NDT Advance Access originally published online on April 16, 2007
Nephrology Dialysis Transplantation 2007 22(9):2554-2562; doi:10.1093/ndt/gfm204
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Insulin resistance and muscle wasting in non-diabetic end-stage renal disease patients
1Division of Nephrology and Hypertension, Department of Internal Medicine, 2Department of Surgery and 3Kidney Disease Research Group, Inha University College of Medicine, Inchon, Korea
Correspondence and offprint requests to: Moon-Jae Kim, MD, Kidney Center, Inha University Hospital, 7-206, 3-Ga, Sinhung-Dong, Jung-Gu, Inchon city, Korea. E-mail: nhkimj{at}inha.ac.kr
 |
Abstract |
|---|
Background. Insulin resistance (IR) is prevalent in uraemia. Recent experimental studies suggested IR to be a central mechanism for uraemic malnutrition. However, it is not known whether IR is related to muscle wasting in non-diabetic end-stage renal disease (ESRD) patients.
Methods. We cross-sectionally assessed IR and muscle wasting in 21 non-diabetic ESRD patients who admitted for the initiation of dialysis. For the assessment of muscle wasting, lean body mass was measured (LBMm) by dual energy X-ray absorptiometry and compared with the estimated LBM (LBMe) from the prediction equation derived from healthy controls using the ratio of LBMm/LBMe. For measurement of IR, the homoeostasis model (HOMA-IR) was used. In addition, among patients who chose continuous ambulatory peritoneal dialysis, muscle was sampled during catheter insertion from the rectus abdominis to measure 14-kDa actin fragments, a marker of muscle protein degradation.
Results. Patients with a low LBMm/LBMe ratio (<1.00) showed higher HOMA-IR and fat mass (FM) (% body weight) and lower LBM (% body weight) than those with a high LBMm/LBMe ratio (
1.00). LBMm/LBMe ratio was negatively correlated with HOMA-IR, regardless of obesity. By multiple regression analysis, HOMA-IR was an independent factor affecting LBMm/LBMe ratio. Furthermore, in the muscle samples, patients with high HOMA-IR had lower LBMm/LBMe ratios and stronger bands for the 14-kDa actin fragments than did patients with low HOMA-IR.
Conclusion. These results suggest that IR seems to be associated with muscle wasting in non-diabetic ESRD patients.
Keywords: end-stage renal disease; insulin resistance; malnutrition; muscle atrophy
Received for publication: 24.12.05
Accepted in revised form: 15. 3.07
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  H. A. Bergrem, T. G. Valderhaug, A. Hartmann, H. Bergrem, J. Hjelmesaeth, and T. Jenssen Glucose tolerance before and after renal transplantation Nephrol. Dial. Transplant., October 23, 2009; (2009) gfp566v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-H. Park and B. Lindholm DEFINITION OF METABOLIC SYNDROME IN PERITONEAL DIALYSIS Perit. Dial. Int., February 1, 2009; 29(Supplement_2): S137 - S144. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. K. Sakkas, C. Karatzaferi, E. Zintzaras, C. D. Giannaki, V. Liakopoulos, E. Lavdas, E. Damani, N. Liakos, I. Fezoulidis, Y. Koutedakis, et al. Liver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patients Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2008; 295(6): R1721 - R1729. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Evans, Z. Nasim, J. Brown, E. Clapp, A. Amin, B. Yang, T. P. Herbert, and A. Bevington Inhibition of SNAT2 by Metabolic Acidosis Enhances Proteolysis in Skeletal Muscle J. Am. Soc. Nephrol., November 1, 2008; 19(11): 2119 - 2129. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Axelsson The emerging biology of adipose tissue in chronic kidney disease: from fat to facts Nephrol. Dial. Transplant., October 1, 2008; 23(10): 3041 - 3046. [Full Text] [PDF]
|
|