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Bodlaj, G; Berg, J; Pichler, R; Biesenbach, G.
Prevalence, severity and predictors of HOMA-estimated insulin resistance in diabetic and nondiabetic patients with end-stage renal disease.
J Nephrol. 2006; 19(5):607-612
Web of Science PubMed

 

Co-authors Med Uni Graz
Berg Jörg
Pichler Robert
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Abstract:
BACKGROUND: Prevalence of insulin resistance (IR) is increased in type 2 diabetes and in end-stage renal disease (ESRD). IR is associated with advanced atherosclerosis and is an independent predictor for cardiovascular disease in diabetes and ESRD patients. We investigated prevalence, severity, predictors and relation to vascular diseases by the homeostasis model assessment (HOMA-IR) in diabetic and nondiabetic ESRD patients. METHODS: ESRD patients with type 2 diabetes (n = 27) and nondiabetic ESRD patients (n = 35) were included in the study. IR was assessed with the HOMA-IR using fasting glucose and insulin levels. Additionally, serum levels of C-peptide, HbA1c, triglycerides, cholesterol and C-reactive protein and blood pressure were assessed. RESULTS: Median HOMA-IR was significantly higher in the diabetic ESRD patients than in the nondiabetic ESRD patients (6.3 [range 0.7-61.7] vs. 2.4 [range 0.3-5.7]; p < 0.001). Systolic blood pressure and triglycerides were significantly higher in patients with higher HOMA-IR, whereas HDL cholesterol was significantly lower in those patients. Only nondiabetic patients with increased HOMA-IR had significantly higher C-peptide levels than those with lower HOMA-IR (14.9 + 5.7 vs. 9.0 + 4.3, p = 0.004). Vascular disease prevalence was significantly higher in diabetic patients with higher HOMA-IR than in those with lower HOMA-IR. CONCLUSIONS: Prevalence and severity of HOMA-IR was greater in diabetic ESRD patients than in those without diabetes. In diabetic patients low HDL cholesterol was the only predictor for higher HOMA-IR, whereas in nondiabetic patients a high C-peptide level was the only predictor for higher HOMA-IR. The prevalence of vascular diseases is associated with higher HOMA-IR in ESRD patients.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Atherosclerosis - blood Atherosclerosis - complications Atherosclerosis - epidemiology
Blood Glucose - analysis
Blood Pressure -
C-Peptide - blood
C-Reactive Protein - analysis
Cholesterol - blood
Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - epidemiology
Diabetic Nephropathies - blood Diabetic Nephropathies - complications Diabetic Nephropathies - epidemiology
Fasting - blood
Female -
Hemoglobin A, Glycosylated - analysis
Humans -
Insulin - blood
Insulin Resistance -
Kidney Failure, Chronic - blood Kidney Failure, Chronic - complications Kidney Failure, Chronic - epidemiology
Male -
Middle Aged -
Models, Cardiovascular -
Prevalence -
Severity of Illness Index -
Triglycerides - blood

Find related publications in this database (Keywords)
end-stage renal disease
homeostasis model assessment
insulin resistance
predictor
type 2 diabetes
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