Metabolic syndrome in peritoneal dialysis patients

Li, Philip Kam-Tao; Kwan, Bonnie Ching-Ha; Szeto, Cheuk Chun; Ko, G. T. C.

doi:10.1093/ndtplus/sfn073

Cited by 26 publications

(61 citation statements)

References 95 publications

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“…Such a protocol minimizes any potential effect of peritoneal glucose absorption, while allowing for dialysis maintenance, as a previous study by Heaton et al showed that there are no differences in fasting plasma glucose and insulin between undialyzed PD patients (with no PD solution in the abdomen) and patients on 1.36% glucose solution, after the first 60 minutes of a 1.36% glucose dwell (38). Assuming this, other investigators focused on metabolic issues, performing measurements after the 1.36% glucose solution overnight dwell (39,40).…”

Section: Discussionmentioning

confidence: 98%

Insulin Resistance in Nondiabetic Peritoneal Dialysis Patients

Bernardo

Oliveira

Santos³

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Insulin resistance has been associated with cardiovascular disease in peritoneal dialysis patients. Few studies have addressed the impact of fast transport status or dialysis prescription on insulin resistance. The aim of this study was to test whether insulin resistance is associated with obesity parameters, peritoneal transport rate, and glucose absorption.Design, setting, participants, & measurements Insulin resistance was evaluated with homeostasis model assessment method (HOMA-IR), additionally corrected by adiponectin (HOMA-AD). Enrolled patients were prevalent nondiabetics attending at Santo António Hospital Peritoneal Dialysis Unit, who were free of hospitalization or infectious events in the previous 3 months (51 patients aged 50.4615.9 years, 59% women). Leptin, adiponectin, insulin-like growth factor-binding protein 1 (IGFBP-1), and daily glucose absorption were also measured. Lean tissue index, fat tissue index (FTI), and relative fat mass (rel.FM) were assessed using multifrequency bioimpedance. Patients were categorized according to dialysate to plasma creatinine ratio at 4 hours, 3.86% peritoneal equilibration test, and obesity parameters.Results Obesity was present in 49% of patients according to rel.FM. HOMA-IR correlated better with FTI than with body mass index. Significant correlations were found in obese, but not in nonobese patients, between HOMA-IR and leptin, leptin/adiponectin ratio (LAR), and IGFBP-1. HOMA-IR correlated with HOMA-AD, but did not correlate with glucose absorption or transport rate. There were no significant differences in insulin resistance indices, glucose absorption, and body composition parameters between fast and nonfast transporters. A total of 18 patients (35.3%) who had insulin resistance presented with higher LAR and rel. FM (7.3 [12.3, interquartile range] versus 0.7 [1.4, interquartile range], P,0.001, and 39.4610.1% versus 27.2611.5%, P=0.002, respectively), lower IGFBP-1 (8.267.2 versus 21.0616.3 ng/ml, P=0.002), but similar glucose absorption and small-solute transport compared with patients without insulin resistance. FTI and LAR were independent correlates of HOMA-IR in multivariate analysis adjusted for glucose absorption and small-solute transport (r=0.82, P,0.001).Conclusions Insulin resistance in nondiabetic peritoneal dialysis patients is associated with obesity and LAR independent of glucose absorption and small-solute transport status. Fast transport status was not associated with higher likelihood of obesity or insulin resistance.

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Section: Discussionmentioning

confidence: 98%

Insulin Resistance in Nondiabetic Peritoneal Dialysis Patients

Bernardo

Oliveira

Santos³

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…fulfillment of at least three of the following: abnormal waist circumference; triglyceride (TG) ≥ 1.7 mmol/L; high-density lipoprotein cholesterol (HDL-C) < 1.0 mmol/L in male or < 1.3 mmol/L in female; blood pressure (BP) ≥ 130/85 mmHg (or drug treatment), and fasting blood glucose (FBG) ≥ 6.1 mmol/L (or previously diagnosed type 2 diabetes). Due to the presumed impact of instilled PD solution, we used body mass index (BMI) ≥ 25 kg/m 2 rather than waist circumference as the marker of central obesity according to Asian standards (30) and previous references (31)(32)(33).…”

