Insulin Receptor of Erythrocytes and Glucose Metabolism in Uremic Children

Abstract

This study represents the results of oral glucose tolerance test (O-GTT) of 28 children with chronic renal failure, including 12 undialyzed and 16 dialyzed cases, compared to their own insulin receptors of erythrocytes. 7 of the 12 undialyzed patients (58.3%) represented abnormal O-GTT, while in dialyzed patients 3 of 16 cases (18.8%) had abnormal O-GTT. The maximum binding of 125 l-insulin to erythrocytes, 6.34 ± 1.93% in dialyzed patients, was significantly lower (p < 0.05) than 7.73 ± 1.03% in controls, and 4.87 ± 1.01% in undialyzed patients was significantly lower than both dialyzed (p < 0.05) and controls (p < 0.001). In undialyzed patients, 350 ± 221 binding sites/cell of insulin receptor was significantly fewer than 544 ± 207 binding sites/cell in controls (p < 0.05), but no significance was detected when compared to the 562 ± 331 binding sites/cell in dialyzed patients, because of the large variation in dialyzed patients. The average affinity of empty site (Ke x 10 7 /M) that 4.18 ± 2.73 in undialyzed patients, 3.40 ± 2.32 in dialyzed patients and 3.37 ± 1.05 in controls, had no significance between any two of the three. There were no significant correlations between receptor concentration and the sum of blood sugar (DBS) or the sum of insulin (SIRI), and no correlation between receptor concentration and BUN or creatinine. Furthermore, no significant relationships could be found when comparing BUN or creatinine with O-GTT. However, if the patients were divided into groups as normal and abnormal of O-GTT, significantly higher values of SBS (p < 0.001) and lower concentrations of insulin receptor (p < 0.05) were found in the abnormal group. No difference was found in SIRI and Ke. In addition, a significantly lower value of serum calcium concentration was found in the abnormal group of O-GTT.

Glucose Tolerance and Insulin Secretion in Children before and during Recombinant Growth Hormone Treatment

“…Most findings were based on oral glucose tolerance tests [7, 14]. There is controversy about intravenous glucose tolerance tests [15], and there is a striking difference between up to 50% pathological oral glucose tolerance tests in children with renal insufficiency and the fact that (apart from children with infantile cystinosis) hardly any of these children develop overt diabetes mellitus.…”

“…Among the possible side effects of GH, a disturbed glucose tolerance and induced hyperinsulinemia have raised concerns [4, 5] since the long-term effects of rh GH-induced hyperinsulinemia are unknown. The data on glucose tolerance in patients with UTS and CRF are limited to glucose and insulin measurements using oral glucose tolerance tests [6, 7]. In order to investigate both the early and second (or metabolic) insulin secretion phases, we routinely used an intravenous glucose infusion test (GIT) [8].…”

Insulin Binding and Glycolytic Activity in Erythrocytes from Dialyzed and Nondialyzed Uremic Patients

“…The patients were not taking any medication known to affect carbohydrate metabolism. The primary renal disease responsible for the renal failure was chronic glomerulonephritis [44], polycystic kidney disease [7], chronic inter stitial nephropathy [10], arteriolar nephrosclerosis [3] and familiar nephropathy [2]. Ages (years ± SEM) were 36.9 ±1.4 for controls, 38.7 ±3.7 for U, 33.1 ±2.9 for HD, and 39.2±3.4 for CAPD.…”

“…Studies from several laboratories have yielded conflicting results regarding insulin binding to cells from uremic individu als. Several studies have reported normal insulin binding to cells from uremic patients [3][4][5][6] or from uremic rats [7,8], Others, however, have reported decreased insulin binding to cells from uremic [9][10][11] or dialysis patients [6].…”

Erythrocyte insulin receptor and glucose tolerance test in children treated with prednisolone.

“…The method used for the measurement of insulin binding to erythrocytes has now been improved (Namikawa et al, 1983) and can easily be used in children because only small amounts of blood are required to perform the test. It is also known that the insulin receptor in erythrocytes usually runs parallel to the insulin receptor in the monocytes or the adipocytes (Dons et al, 1981;Caro andAmatruda, 1982, Ward et al, 1981), and in view of these facts, we used erythrocytes to investigate the insulin receptor analysis in the present study.…”