Liver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patients.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
AuthorsSakkas, Giorgos K
Giannaki, Christoforos D
MetadataShow full item record
AbstractHemodialysis 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.
CitationAmerican journal of physiology. Regulatory, integrative and comparative physiology, 295 (6): R1721-9
PublisherAmerican Physiological Society
JournalAmerican journal of physiology. Regulatory, integrative and comparative physiology
CollectionsSport, Exercise and Health Research Group
- Visceral, subcutaneous abdominal adiposity and liver fat content distribution in normal glucose tolerance, impaired fasting glucose and/or impaired glucose tolerance.
- Authors: Borel AL, Nazare JA, Smith J, Aschner P, Barter P, Van Gaal L, Eng Tan C, Wittchen HU, Matsuzawa Y, Kadowaki T, Ross R, Brulle-Wohlhueter C, Alméras N, Haffner SM, Balkau B, Després JP
- Issue date: 2015 Mar
- Study of genetic prediabetic south Indian subjects. Importance of hyperinsulinemia and beta-cell dysfunction.
- Authors: Snehalatha C, Ramachandran A, Satyavani K, Latha E, Viswanathan V
- Issue date: 1998 Jan
- [Application of extended hyperinsulinemic euglycemic clamp in the assessment of insulin sensitivity in obese individuals with glucose intolerance].
- Authors: Bao YQ, Jia WP, Chen L, Lu JX, Zhu M, Lu W, Xiang KA
- Issue date: 2006 Dec
- Anthropometry, CT, and DXA as predictors of GH deficiency in premenopausal women: ROC curve analysis.
- Authors: Bredella MA, Utz AL, Torriani M, Thomas B, Schoenfeld DA, Miller KK
- Issue date: 2009 Feb
- Glucose tolerance is affected by visceral adiposity and sex, but not birth weight, in Yucatan miniature pigs.
- Authors: McKnight LL, Myrie SB, Mackay DS, Brunton JA, Bertolo RF
- Issue date: 2012 Feb