Srivastava Neha, Singh R G, Kumar Alok, Singh Shivendra
Department of Nephrology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of Pathology, Division of Immunopathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Saudi J Kidney Dis Transpl. 2017 Jan-Feb;28(1):36-43. doi: 10.4103/1319-2442.198114.
Most investigations have focused on patients with end-stage renal disease (ESRD). More recently, due to increased recognition of the high prevalence of moderate-to-severe chronic kidney disease (CKD), attention has been redirected to this patient population to identify risk factors associated with hospitalization, death, and progression to ESRD. The objective of this study was to examine the degree and determinants of insulin resistance (IR) in predialytic, nondiabetic, CKD patients. Our study is a hospital-based cross-sectional study. The participants were aged 18 years and above with CKD due to any cause, were all nondiabetic patients, and the mean serum creatinine was 1.41-5 mg/dL. Anthropometric parameters included body weight, height, and skinfold thickness. Homeostasis model assessment of IR (HOMA-IR) score was 2.5 ± 1.2 in CKD patients and 1.9 ± 0.7 in controls. In the unadjusted analysis, there was a significant (P <0.05) correlation between HOMA-IR and body mass index (BMI), waist circumference, cholesterol, and triglyceride (TG) levels. Upon adjusting for age and sex, total body fat (BF), globulin, TG, and C-reactive protein were having positive, significant (P <0.05) correlation with HOMA-IR. In multivariate regression models, BMI and total BF% were significant (P <0.05) predictors of IR in patients with CKD but not in controls. BF% and BMI are indicators of IR in CKD as in non-CKD population.
大多数研究都集中在终末期肾病（ESRD）患者身上。最近，由于对中重度慢性肾脏病（CKD）高患病率的认识增加，注意力已转向这一患者群体，以确定与住院、死亡以及进展为ESRD相关的危险因素。本研究的目的是检查透析前非糖尿病CKD患者胰岛素抵抗（IR）的程度和决定因素。我们的研究是一项基于医院的横断面研究。参与者年龄在18岁及以上，因任何原因患有CKD，均为非糖尿病患者，平均血清肌酐为1.41 - 5mg/dL。人体测量参数包括体重、身高和皮褶厚度。CKD患者的胰岛素抵抗稳态模型评估（HOMA-IR）评分为2.5±1.2，对照组为1.9±0.7。在未调整分析中，HOMA-IR与体重指数（BMI）、腰围、胆固醇和甘油三酯（TG）水平之间存在显著（P<0.05）相关性。在调整年龄和性别后，全身脂肪（BF）、球蛋白、TG和C反应蛋白与HOMA-IR呈正相关且显著（P<0.05）。在多变量回归模型中，BMI和总BF%是CKD患者IR的显著（P<0.05）预测因素，但在对照组中不是。与非CKD人群一样，BF%和BMI是CKD患者IR的指标。
