Conkar Seçil, Mir Sevgi
Department of Pediatric Nephrology, Ege University Medical Faculty, Izmir, Turkey.
Saudi J Kidney Dis Transpl. 2017 Sep-Oct;28(5):1078-1084. doi: 10.4103/1319-2442.215144.
Insulin Resistance is common in patients with mild-to-moderate stage chronic kidney disease (CKD), even when the glomerular filtration rate is within the normal range. This study aimed to investigate the association of IR and 25-hydroxyvitamin D levels. In this study, we evaluated the frequency of IR in predialysis patients and the association with 25-hydroxyvitamin (OH)D levels. A total of 32 non-diabetic patients with predialysis were included in the study. Homeostasis model assessment for insulin resistance (HOMA-IR) index was calculated to show presence of IR. Data were analyzed with the Statistical Package for the Social Sciences (SPSS) program version 13.0 (SPSS Inc, Chicago, Ill, USA) using the Chi-square, Student t-test, and logistic regression analysis. Nineteen of 32 subjects (59.4%) were detected to have IR. There was no consistent relationship was detected between IR and glomerular filtration rate, body mass index, and blood pressure in chronic kidney disease (CKD). However; significant difference was detected in 25(OH)D levels with IR in CKD (P = 0.49). The regression analysis showed that 25(OH)D was an independent predictor of IR with an odds ratio of 1.2. In our study, we demonstrated that IR was high in different stages of CKD. Insulin-resistance in non-diabetic CKD was correlated with 25(OH)D levels. 25(OH) vitamin D levels can play a significant role in the development of IR in pediatric patients with CKD. This is important for the early detection and intervention of vitamin D deficiency thereby preventing potentially future complications related to IR.
胰岛素抵抗在轻度至中度慢性肾脏病（CKD）患者中很常见，即使肾小球滤过率在正常范围内。本研究旨在探讨胰岛素抵抗（IR）与25-羟基维生素D水平之间的关联。在本研究中，我们评估了透析前患者中IR的发生率及其与25-羟基维生素（OH）D水平的关联。共有32例非糖尿病透析前患者纳入本研究。计算胰岛素抵抗的稳态模型评估（HOMA-IR）指数以显示IR的存在。使用社会科学统计软件包（SPSS）13.0版（美国伊利诺伊州芝加哥SPSS公司）对数据进行分析，采用卡方检验、学生t检验和逻辑回归分析。32名受试者中有19名（59.4%）被检测出存在IR。在慢性肾脏病（CKD）中，未检测到IR与肾小球滤过率、体重指数和血压之间存在一致关系。然而，CKD患者中IR与25（OH）D水平存在显著差异（P = 0.49）。回归分析显示，25（OH）D是IR的独立预测因子，比值比为1.2。在我们的研究中，我们证明了CKD不同阶段的IR发生率较高。非糖尿病CKD患者的胰岛素抵抗与25（OH）D水平相关。25（OH）维生素D水平在CKD儿童患者IR的发生中可能起重要作用。这对于早期发现和干预维生素D缺乏从而预防未来可能与IR相关的并发症很重要。
