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The determination of insulin sensitivity in hemodialysis and continuous ambulatory peritoneal dialysis in nondiabetic patients with end-stage renal disease.
Saudi Med J. 2005 May; 26(5):786-91.SM

Abstract

OBJECTIVE

To determine the beta-cell function and insulin sensitivity with homeostasis model assessment (HOMA) and area under curve (AUC) in nondiabetic uremic hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients cross sectionally.

METHODS

The study was performed between January to August 2001 in the Department of Nephrology, Dicle University School of Medicine, Diyarbakir, Turkey. Fifty-one HD patients, 45 CAPD patients, and 50 healthy control subjects were included in the study. Height, weight, waist and hip circumference, fat mass and percentage of body fat, and body mass index (BMI) were measured. The total high density lipoprotein (HDL) and low density lipoprotein (LDL)-cholesterol, triglyceride, urea, creatinine, insulin, potassium, parathyroid hormone (PTH) and 1,25 dihydroxycholecalciferol levels were measured. Oral glucose tolerance test (OGTT) was performed in the mid-week dialysis-free interval in HD patients, whereas after at least a night without dialysis exchanges in CAPD group. Area under curve both of insulin and glucose were calculated. The HOMA [insulin sensitivity (%S)] and AUC were used as indices of tissue insulin sensitivity.

RESULTS

The LDL-cholesterol levels of patients with CAPD was higher than the HD group (p<0.001) and control group (p<0.0001). The baseline glucose levels of the 2 groups were not significantly different. Baseline insulin levels of CAPD group were higher than the HD group (p<0.001) and the control group (p<0.0001). Area under curve for glucose (AUCgluc) and insulin (AUCins) value of CAPD patients were higher than the HD patients than the control group (p<0.0001). The HOMA [beta-cell function (%B)] values of CAPD group were higher than both HD (p<0.02) and control group (p<0.04). The HOMA [insulin sensitivity (%S)] levels of CAPD group was significantly lower than the HD patients (p<0.002) and the control group (p<0.001).

CONCLUSION

The CAPD treatment may lead to insulin insensitivity in non-diabetic end-stage renal disease patients and the high glucose content of CAPD solutions may be responsible for insulin resistance in CAPD patients.

Authors+Show Affiliations

Department of Endocrinology and Metabolism, University of Dicle, School of Medicine, Diyarbakir, Turkey. atuzcu@dicle.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15951871

Citation

Tuzcu, Alpaslan, et al. "The Determination of Insulin Sensitivity in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis in Nondiabetic Patients With End-stage Renal Disease." Saudi Medical Journal, vol. 26, no. 5, 2005, pp. 786-91.
Tuzcu A, Bahceci M, Yilmaz ME, et al. The determination of insulin sensitivity in hemodialysis and continuous ambulatory peritoneal dialysis in nondiabetic patients with end-stage renal disease. Saudi Med J. 2005;26(5):786-91.
Tuzcu, A., Bahceci, M., Yilmaz, M. E., Turgut, C., & Kara, I. H. (2005). The determination of insulin sensitivity in hemodialysis and continuous ambulatory peritoneal dialysis in nondiabetic patients with end-stage renal disease. Saudi Medical Journal, 26(5), 786-91.
Tuzcu A, et al. The Determination of Insulin Sensitivity in Hemodialysis and Continuous Ambulatory Peritoneal Dialysis in Nondiabetic Patients With End-stage Renal Disease. Saudi Med J. 2005;26(5):786-91. PubMed PMID: 15951871.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The determination of insulin sensitivity in hemodialysis and continuous ambulatory peritoneal dialysis in nondiabetic patients with end-stage renal disease. AU - Tuzcu,Alpaslan, AU - Bahceci,Mithat, AU - Yilmaz,Mehmet E, AU - Turgut,Cengiz, AU - Kara,Ismail H, PY - 2005/6/14/pubmed PY - 2006/8/24/medline PY - 2005/6/14/entrez SP - 786 EP - 91 JF - Saudi medical journal JO - Saudi Med J VL - 26 IS - 5 N2 - OBJECTIVE: To determine the beta-cell function and insulin sensitivity with homeostasis model assessment (HOMA) and area under curve (AUC) in nondiabetic uremic hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients cross sectionally. METHODS: The study was performed between January to August 2001 in the Department of Nephrology, Dicle University School of Medicine, Diyarbakir, Turkey. Fifty-one HD patients, 45 CAPD patients, and 50 healthy control subjects were included in the study. Height, weight, waist and hip circumference, fat mass and percentage of body fat, and body mass index (BMI) were measured. The total high density lipoprotein (HDL) and low density lipoprotein (LDL)-cholesterol, triglyceride, urea, creatinine, insulin, potassium, parathyroid hormone (PTH) and 1,25 dihydroxycholecalciferol levels were measured. Oral glucose tolerance test (OGTT) was performed in the mid-week dialysis-free interval in HD patients, whereas after at least a night without dialysis exchanges in CAPD group. Area under curve both of insulin and glucose were calculated. The HOMA [insulin sensitivity (%S)] and AUC were used as indices of tissue insulin sensitivity. RESULTS: The LDL-cholesterol levels of patients with CAPD was higher than the HD group (p<0.001) and control group (p<0.0001). The baseline glucose levels of the 2 groups were not significantly different. Baseline insulin levels of CAPD group were higher than the HD group (p<0.001) and the control group (p<0.0001). Area under curve for glucose (AUCgluc) and insulin (AUCins) value of CAPD patients were higher than the HD patients than the control group (p<0.0001). The HOMA [beta-cell function (%B)] values of CAPD group were higher than both HD (p<0.02) and control group (p<0.04). The HOMA [insulin sensitivity (%S)] levels of CAPD group was significantly lower than the HD patients (p<0.002) and the control group (p<0.001). CONCLUSION: The CAPD treatment may lead to insulin insensitivity in non-diabetic end-stage renal disease patients and the high glucose content of CAPD solutions may be responsible for insulin resistance in CAPD patients. SN - 0379-5284 UR - https://www.unboundmedicine.com/medline/citation/15951871/The_determination_of_insulin_sensitivity_in_hemodialysis_and_continuous_ambulatory_peritoneal_dialysis_in_nondiabetic_patients_with_end_stage_renal_disease_ DB - PRIME DP - Unbound Medicine ER -