Insulin Resistance and Cardiovascular Risks in Different Groups of Hemodialysis Patients: A Multicenter Study

Duong, Tuyen Van; Shih, Chun Kuang; Wong, Te-Chih; Chen, Hsi Hsien; Chen, Tso Hsiao; Hsu, Yung Ho; Peng, Sheng; Kuo, Ko Lin; Liu, Hsiang Chung; Lin, En Tzu; Su, Chien Tien; Yang, Shwu Huey

doi:10.1155/2019/1541593

Cited by 6 publications

(4 citation statements)

References 44 publications

(53 reference statements)

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“…Moreover, the inflammatory reaction toward the dialysis procedure itself, such as dialysis membranes and dialysate fluid, contributes mainly to persistent inflammation. 29,30 On the other hand, we found a significant positive correlation of TSH level and inflammatory markers (hs-CRP and serum ferritin). A similar finding was reported in non-CKD patients by Gupta et al 31 In addition, Valencia and colleagues have reported significantly higher TSH in HD patients with malnutrition, inflammation, and complex syndrome (MICS).…”

Section: Discussionmentioning

confidence: 59%

Thyroid dysfunction and insulin resistance in end‐stage renal disease patients before and 1 year after starting maintenance hemodialysis: A prospective multicenter study

Tawfik

Fathy

Mousa

et al. 2021

Seminars in Dialysis

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Background: Thyroid dysfunction and insulin resistance (IR) are common findings in patients with ESRD. We aimed to evaluate thyroid dysfunction and IR in ESRD before and after 1 year of starting hemodialysis (HD).Methods: This was a prospective study that recruited newly starting HD patients who fulfilled the inclusion criteria. Patients were evaluated for TSH, free T4, free T3, fasting insulin, fasting glucose, HOMA-IR, serum ferritin, and hs-CRP levels before starting their first dialysis session and after 1 year of regular HD.Results: Eighty-one patients have completed the 1-year follow-up period. After 1 year of regular HD, there were statistically significant increments of hs-CRP, serum ferritin, and TSH levels. On the other hand, fasting insulin level and HOMA-IR showed statistically significant increments after 1 year of starting HD. After 1 year of regular HD, TSH level showed a positive correlation with hs-CRP and serum ferritin level, while free T3 was negatively correlated with HOMA-IR. On the other hand, there was a significant positive correlation between HOMA-IR, hs-CRP, and serum ferritin levels, while HOMA-IR was negatively correlated with Kt/V.Conclusions: This study suggests overlapping complex pathogenesis of thyroid dysfunction, chronic inflammation, and IR in chronic HD patients.

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Section: Discussionmentioning

confidence: 59%

Thyroid dysfunction and insulin resistance in end‐stage renal disease patients before and 1 year after starting maintenance hemodialysis: A prospective multicenter study

Tawfik

Fathy

Mousa

et al. 2021

Seminars in Dialysis

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“…RBP4, a 21-kilodalton protein produced by adipocytes, is also chiefly excreted by the kidney and plays a pivotal role in insulin resistance (IR) 37 . In turn, IR is significantly associated with cardiovascular risk, and can significantly predict cardiovascular disease and mortality in dialysis patients 38 . Additionally, RBP4 is also known to be associated with inflammation and oxidative stress 39 .…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of therapeutic effects between medium cut-off and high flux dialyzers using metabolomics and proteomics: exploratory, prospective study in hemodialysis

