Original investigationsPathogenesis and treatment of kidney disease and hypertensionInsulin resistance in patients with chronic kidney disease
Section snippets
Methods
Twenty-nine Japanese patients with CKD aged 29 to 78 years were examined; 16 patients had biopsy-confirmed chronic glomerulonephritis, and the remaining 13 patients had nephrosclerosis. No patient had diabetes mellitus or autosomal dominant polycystic kidney disease. Other exclusion criteria were liver disease, malignant tumors, previous history of stroke or ischemic heart disease, or such systemic disorders as rheumatoid arthritis or systemic lupus erythematosus. CKD is defined as evident
Results
Steady-state plasma glucose concentrations during the last 30 minutes of the glucose clamp study were 98.1 ± 1.5 mg/dL (5.4 ± 0.1 mmol/L) for patients and 98.3 ± 1.6 mg/dL (5.5 ± 0.1 mmol/L) for controls. Mean plasma insulin values determined at 120 minutes during the glucose clamp study were 64.8 ± 10.8 μU/mL (465 ± 77 pmol/L) in healthy subjects and 72.7 ± 9.8 μU/mL (522 ± 70 pmol/L) in patients.
In healthy subjects, GDR was 9.93 ± 1.33 mg/kg/min. GDR of patients with CKD was 6.91 ± 2.46
Discussion
It recently was reported that insulin resistance is present early in the course of renal disease.9, 10, 11, 12 In the present study, contributing factors related to insulin resistance in addition to traditional atherosclerotic cardiovascular risk factors were determined. Among lipid profiles, we found that Apo A-1/B and TG levels are both associated with GDR. Regarding TG level, data are in good agreement with observations of Fliser et al.11 However, we first report that Apo A-1/B ratio is
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Originally published online as doi:10.1053/j.ajkd.2004.09.034 on December 22, 2004.