| A comparison of novel and commonly-used indices of insulin sensitivity in African American chronic hemodialysis patients. | |
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MedLine Citation:
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PMID: 21441124 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Insulin resistance (IR) is highly prevalent in chronic hemodialysis (CHD) patients and is associated with poor cardiovascular outcomes. Hyperinsulinemic euglycemic glucose clamp (HEGC) is the gold standard for measuring IR. The comparison of commonly-used indirect indices of IR to HEGC has not been adequately performed in this population. Furthermore, the validity of newly proposed adipokine-based IR indices has not been explored. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This is an observational study performed in a single center, involving 12 prevalent CHD patients (50 ± 9 years old, 100% African American, 33% women, body mass index of 34.4 ± 7.6 kg/m(2)) who were studied three consecutive times. IR was assessed by HEGC (glucose-disposal rate [GDR]), homeostatic model assessment of IR (HOMA-IR), HOMA-IR corrected by adiponectin (HOMA-AD), leptin adiponectin ratio (LAR), QUICKI, and the McAuley's index at each time point. RESULTS: Eighty-three percent of the subjects displayed either glucose intolerance or overt insulin resistance by HEGC (GDR median, 5.71; interquartile range [IQR], 4.16, 6.81). LAR and HOMA-AD were the best correlates of IR measured by HEGC (r=-0.72, P<0.001, and -0.67, P<0.001), respectively. Fat percentage, interleukin-6, and adipokines (leptin, adiponectin, and resistin) were strongly associated with GDR. HEGC, LAR, and HOMA-AD had the best intraclass correlation coefficients. CONCLUSION: IR is common in CHD patients. Adipokine-based indices are the best correlates of IR measurements by HEGC. HOMA-IR and QUICKI are reasonable alternatives. Use of these indices may allow better detection of alterations in insulin sensitivity in CHD patients. |
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Authors:
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Adriana M Hung; Mary B Sundell; Phyllis Egbert; Edward D Siew; Ayumi Shintani; Charles D Ellis; Aihua Bian; T Alp Ikizler |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S. Date: 2011-03-24 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 6 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-04-08 Completed Date: 2011-08-18 Revised Date: 2012-04-02 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 767-74 Citation Subset: IM |
Copyright Information:
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© 2011 by the American Society of Nephrology |
Affiliation:
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Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult African Americans* Aged Female Glucose / metabolism Humans Insulin Resistance* Kidney Failure, Chronic / metabolism, therapy Male Middle Aged Renal Dialysis* |
| Grant Support | |
ID/Acronym/Agency:
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1UL-1RR024975/RR/NCRR NIH HHS; K24 DK 62849/DK/NIDDK NIH HHS |
| Chemical | |
Reg. No./Substance:
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50-99-7/Glucose |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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