Division of Nephrology, Ege University School of Medicine, 35100 Bornova, Izmir, Turkey.
Int Urol Nephrol. 2012 Feb;44(1):255-62. doi: 10.1007/s11255-011-9984-z. Epub 2011 Jun 4.
Insulin resistance is a risk factor for cardiovascular morbidity and mortality in the general and end-stage renal disease populations. In this study, we investigated the association between insulin resistance and arterial stiffness in nondiabetic peritoneal dialysis (PD) patients.
Fifty-three patients were enrolled. Patients were divided into 2 groups as homeostasis model assessment of insulin resistance (HOMA-IR) ≤ 2.97 (low) and >2.97 (high). Carotid-femoral pulse wave velocity (c-f PWV) analysis and intima-media thickness of the carotid artery were measured.
Mean age was 46 ± 12 years and HOMA-IR was 2.97 ± 1.77 (0.77-8.88). Mean c-f PWV was 7.6 ± 1.7 m/s. HOMA-IR was positively correlated with age, body mass index, and c-f PWV and negatively with serum HDL cholesterol and parathormone. In linear regression analysis, age and mean arterial pressure were predictors for c-f PWV. When patients were divided into 2 groups according to median age as ≤ 49 and >50, mean arterial pressure, male gender, and age were predictors for c-f PWV in patients aged ≤ 49, whereas HOMA-IR was the only predictor for c-f PWV in patients aged >50 years.
Insulin resistance is an independent risk factor for arterial stiffness in PD patients older than 50 years. IR is not associated with carotid intima-media thickness.
胰岛素抵抗是普通人群和终末期肾病患者心血管发病率和死亡率的一个危险因素。在这项研究中，我们调查了非糖尿病腹膜透析（PD）患者胰岛素抵抗与动脉僵硬之间的关系。
纳入 53 名患者。根据稳态模型评估的胰岛素抵抗（HOMA-IR）≤2.97（低）和>2.97（高）将患者分为 2 组。测量颈动脉-股动脉脉搏波速度（c-f PWV）分析和颈动脉内-中膜厚度。
平均年龄为 46±12 岁，HOMA-IR 为 2.97±1.77（0.77-8.88）。平均 c-f PWV 为 7.6±1.7 m/s。HOMA-IR 与年龄、体重指数和 c-f PWV 呈正相关，与血清高密度脂蛋白胆固醇和甲状旁腺激素呈负相关。在线性回归分析中，年龄和平均动脉压是 c-f PWV 的预测因素。当根据中位年龄≤49 和>50 将患者分为两组时，在年龄≤49 的患者中，平均动脉压、男性和年龄是 c-f PWV 的预测因素，而在年龄>50 岁的患者中，HOMA-IR 是 c-f PWV 的唯一预测因素。
胰岛素抵抗是 50 岁以上 PD 患者动脉僵硬的一个独立危险因素。IR 与颈动脉内-中膜厚度无关。