Section: Ms Definitionmentioning

confidence: 99%

Associations between Serum-Intact Parathyroid Hormone, Serum 25-Hydroxyvitamin D. Oral Vitamin D Analogs and Metabolic Syndrome in Peritoneal Dialysis Patients: A Multi-Center Cross-Sectional Study

et al. 2014

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M etabolic syndrome (MS) consists of a cluster of metabolic and hemodynamic abnormalities. The components of MS such as abdominal obesity, high blood pressure, insulin resistance and dyslipidemia are risk factors for chronic kidney disease (CKD) (1,2), diabetes (3), cardiovascular disease (4) and high cardiovascular mortality (5). on the other hand, the components of MS develop early in CKD and are exacerbated during the progression to end-stage renal disease (eSRD) (6,7). The prevalence of MS is remarkably high in CKD patients, being approximately 30% -65% for non-dialysis patients (6-8) and 47% -69% for dialysis patients (9-12). MS represents a global epidemic and it is clearly important to explore new, non-traditional risk factors.In the general population, MS has been positively associated with serum intact parathyroid hormone (iPTH) (13-15) and negatively with vitamin D status, as measured using 25-hydroxyvitamin D (25(oH)D) concentrations (16)(17)(18)(19)(20). Decreased vitamin D levels and elevated iPTH levels may play critical roles in the etiology of MS, either through an association with the Correspondence to: Jie Dong,

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“…Metabolic syndrome is an important cause of morbidity and mortality as insulin resistance, pro-inflammatory cytokines (e.g., IL-6, TNF-α) released from adipose tissue, hypercoagulability, and hypertension worsens vessel wall injury (13). Metabolic syndrome is becoming a worldwide pandemic.…”

Section: Discussionmentioning

confidence: 99%

Metabolic Syndrome and Arterial Stiffness in Peritoneal Dialysis Patients

Akdam¹,

Alp²,

karakütük³

et al. 2016

Turk Neph Dial Transpl

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OBJeCTIVe: The metabolic syndrome (MetS) is an endocrinopathy that increases the risk of cardiovascular disease. Arterial stiffness is commonly used to evaluate the risk of cardiovascular disease, which is quantified by pulse wave velocity (PWV) and augmentation index (AIx). Our study aim was evaluate the prevalence of MetS and arterial stiffness in peritoneal dialysis patients. MATerIAl and MeTHODS:A total of 36 peritoneal dialysis patients were included. Patients' waist circumference, body mass index (BMI), blood pressure, glucose, triglyceride, and HDL-cholesterol levels were recorded. PWV and AIx measurements were performed by means of the Mobil-O-Graph device. Adult Treatment Panel III criteria were used for the diagnosis of MetS.reSulTS: 47.2% of peritoneal dialysis patients had MetS, and the prevalence of MetS was found to be 61% above the age of 55 years. Patients with MetS had higher BMI, waist circumference, glucose, triglyceride levels. Median age was significantly higher in the MetS group (p=0.044). Ageadjusted analysis revealed significantly higher Alx@75 in the MetS group (p=0.025); but no significant difference was observed in PWV. In regression analysis, the age, central systolic blood pressure, and augmentation pressure appeared as the independent determinants of PWV.CONCluSION: Metabolic Syndrome prevalence was found to be 47.2%, and it was more common in subjects older than 55 years. In the MetS group, the Alx@75 values were found to be significantly higher. BulGulAr: Periton diyalizi hastalarının %47,2'sinde MetS saptandı ve 55 yaş üstünde sıklığı %61 bulundu. MetS grubunda VKİ, bel çevresi, glikoz, trigliserid düzeyleri yüksekti. MetS grubu ortanca yaşı anlamlı yüksekti (p=0,044). Yaş ile düzeltilmiş analizde Alx@75 MetS grubunda anlamlı yüksek saptandı (p=0,025), fakat NDH'ında anlamlı fark saptanmadı. Regresyon analizinde NDH'nın bağımsız belirleyicileri yaş, santral sistolik kan basıncı ve augmentasyon basıncı olduğu saptandı.SONuç: Metabolik sendrom sıklığı % 47,2'dir ve 55 yaş üstünde daha yaygındır. Alx@75 değerleri MetS grubunda anlamlı yüksektir.

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Metabolic syndrome in peritoneal dialysis patients

Cited by 26 publications

References 95 publications

Insulin Resistance in Nondiabetic Peritoneal Dialysis Patients

Insulin Resistance in Nondiabetic Peritoneal Dialysis Patients

Associations between Serum-Intact Parathyroid Hormone, Serum 25-Hydroxyvitamin D. Oral Vitamin D Analogs and Metabolic Syndrome in Peritoneal Dialysis Patients: A Multi-Center Cross-Sectional Study

Metabolic Syndrome and Arterial Stiffness in Peritoneal Dialysis Patients

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