstract: Objective To explore the association of estimated glomerular filtration rate (eGFR)with insulin resistance and β-cell function in the elderly patients with type 2 diabetes mellitus(T2DM). Methods A total of 944 elderly patients with T2DM were divided into three groups according to the level of eGFR:normal renal function group[eGFR≥90 mL/(min·1.73 m²), n=315], mild renal dysfunction group [eGFR: 60-<90 mL/(min·1.73 m²), n=357] and moderate and severe renal dysfunction group[eGFR<60 mL/(min·1.73 m²), n=272]. All the patients underwent oral glucose tolerance test (OGTT) and insulin releasing test. According to the levels of blood glucose and insulin 0, 30, 60 and 120 min after taking glucose, the insulin resistance indexes [homeostasis model assessment of insulin resistance (HOMA-IR),GluAUC30×InsAUC30] and islet secretion function indexes (HOMA-β, ΔI30/ΔG30, InsAUC30, IG30, InsAUC120, IG120) were counted. The correlations of eGFR with insulin resistance and β-cell function indexes were analyzed. Results With the decrease of the level of eGFR, HOMA-IR, GluAUC30×InsAUC30, HOMA-β, ΔI30/ΔG30, InsAUC30, IG30, InsAUC120 and IG120 increased gradually (all P<0.05). After adjustment for confounders, eGFR was still negatively correlated with HOMA-IR, GluAUC30×InsAUC30, HOMA-β, ΔI30/ΔG30, InsAUC30, IG30, InsAUC120 and IG120(all P<0.01). Conclusions eGFR is negatively influenced by insulin resistance and compensatory secretion of islet cells in the elderly patients with T2DM.

Key words: type 2 diabetes mellitus, estimated glomerular filtration rate, insulin resistance, β-cell function