Document Detail


Renal insulin resistance syndrome, adiponectin and cardiovascular events in patients with kidney disease: the mild and moderate kidney disease study.
MedLine Citation:
PMID:  15743998     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relationship among insulin resistance, adiponectin, and cardiovascular (CV) morbidity in patients with mild and moderate kidney disease was investigated. Insulin sensitivity (Homeostasis Model Assessment of Insulin Resistance [HOMA-IR]) and adiponectin plasma levels were assessed in 227 nondiabetic renal patients at different degrees of renal dysfunction and in 76 healthy subjects of similar age and gender distribution and body mass index. In renal patients, association with prevalent CV events was evaluated, and incident CV events were evaluated in a prospective study. HOMA-IR was markedly higher in patients than in healthy subjects (3.59 +/- 3.55 versus 1.39 +/- 0.51; P < 0.01). In renal patients, HOMA-IR was significantly correlated with body mass index (r = 0.477; P < 0.01), triglycerides (r = 0.384; P < 0.01), adiponectin plasma levels (r = -0.253; P < 0.01), and age (r = 0.164; P < 0.05), but not with renal function (GFR by iod-thalamate clearance). Patients with previous CV events were significantly older, had higher HOMA-IR and serum triglycerides, and had lower adiponectin plasma levels (all P < 0.05). Logistic regression analysis revealed age (P < 0.001) and adiponectin (P < 0.002) as independent variables related to prevalent CV events. In the prospective study, median follow-up was 54 mo. Patients who experienced CV events had significantly higher serum glucose and lower adiponectin plasma levels (both P < 0.05). In patients with chronic kidney diseases, a syndrome of insulin resistance is present even in the earliest stage of renal dysfunction, and several components of this syndrome are associated with CV events. Moreover, hypoadiponectinemia is a novel putative CV risk factor in patients with mild and moderate renal failure.
Authors:
Bjoern Becker; Florian Kronenberg; Jan T Kielstein; Hermann Haller; Christian Morath; Eberhard Ritz; Danilo Fliser;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-03-02
Journal Detail:
Title:  Journal of the American Society of Nephrology : JASN     Volume:  16     ISSN:  1046-6673     ISO Abbreviation:  J. Am. Soc. Nephrol.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-03-24     Completed Date:  2005-09-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9013836     Medline TA:  J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1091-8     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Hannover Medical School, Carl Neuberg Strasse 1, 30625 Hannover, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adiponectin
Adult
Cardiovascular Diseases / epidemiology,  etiology*
Cohort Studies
Female
Follow-Up Studies
Homeostasis
Humans
Incidence
Insulin Resistance*
Intercellular Signaling Peptides and Proteins / blood*
Kidney Diseases / complications*,  physiopathology*
Male
Medical Records
Middle Aged
Prospective Studies
Risk Factors
Severity of Illness Index
Syndrome
Chemical
Reg. No./Substance:
0/Adiponectin; 0/Intercellular Signaling Peptides and Proteins

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