Comparison of insulin resistance in the various stages of chronic kidney disease and inflammation

Abstract

Objective: In this study, we compared predialysis and dialysis patients with the controls in terms of insulin resistance and evaluated the association with inflammation that is a risk factor for cardiovascular disease. Materials and methods: A total of 134 non-diabetic patients with controls (n ¼ 33), predialysis (n ¼ 29) and dialysis patient group (n ¼ 72) were included in the study. Fasting blood glucose, insulin, C-peptide, albumin, CRP (C-reactive protein) and homocysteine plasma levels were simultaneously analyzed in all the patients. HOMA-IR index was calculated to show existence of insulin resistance. Results: Mean insulin and HOMA-IR index values were found to be higher in the predialysis and dialysis patient groups than in the control group (p ¼ 0.019, p ¼ 0.014; respectively). When three groups were compared in terms of C-peptide levels; these values were found to be statistically significantly higher in the predialysis patients than in controls (p ¼ 0.017) and in the dialysis group than in the predialysis patients and controls (p ¼ 0.0001, p ¼ 0.0001; respectively). CRP and homocysteine levels were found to be statistically higher (p ¼ 0.0001, p ¼ 0.0001; respectively), while albumin levels were significantly lower (p ¼ 0.0001) in the dialysis patient group. Conclusion: In our study, we demonstrated that insulin resistance was higher in patients in the various stages of chronic kidney disease compared to healthy population. We found that insulin resistance, C-peptid and inflammation related cardiovascular risk factors increased.

Fructose downregulates miR‐330 to induce renal inflammatory response and insulin signaling impairment: Attenuation by morin

“…In our previous study, GLUT5 and GLUT2 were also detected in the renal tubular and glomerulus of rats . High fructose consumption is a risk factor for kidney diseases , possibly resulting from insulin signaling impairment . Inflammation response with the activation of NF‐κB and NLRP3 inflammasome is also detected in the kidney of fructose‐fed animals .…”

“…High fructose consumption is suggested to be a risk factor for kidney diseases in experimental animals and humans , which may result from insulin signaling abnormality and insulin resistance . Pro‐inflammatory cytokine IL‐1β directly reduces insulin sensitivity .…”

Severe Insulin-resistant Diabetes due to Insulin Antibodies Associated with Eosinophilia

“…In the present case, the fasting serum C-peptide level was 1.97 ng/mL despite a decreased urine C-peptide level (17 μg/day) before starting insulin analog treatments and hemodialysis. The discrepancy between the serum and urine C-peptide levels may be the result of renal failure (8). In addition, probably due to interference by insulin antibodies (9,10), the serum C-peptide concentration in the immunoassay had further increased (5.24 ng/mL) at the time of admission.…”

Insulin Resistance in End Stage Renal Disease

“…This could reflect altered insulin dynamics or better control of uremia with dialysis. Measurement of IR using c-peptide could be a better method in patients with CKD (6) .…”