Kim

Seong

Lee

et al. 2021

Sci Rep

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In this single-center prospective study of 20 patients receiving maintenance hemodialysis (HD), we compared the therapeutic effects of medium cut-off (MCO) and high flux (HF) dialyzers using metabolomics and proteomics. A consecutive dialyzer membrane was used for 15-week study periods: 1st HF dialyzer, MCO dialyzer, 2nd HF dialyzer, for 5 weeks respectively. 1H-nuclear magnetic resonance was used to identify the metabolites and liquid chromatography-tandem mass spectrometry (LC–MS/MS) analysis was used to identify proteins. To compare the effects of the HF and MCO dialyzers, orthogonal projection to latent structure discriminant analysis (OPLS-DA) was performed. OPLS-DA showed that metabolite characteristics could be significantly classified by 1st HF and MCO dialyzers. The Pre-HD metabolites with variable importance in projection scores ≥ 1.0 in both 1st HF versus MCO and MCO versus 2nd HF were succinate, glutamate, and histidine. The pre-HD levels of succinate and histidine were significantly lower, while those of glutamate were significantly higher in MCO period than in the HF period. OPLS-DA of the proteome also substantially separated 1st HF and MCO periods. Plasma pre-HD levels of fibronectin 1 were significantly higher, and those of complement component 4B and retinol-binding protein 4 were significantly lower in MCO than in the 1st HF period. Interestingly, as per Ingenuity Pathway Analysis, an increase in epithelial cell proliferation and a decrease in endothelial cell apoptosis occurred during the MCO period. Overall, our results suggest that the use of MCO dialyzers results in characteristic metabolomics and proteomics profiles during HD compared with HF dialyzers, which might be related to oxidative stress, insulin resistance, complement-coagulation axis, inflammation, and nutrition.

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“…In addition, diabetes was one of the most common causes of CKD [39,40,43]. On the other hand, insulin resistance was independently associated with cardiovascular risks in ESRD patients [44]. Therefore, there is a consensus that better management of hypertension, and diabetes is required to improve CKD patient care [45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Associations of Waist Circumference, Socioeconomic, Environmental, and Behavioral Factors with Chronic Kidney Disease in Normal Weight, Overweight, and Obese People

Duong

Yang

et al. 2019

IJERPH

Self Cite

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Background: Chronic kidney disease (CKD) places a heavy burden on the healthcare system worldwide. The risk factors may vary by body adiposity. We aimed to investigate the associations of socioeconomic, environmental, and behavioral factors with CKD in different groups of body mass indexes (BMI). Methods: A case-control study was conducted in 3280 participants (1048 CKD and 2232 non-CKD) from seven hospitals and nearby communities from May 2012 to August 2015. Personal characteristics, anthropometrics, environmental exposures, and health−related behaviors were assessed using a structured questionnaire. The logistic regression models were utilized for analysis. Results: Older age (odd ratio, OR = 2.85; p < 0.001), being men (OR = 4.23; p < 0.001), smoking (OR = 3.36; p < 0.001), stable income (OR = 0.33; p < 0.001), higher education (OR = 0.37~0.38; p < 0.001), and daily adequate water intake (OR = 0.64; p = 0.010) were associated with CKD in normal weight people. Older age (OR = 2.49; p < 0.001), being men (OR = 3.36; p < 0.001), education (OR = 0.44, p = 0.004), hypertension (OR = 2.93; p < 0.001), diabetes (OR = 1.83; p = 0.004), and using traditional Chinese medicine (OR = 2.03, p = 0.014) were associated with CKD in overweight people. Older age (OR = 2.71; p < 0.001), being men (OR = 2.69; p < 0.001), hypertension (OR = 2.93; p < 0.001), diabetes (OR = 1.94; p = 0.001) were associated with CKD in obese people. Conclusions: The associated factors of CKD varied by different groups of BMI. These findings may help to develop potential interventions to manage CKD.Participants recruited were Taiwanese citizens aged 18 years or older, who understand Mandarin Chinese. We excluded participants who were diagnosed as CKD stage 5 or end-stage renal disease (ESRD), or who lacked renal function parameters. Cases were patients with chronic kidney disease stage 1 to stage 4. Controls were non-CKD patients, relatives of CKD patients, healthy people who underwent annual health checks, and in the communities around the selected hospitals. The final sample for analysis was 3280 participants with N = 1048 cases, and N = 2232 controls (Figure 1).

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Insulin Resistance and Cardiovascular Risks in Different Groups of Hemodialysis Patients: A Multicenter Study

Cited by 6 publications

References 44 publications

Thyroid dysfunction and insulin resistance in end‐stage renal disease patients before and 1 year after starting maintenance hemodialysis: A prospective multicenter study

Thyroid dysfunction and insulin resistance in end‐stage renal disease patients before and 1 year after starting maintenance hemodialysis: A prospective multicenter study

Comparative analysis of therapeutic effects between medium cut-off and high flux dialyzers using metabolomics and proteomics: exploratory, prospective study in hemodialysis

Associations of Waist Circumference, Socioeconomic, Environmental, and Behavioral Factors with Chronic Kidney Disease in Normal Weight, Overweight, and Obese People

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