Insulin Resistance and Insulin Handling in Chronic Kidney Disease

Parvathareddy, Vishnu P.; Wu, Jiao; Thomas, Sandhya S.

doi:10.1002/cphy.c220019

Cited by 1 publication

(3 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One of the main effects of IR is hyperinsulinemia, which impairs kidney function by increased vascular permeability, endothelial dysfunction, and glomerular hyperfiltration [ 4 ]. In a longitudinal study involving patients with CKD, individuals who exhibited IR were observed to have a greater decline in renal function compared to insulin-sensitive people [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…The weakening of the effects of insulin in skeletal muscle, adipose tissue, or liver cells is known as insulin resistance (IR), which is also defined as the state of aberrant blood glucose response linked to a specific insulin concentration [ 3 ]. In patients with CKD, the etiology of tissue insensitivity to insulin is complex and includes uremic toxins, inflammatory factors, metabolic acidosis, and renin–angiotensin–aldosterone system activation [ 4 ]. Diseases such as diabetes mellitus (DM), hypertension, and metabolic syndrome (MetS) are closely related to IR and are risk factors for CKD [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Based on body mass index (BMI) and MetS, CKD patients were classified into metabolically healthy normal weight/overweight/obesity and metabolically unhealthy normal weight/overweight/obesity groups according to a recent study, which demonstrated that metabolic abnormality was a significant risk factor for CKD in the Chinese population [ 6 ]. Due to its promotion of endothelial dysfunction, oxidative stress, and inflammation, IR may have a role in the onset and course of CKD [ 4 ]. Clinical studies have found that elevated IR is associated with proteinuria and CKD in patients with or without DM [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The U-shape relationship between insulin resistance-related indexes and chronic kidney disease: a retrospective cohort study from National Health and Nutrition Examination Survey 2007–2016

Shen,

Lin,

Bin

et al. 2024

Diabetol Metab Syndr

View full text Add to dashboard Cite

Background There is ongoing debate on the correlation between chronic kidney disease (CKD) and insulin resistance (IR)-related indices. Our objective was to explore the prognostic ability of IR-related indexes for the prevalence of CKD, as well as the mortality from all causes and cardiovascular disease (CVD) in CKD patients. Methods The data used in this study came from the National Health and Nutrition Examination Survey (NHANES). Binary logistic regression analysis, Cox proportional hazards model, and restricted cubic spline (RCS) were used to analyze the relationship between IR-related indexes, including metabolic score of IR (METS-IR), homeostatic model assessment for IR (HOMA-IR), triglyceride glucose index (TyG), triglyceride glucose-waist-to-height ratio (TyG-WHtR), triglyceride glucose-body mass index (TyG-BMI), with CKD and its all-cause mortality and CVD mortality. Subgroup analysis was performed to test the stability of the results. Finally, the predictive power of IR-related indexes for CKD was tested by the receiver operating characteristic (ROC) curve. Results Among the recruited 10,660 participants, 15.42% were CKD patients. All IR-related indexes were found to be nonlinearly correlated to the prevalence of CKD in the study. When the TyG index was higher than 9.05, it was positively associated with CKD (OR: 1.77, 95% CI 1.44–2.18). Moreover, increased TyG-WHtR level was correlated with a greater prevalence of CKD when it was higher than 4.3 (OR: 1.31, 95% CI 1.19–1.45). Other IR-related indexes (METS-IR, HOMA-IR, and TyG-BMI) showed fewer notable correlations with CKD. The association of IR-related indexes and the prevalence of CKD remained consistent in most subgroups (P for interactions > 0.05). TyG-WHtR was also the predictor of all-cause mortality in CKD patients (HR: 1.34, 95% CI 1.14–1.58), while other IR-related indexes were not correlated with the all-cause mortality or CVD mortality in CKD patients (P > 0.05). Otherwise, ROC curves showed that TyG-WHtR had more robust diagnostic efficacy than other IR-related indexes (METS-IR, HOMA-IR, TyG, and TyG-BMI) in predicting CKD (area under the curve: 0.630, 95% CI 0.615–0.644). Conclusions IR-related biomarkers (METS-IR, HOMA-IR, TyG, and TyG-BMI) were positively correlated with the prevalence of CKD. Moreover, TyG-WHtR enhanced CKD and its all-cause mortality prediction. In patients with elevated levels of IR-related indexes, the early detection and intervention of IR may reduce the occurrence of CKD and the prognosis of CKD patients.

show abstract

Section: Discussionmentioning

confidence: 99%