Obesity is considered one of the most common syndromes in medical practice. Over the past 40 years, the average body mass index (BMI) has increased by 10.3 % in men and by 9.4 % in women. It is believed that obesity, diagnosed by BMI, is a significant risk factor for the development of cardiovascular diseases, and, accordingly, negatively affects a person's life expectancy. Among the methods that make it possible not only to characterize the ratio of height and body weight but to give an idea of the amount of body fat, the most popular in our country are caliperometry and bioimpedance measurement. THE AIM: to assess the possibility of interchangeability of caliperometry and bioimpedance measurement in determining body fat mass in dialysis patients.PATIENTS AND METHODS. The study involved 140 patients, including 66 men and 58 women, receiving HD treatment. In general, the surveyed group can be characterized as clinically stable. To determine the body composition, all patients underwent caliperometry using the TVES KETS 100 electronic caliper.RESULTS. Fat mass according to caliperometry data was 40.0 % in women, 30.0 % in men, p = 0.0001. According to bioimpedance measurements – 39.9 and 28.3 %, respectively, p = 0.0001. During the ROC analysis, the area under the curve for caliperometry was 0.851 (CI 0.729-0.932), for bioimpedance measurements 0.839 (CI 0.715-0.932). The correlation between the two methods in determining body fat mass in kg was Rs = 0.991 p = 0.0001, and in % Rs = 0.985 p = 0.0001. When comparing the results of determining body fat by the Bland-Altman method, the average difference between the two methods was 0.6 ± 2.3 %, the degree of discrepancy was from -4 to + 5 %. The prevalence of obesity among dialysis patients by BMI was 29.4 % among women and 19.4 % among men. However, according to the results of both caliperometry and bioimpedance measurements, the real prevalence of obesity exceeded 90 %.CONCLUSION. Diagnosing obesity by BMI does not provide an indication of the true prevalence of obesity in dialysis patients. For this purpose, it is necessary to use bioimpedance or caliperometry. Both methods give comparable results and can be considered interchangeable.
Insulin resistance (IR) is defined as a violation of the biological response to stimulation of the heart, skeletal muscle, liver, and adipose tissue. The reasons for the formation of the syndrome are diverse, and clinical diagnosis is difficult since there is no generally accepted test available to determine it. For the diagnosis of IR directly and indirectly developed test groups. The complexity of their implementation in some cohorts of patients led to the development of a number of glycemic indices. However, no consensus has yet been reached on which one should be preferred. THE AIM: to compare IR screening methods in a cohort of hemodialysis patients. PATIENTS AND METHODS. 124 patients were examined, including 66 men and 58 women aged 57.6 ± 13.6 years, receiving HD treatment for 75.4 ± 44.5 months. For the screening of IR, the HOMA-1 and HOMA-2 glucose homeostasis model, QUICKI index, and triglycerides/glucose (TriH) were used. RESULTS. When conducting a nonparametric correlation analysis for fasting insulin plasma concentrations, statistically significant relationships were revealed only in men: with BMI (Rs = 0.258 p = 0.049), waist circumference to height ratio (Rs = 0.316 p = 0.015), and amount of dietary protein (Rs = 0.271 p = 0.039), systolic blood pressure (Rs = 0.308 p = 0.018), diastolic blood pressure (Rs = 0.290 p = 0.027), C-reactive protein level (Rs = 0.579 p = 0.0001). In women, no statistically significant correlations were found. The value of the Charlson index, as well as tobacco smoking, currently or in the history of the indicators of insulin resistance had no effect. According to the results of logistic regression analysis, the risk of developing clinical manifestations of atherosclerotic lesions of any vascular pool increased by 4.5 times (χ2 = 4.582 p = 0.032) with IR in the HOMA-1 model of more than 2.7 units, however, only in men. The relationship of other indicators of IR with atherosclerosis was not identified. CONCLUSION. A comparison of surrogate models of IR, from our point of view, allows us to distinguish HOMA-1 and HOMA-2. Probably, for the cross-sectional studies it is advisable to use the first of them, and for longitudinal – the second.
Background and Aims insulin resistance (IR) is a decrease in the biological response of sensitive tissues to insulin. IR is known as an adverse risk factor in cardiovascular disease, which largely determines the prognosis of patients receiving hemodialysis (HD). But this issue is not well understood. For the screening of IR, special indices have been developed that characterize the sensitivity of tissues to insulin. The aim of the study was to compare the methods of screening for IR in patients receiving HD in relation to the markers of systemic inflammation and atherogenic dyslipidemia (AtD). Method 124 patients receiving HD for 75.4 ± 44.5 months were examined including 66 men and 58 women aged 57.6 ± 13.6 years. For IR screening, the Homeostatic Model Assessment-1 and 2 indices (HOMA-1 and HOMA-2), the Quantitative Insulin Sensitivity Check Index (QUICKI) and triglycerides / glucose (Tri/G) were used. Patients were examined in accordance with the recommendations of KDIGO. Data analysis was carried out using “STATISTICA 10.0”. Results fasting insulin levels were elevated in 19% of patients. But, the calculated indices were consistent with the idea that IR is much more common. So, the IR index in the HOMA -1 model was increased in 47%, in the HOMA -2 model - in 33%, in the QUICKI model - in 36%, the TriH indicator - in 91%. The sensitivity of peripheral tissues in the HOMA-1 and HOMA-2 models was equally reduced by 35-40%. The results of the correlation analysis between indicators of IR and plasma concentration of C-reactive protein and lipid profile are presented in table 1. Informativeness of IR indicators depending on the presence of obesity is presented in table 2 We were also interested in whether insulin resistance affects the development of clinical manifestations of atherosclerosis, cardiac arrhythmias, and heart failure. An analysis of this relationship did not reveal. Only the IR index in the HOMA-1 model with a value of more than 2.7 units was associated with a 4.5-fold increase in the risk of developing clinical manifestations of atherosclerotic lesions (χ2 = 4.582 p = 0.032). Statistically significant it was only in men. Given our data, perhaps IR is one of the reasons for the higher morbidity and mortality of men at HD. Conclusion a comparison of IR models allows us to distinguish HOMA-2 as the most accurate index. The highest correlation with systemic inflammation and AtD was in the HOMA-1 and HOMA-2 indices.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.