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Insulin resistance is associated with circulating fibrinogen levels in nondiabetic patients receiving peritoneal dialysis.
J Ren Nutr. 2007 Mar; 17(2):132-7.JR

Abstract

BACKGROUND

Insulin resistance (IR) and inflammation are associated with increased risk of cardiovascular disease in the general population. Continuous glucose absorption in peritoneal dialysis (PD) may induce hyperglycemia and hyperinsulinemia.

METHODS

We evaluated IR in nondiabetic patients receiving PD, and analyzed the association between IR and systemic inflammation biomarkers by performing a cross-sectional study on ambulatory dialysis. A total of 25 nondiabetic patients receiving PD and 25 healthy individuals, matched for gender, age, and body mass index (BMI), were included. The PD group was composed of 11 men and 14 women, with a mean age of 47 +/- 14 years and mean BMI of 25.5 +/- 4.7 kg/m(2). The control group was composed of 10 men and 15 women, with a mean age of 45 +/- 12 years and BMI of 24.0 +/- 2.8 kg/m(2).

RESULTS

IR was evaluated by the homeostasis model assessment method (HOMA-IR). Inflammation was assessed through high-sensitivity C-reactive protein (CRP) and fibrinogen. Body composition and truncal fat were evaluated by dual energy x-ray absorptiometry. HOMA-IR was significantly higher (P < .0001) in subjects receiving PD (4.9, range: 2.3-9.3 mmol/L x muU/mL) compared with healthy subjects (1.2, range: 0.4-4.8 mmol/L x muU/mL). As expected, compared with controls, patients receiving PD had significantly higher levels of insulin (26.5 +/- 7.5 muU/mL vs 6.3 +/- 3.4 muU/mL; P < .0001), CRP (6.3, range: 0.3-61.1 mg/L vs 2.4, range: 0.6-5.9 mg/L; P = .001), and fibrinogen (379 +/- 101 mg/dL vs 268 +/- 66 mg/dL; P < .0001). However, there were no significant differences in body and truncal fat mass between the groups. A significant correlation between HOMA-IR and fibrinogen (Rho = 0.48; P = .01) was observed. However, no correlation was found between HOMA-IR and CRP. Also, no significant correlations were found between HOMA-IR and body fat mass (Rho = 0.11), and between HOMA-IR and truncal fat mass (Rho = 0.19).

CONCLUSIONS

Patients receiving PD demonstrate a state of IR that is associated with high circulating levels of fibrinogen. This suggests that hyperfibrinogenemia may be involved in the pathogenesis of IR in this setting.

Authors+Show Affiliations

Renal Diabetes and Hypertension Research Center, Pró-Renal Foundation of Curitiba, Curitiba, Brazil. crismar@onda.com.br <crismar@onda.com.br>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17321953

Citation

Martins, Cristina, et al. "Insulin Resistance Is Associated With Circulating Fibrinogen Levels in Nondiabetic Patients Receiving Peritoneal Dialysis." Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, vol. 17, no. 2, 2007, pp. 132-7.
Martins C, Mazza do Nascimento M, Pecoits-Filho R, et al. Insulin resistance is associated with circulating fibrinogen levels in nondiabetic patients receiving peritoneal dialysis. J Ren Nutr. 2007;17(2):132-7.
Martins, C., Mazza do Nascimento, M., Pecoits-Filho, R., Leinig, C., Gonçalves, L. F., Fuerbringer, R., Stenvinkel, P., Lindholm, B., & Riella, M. C. (2007). Insulin resistance is associated with circulating fibrinogen levels in nondiabetic patients receiving peritoneal dialysis. Journal of Renal Nutrition : the Official Journal of the Council On Renal Nutrition of the National Kidney Foundation, 17(2), 132-7.
Martins C, et al. Insulin Resistance Is Associated With Circulating Fibrinogen Levels in Nondiabetic Patients Receiving Peritoneal Dialysis. J Ren Nutr. 2007;17(2):132-7. PubMed PMID: 17321953.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance is associated with circulating fibrinogen levels in nondiabetic patients receiving peritoneal dialysis. AU - Martins,Cristina, AU - Mazza do Nascimento,Marcelo, AU - Pecoits-Filho,Roberto, AU - Leinig,Cyntia, AU - Gonçalves,Luiz Felipe, AU - Fuerbringer,Roseana, AU - Stenvinkel,Peter, AU - Lindholm,Bengt, AU - Riella,Miguel Carlos, PY - 2006/01/17/received PY - 2007/2/27/pubmed PY - 2007/3/30/medline PY - 2007/2/27/entrez SP - 132 EP - 7 JF - Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation JO - J Ren Nutr VL - 17 IS - 2 N2 - BACKGROUND: Insulin resistance (IR) and inflammation are associated with increased risk of cardiovascular disease in the general population. Continuous glucose absorption in peritoneal dialysis (PD) may induce hyperglycemia and hyperinsulinemia. METHODS: We evaluated IR in nondiabetic patients receiving PD, and analyzed the association between IR and systemic inflammation biomarkers by performing a cross-sectional study on ambulatory dialysis. A total of 25 nondiabetic patients receiving PD and 25 healthy individuals, matched for gender, age, and body mass index (BMI), were included. The PD group was composed of 11 men and 14 women, with a mean age of 47 +/- 14 years and mean BMI of 25.5 +/- 4.7 kg/m(2). The control group was composed of 10 men and 15 women, with a mean age of 45 +/- 12 years and BMI of 24.0 +/- 2.8 kg/m(2). RESULTS: IR was evaluated by the homeostasis model assessment method (HOMA-IR). Inflammation was assessed through high-sensitivity C-reactive protein (CRP) and fibrinogen. Body composition and truncal fat were evaluated by dual energy x-ray absorptiometry. HOMA-IR was significantly higher (P < .0001) in subjects receiving PD (4.9, range: 2.3-9.3 mmol/L x muU/mL) compared with healthy subjects (1.2, range: 0.4-4.8 mmol/L x muU/mL). As expected, compared with controls, patients receiving PD had significantly higher levels of insulin (26.5 +/- 7.5 muU/mL vs 6.3 +/- 3.4 muU/mL; P < .0001), CRP (6.3, range: 0.3-61.1 mg/L vs 2.4, range: 0.6-5.9 mg/L; P = .001), and fibrinogen (379 +/- 101 mg/dL vs 268 +/- 66 mg/dL; P < .0001). However, there were no significant differences in body and truncal fat mass between the groups. A significant correlation between HOMA-IR and fibrinogen (Rho = 0.48; P = .01) was observed. However, no correlation was found between HOMA-IR and CRP. Also, no significant correlations were found between HOMA-IR and body fat mass (Rho = 0.11), and between HOMA-IR and truncal fat mass (Rho = 0.19). CONCLUSIONS: Patients receiving PD demonstrate a state of IR that is associated with high circulating levels of fibrinogen. This suggests that hyperfibrinogenemia may be involved in the pathogenesis of IR in this setting. SN - 1532-8503 UR - https://www.unboundmedicine.com/medline/citation/17321953/Insulin_resistance_is_associated_with_circulating_fibrinogen_levels_in_nondiabetic_patients_receiving_peritoneal_dialysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-2276(06)00164-6 DB - PRIME DP - Unbound Medicine ER -