Giers Kinga, Niemczyk Stanisław, Szamotulska Katarzyna, Romejko-Ciepielewska Katarzyna, Paklerska Ewa, Bartoszewicz Zbigniew, Pacho Ryszard, Jasik Mariusz, Matuszkiewicz-Rowińska Joanna
Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland.
Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland.
Med Sci Monit. 2015 Feb 20;21:557-62. doi: 10.12659/MSM.892078.
It has not been definitively established which factors affect insulin resistance (IR) and whether dialysis decreases IR. The aim of this study was to investigate factors that may have an influence on homeostasis model assessment (HOMA-IR) in hemodialyzed patients (HDpts) and to compare IR between HDpts and healthy subjects.
We examined 33 HDpts and paired 33 subjects of the control group, matched for sex, age, and BMI. We analyzed concentrations of insulin, glucose, leptin, resistin, and total and high-molecular-weight adiponectin (HMWad) in serum. Using computed tomography in HDpts, we evaluated visceral adipose tissue (VAT), concentrations of visfatin, CRP, and IL-6.
HOMA-IR (median, 1.3 vs. 1.4, P=0.19), insulin (median 6.8 vs. 6.0 µIU/mL, P=0.7), glucose (79 mg/dL vs. 93 mg/dL, P=0.001). IR in HDpts is dependent on VAT (r=0.36, P=0.04) and this relationship is stronger than the relationship of BMI and IR (r=0.3, P=0.1). In HDpts we found higher concentrations of leptin (P=0.001) and resistin (P<0.001), with no relation to IR. HMWad and its percentage in relation to total adiponectin are higher in HDpts (P=0.03 and P<0.001, respectively).
HOMA-IR in HDpts does not differ from the control group. In HDpts it depends on the quantity of VAT and this relationship is stronger than with BMI. In HDpts leptin and resistin do not influence IR. HMWad and its percentage in total adiponectin are significantly higher in HDpts.
尚未明确确定哪些因素会影响胰岛素抵抗（IR）以及透析是否会降低IR。本研究的目的是调查可能影响血液透析患者（HDpts）稳态模型评估（HOMA-IR）的因素，并比较HDpts与健康受试者之间的IR。
我们检查了33例HDpts，并配对了33名对照组受试者，在性别、年龄和BMI方面进行了匹配。我们分析了血清中胰岛素、葡萄糖、瘦素、抵抗素以及总脂联素和高分子量脂联素（HMWad）的浓度。在HDpts中使用计算机断层扫描，我们评估了内脏脂肪组织（VAT）、内脂素、CRP和IL-6的浓度。
HOMA-IR（中位数，1.3对1.4，P = 0.19），胰岛素（中位数6.8对6.0 μIU/mL，P = 0.7），葡萄糖（79 mg/dL对93 mg/dL，P = 0.001）。HDpts中的IR取决于VAT（r = 0.36，P = 0.04），并且这种关系比BMI与IR的关系更强（r = 0.3，P = 0.1）。在HDpts中，我们发现瘦素（P = 0.001）和抵抗素（P < 0.001）的浓度较高，与IR无关。HDpts中HMWad及其占总脂联素的百分比更高（分别为P = 0.03和P < 0.001）。
HDpts中的HOMA-IR与对照组无差异。在HDpts中，它取决于VAT的量，并且这种关系比与BMI的关系更强。在HDpts中，瘦素和抵抗素不影响IR。HDpts中HMWad及其占总脂联素的百分比显著更高。
