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Wolverhampton Intellectual Repository and E-Theses > Research Institutes > Research Institute in Healthcare Science > Sport, Exercise and Health Research Group > Liver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patients.

Please use this identifier to cite or link to this item: http://hdl.handle.net/2436/111404
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Title: Liver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patients.
Authors: Sakkas, Giorgos K
Karatzaferi, Christina
Zintzaras, Elias
Giannaki, Christoforos D
Liakopoulos, Vassilios
Lavdas, Eleftherios
Damani, Eleni
Liakos, Nikos
Fezoulidis, Ioannis
Koutedakis, Yiannis
Stefanidis, Ioannis
Citation: American journal of physiology. Regulatory, integrative and comparative physiology, 295 (6): R1721-9
Publisher: American Physiological Society
Journal: American journal of physiology. Regulatory, integrative and comparative physiology
Issue Date: Dec-2008
URI: http://hdl.handle.net/2436/111404
DOI: 10.1152/ajpregu.00935.2007
PubMed ID: 18832089
Abstract: Hemodialysis patients exhibit insulin resistance (IR) in target organs such as liver, muscles, and adipose tissue. The aim of this study was to identify contributors to IR and to develop a model for predicting glucose intolerance in nondiabetic hemodialysis patients. After a 2-h, 75-g oral glucose tolerance test (OGTT), 34 hemodialysis patients were divided into groups with normal (NGT) and impaired glucose tolerance (IGT). Indices of insulin sensitivity were derived from OGTT data. Measurements included liver and muscle fat infiltration and central adiposity by computed tomography scans, body composition by dual energy X-ray absorptiometer, sleep quality by full polysomnography, and functional capacity and quality of life (QoL) by a battery of exercise tests and questionnaires. Cut-off points, as well as sensitivity and specificity calculations were based on IR (insulin sensitivity index by Matsuda) using a receiver operator characteristics (ROC) curve analysis. Fifteen patients were assigned to the IGT, and 19 subjects to the NGT group. Intrahepatic fat content and visceral adiposity were significantly higher in the IGT group. IR indices strongly correlated with sleep disturbances, visceral adiposity, functional capacity, and QoL. Visceral adiposity, O2 desaturation during sleep, intrahepatic fat content, and QoL score fitted into the model for predicting glucose intolerance. A ROC curve analysis identified an intrahepatic fat content of > 3.97% (sensitivity, 100; specificity, 35.7) as the best cutoff point for predicting IR. Visceral and intrahepatic fat content, as well as QoL and sleep seemed to be involved at some point in the development of glucose intolerance in hemodialysis patients. Means of reducing fat depots in the liver and splachnic area might prove promising in combating IR and cardiovascular risk in hemodialysis patients.
Type: Article
Language: en
MeSH: Absorptiometry, Photon
Adiposity
Adolescent
Adult
Aged
Female
Glucose Intolerance
Glucose Tolerance Test
Humans
Insulin Resistance
Intra-Abdominal Fat
Liver
Male
Middle Aged
Models, Biological
Muscle, Skeletal
Nutritional Status
Polysomnography
Predictive Value of Tests
Quality of Life
Questionnaires
ROC Curve
Renal Dialysis
Risk Assessment
Risk Factors
Sleep Disorders
Tomography, X-Ray Computed
Young Adult
ISSN: 0363-6119
Appears in Collections: Sport, Exercise and Health Research Group

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