Evidence for Increased Risk of Prediabetes in the Uremic Patient

Shehab-Eldin, Walid; Ragheb, Ahmed; Klassen, J; Shoker, Ahmed

doi:10.1159/000112529

Cited by 18 publications

(5 citation statements)

References 145 publications

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“…This result is consistent with our previous report of 51% in a larger group of 252 CKD patients [1]. This increased prevalence of pre-diabetes thus explains at least in part the elevated cardiovascular morbidity and mortality seen in patients with CKD.…”

Section: Discussionsupporting

confidence: 93%

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Susceptibility to Hyperglycemia in Patients with Chronic Kidney Disease

Shehab-Eldin

Zaki²,

Gazareen³

et al. 2008

Am J Nephrol

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Background: Patients with chronic kidney disease (CKD) are susceptible to hyperglycemia. Aim: To study the prevalence of pre-diabetes in CKD patients and determine the contribution of insulin resistance (IR) versus β-cell dysfunction in patients with CKD. Methods: 45 consecutive nondiabetic CKD patients and 40 healthy subjects were included. Patients were divided into a normoglycemic (NG) and a pre-diabetic (PDM) group. IR was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and β-cell function was assessed by proinsulin/insulin ratio and β-cell%. Results: The prevalence of PDM was 40%. The prevalence of high HOMA-IR was 22.2 and 77.8% in the NG and PDM groups. Compared to NG patients, the PDM group showed higher fasting plasma glucose, HOMA-IR, insulin, and proinsulin, while the prevalence of β-cell dysfunction of 22.2% was lower than the 37% present in the NG group. Conclusion: Increased IR, rather than β-cell dysfunction, is the primary mechanism of PDM in CKD patients.

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Section: Discussionsupporting

confidence: 93%

“…We, as well as other groups, have presented evidence to support the increased incidence of hyperglycemia in nondiabetic patients with chronic kidney disease (CKD) [1]. Both β-cell dysfunction and IR are blamed for hyperglycemia in patients with CKD.…”

Section: Introductionmentioning

confidence: 98%

Susceptibility to Hyperglycemia in Patients with Chronic Kidney Disease

Shehab-Eldin

Zaki²,

Gazareen³

et al. 2008

Am J Nephrol

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“…CKD is characterised as the progressive retention of toxic uraemic metabolites, many of which adversely influence a number of organs. Approximately half of all people with CKD are affected by impaired glucose homeostasis [5][6][7]. In addition to end-stage renal disease (ESRD), insulin resistance appears to exist in the early stages of CKD and is exacerbated as renal function declines [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Association and risk factors of chronic kidney disease and incident diabetes: a nationwide population-based cohort study

et al. 2019

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Aims/hypothesis Chronic kidney disease (CKD) is a known complication of diabetes mellitus, and insulin resistance is a well-known complication of CKD. However, there is no consensus in the published data on the association of CKD with incident diabetes. Methods A total of 15,403 people with CKD were identified from the Taiwan National Health Insurance Research Database to determine their risk of incident diabetes compared with that of 15,403 matched individuals without CKD. Fine and Gray regression models using death as a competing risk were performed to calculate adjusted HRs and 95% CIs. Risk factors for incident diabetes in people with CKD were also determined. Results The CKD cohort had a higher incidence rate of diabetes compared with the non-CKD cohort (11.23/1000 person-years vs 8.93/1000 person-years). In the fully adjusted model, CKD was a significant and independent predictor of incident diabetes (adjusted HR 1.204; 95% CI 1.11, 1.31). The influence of CKD on incident diabetes showed consistent results in three levels of sensitivity analysis. In the CKD cohort, the significant risk factors for incident diabetes included increased age, geographical location, hypertension, hyperlipidaemia and gout. Of these, hypertension was associated with the highest risk of developing incident diabetes (adjusted HR 1.682; 95% CI 1.47, 1.93). Conclusions/interpretation People with CKD were at higher risk of developing incident diabetes. People with CKD and hypertension, hyperlipidaemia, increased age or gout and who lived in certain geographical regions of Taiwan were more likely to develop diabetes as a complication compared with people without those characteristics. Keywords Chronic kidney disease. CKD. Competing-risk regression. Incident diabetes mellitus. Insulin resistance. New-onset diabetes mellitus Abbreviations CKD Chronic kidney disease eGFR Estimated glomerular filtration rate ESRD End-stage renal disease

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“…Besides, the relationship of pseudouridine and the risk of diabetes had been disclosed. Pseudouridine inhibits glucose utilization at the postreceptor level through lowering the intracellular Ca concentration to affect the progression of T2DM (35), and plasma pseudouridine predict both the risk and prevalence (36) and insulin resistance of T2DM (37). Moreover, plasma pseudouridine has been shown to be correlated with declining renal function and albuminuria in diabetic kidney disease (38,39), suggesting a close relationship between the level of plasma pseudouridine and diabetic microangiopathy.…”

Section: Discussionmentioning

confidence: 99%

Plasma Metabolomics Reveals Metabolic Profiling For Diabetic Retinopathy and Disease Progression

Sun

Zou

et al. 2021

Front. Endocrinol.

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BackgroundsDiabetic retinopathy (DR), the main retinal vascular complication of DM, is the leading cause of visual impairment and blindness among working-age people worldwide. The aim of this study was to investigate the difference of plasma metabolic profiles in patients with DR to better understand the mechanism of this disease and disease progression.MethodsWe used ultrahigh-performance liquid Q-Exactive mass spectrometry and multivariate statistical analyses to conduct a comprehensive analysis of plasma metabolites in a population with DR and proliferative DR (PDR). A risk score based on the level of the selected metabolite was established and evaluated using the least absolute shrinkage and selection operator regularization logistic regression (LASSO-LR) based machine learning model.Results22 differentially expressed metabolites which belonged to different metabolic pathway were identified and confirmed to be associated with the occurrence of DR. A risk score based on the level of the selected metabolite pseudouridine was established and evaluated to strongly associated with the occurrence of DR. Four circulating plasma metabolites (pseudouridine, glutamate, leucylleucine and N-acetyltryptophan) were identified to be differentially expressed between patients with PDR and other patients, and a risk score formula based on these plasma metabolites was developed and assessed to be significantly related to PDR.ConclusionsOur work highlights the possible use of the risk score assessment based on the plasma metabolites not only reveal in the early diagnosis of DR and PDR but also assist in enhancing current therapeutic strategies in the clinic.

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Evidence for Increased Risk of Prediabetes in the Uremic Patient

Cited by 18 publications

References 145 publications

Susceptibility to Hyperglycemia in Patients with Chronic Kidney Disease

Susceptibility to Hyperglycemia in Patients with Chronic Kidney Disease

Association and risk factors of chronic kidney disease and incident diabetes: a nationwide population-based cohort study

Plasma Metabolomics Reveals Metabolic Profiling For Diabetic Retinopathy and Disease Progression

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