Insulin resistance is a significant determinant of sarcopenia in advanced kidney disease

Değer, Serpil Müge; Hewlett, Jennifer R.; Gamboa, Jorge L.; Ellis, Charles D.; Hung, Adriana M.; Siew, Edward D.; Mamnungu, Cindy; Shi, Feng; Bian, Aihua; Stewart, Thomas G.; Abumrad, Naji N.; İkizler, T. Alp

doi:10.1152/ajpendo.00070.2018

Cited by 25 publications

(15 citation statements)

References 24 publications

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“…Most differences between patients with and without diabetes are related to body composition, with reduced lean tissue mass in patients with diabetes (Table 1). This difference in body composition is expected: insulin resistance is a significant determinant of sarcopenia in advanced kidney disease [38].…”

Section: Discussionmentioning

confidence: 95%

Glucose tolerance in patients with and without type 2 diabetes mellitus during hemodialysis

Niemczyk

Schneditz

Wojtecka

et al. 2021

Diabetes Research and Clinical Practice

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The disposal of a glucose bolus was studied to identify glucose metabolism in patients with and without type 2 diabetes mellitus (T2DM) during their regular hemodialysis (HD) treatment. Methods: Plasma glucose, insulin, and c-peptide concentrations were measured during a 60 min observation phase following a rapid glucose infusion (0.5 g/kg dry weight). Glucose disposition and elimination rates were determined from kinetic analysis, and insulinogenic index was calculated. Insulin resistance (R HOMA ) was determined by homeostatic model assessment (HOMA). Results: 35 HD patients (14 with T2DM) distinguished by a higher age (median: 70 vs. 55 y, p < 0.01) in T2DM patients were studied. Glucose kinetic data showed only small differences between patients with or without T2DM, but as R HOMA measured in all patients increased, a larger fraction of glucose was removed by the extracorporeal system (r = 0.430, p = 0.01).One hour after glucose bolus injection the glucose level was not different from that before HD also in patients with T2DM (p = 0.115). Conclusions: The larger glucose amount recovered in dialysate in patients with increasing R HOMA indicates that impaired glucose disposal could be measured during HD using a non-invasive dialysis quantification approach without blood sampling. Glucose infusion during HD is safe also in patients with T2DM.

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Section: Discussionmentioning

confidence: 95%

Glucose tolerance in patients with and without type 2 diabetes mellitus during hemodialysis

Niemczyk

Schneditz

Wojtecka

et al. 2021

Diabetes Research and Clinical Practice

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“…IR presents as a shift of the insulin concentration-effect curve towards higher insulin concentrations. IR is highly correlated with occurrence of atherosclerosis, cardiovascular risk, and progression of chronic kidney disease (CKD) (5)(6)(7)(8)(9). Hyperinsulinemic-euglycemic clamp (HEC) test and homeostatic model assessment (HOMA) are effective methods for determination of IR (10,11).…”

Section: Introductionmentioning

confidence: 99%

Elevated TyG Index Predicts Incidence of Contrast-Induced Nephropathy: A Retrospective Cohort Study in NSTE-ACS Patients Implanted With DESs

Qin

et al. 2022

Front. Endocrinol.

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BackgroundTriglyceride-glucose (TyG) index is a reliable and specific biomarker for insulin resistance and is associated with renal dysfunction. The present study sought to explore the relationship between TyG index and the incidence of contrast-induced nephropathy (CIN) in non-ST elevation acute coronary syndrome (NSTE-ACS) patients implanted with drug-eluting stents (DESs).MethodsA total of 1108 participants were recruited to the study and assigned to two groups based on occurrence of CIN. TyG index was calculated as ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Baseline characteristics and incidence of CIN were compared between the two groups. Logistic regression analysis was performed to evaluate the relationship between TyG index and CIN.ResultsThe results showed that 167 participants (15.1%) developed CIN. Subjects in the CIN group had a significantly higher TyG index compared with subjects in the non-CIN group (8.9 ± 0.7 vs. 9.3 ± 0.7, P<0.001). TyG index was significantly correlated with increased risk of CIN after adjusting for confounding factors irrespective of diabetes mellitus status and exhibited a J-shaped non-linear association. Subgroup analysis showed a significant gender difference in the relationship between TyG index and CIN. Receiver operating characteristic (ROC) curve analysis indicated that the risk assessment performance of TyG index was superior compared with other single metabolic indexes. Addition of TyG index to the baseline model increased the area under the curve from 0.713 (0.672-0.754) to 0.742 (0.702-0.782) and caused a reclassification improvement of 0.120 (0.092-0.149).ConclusionThe findings from the present study show that a high TyG index is significantly and independently associated with incidence of CIN in NSTE-ACS patients firstly implanted with DESs. Routine preoperative assessment of TyG index can alleviate CIN and TyG index provides a potential target for intervention in prevention of CIN.

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“…A study conducted by Deger et al showed that skeletal muscle protein synthesis decreased significantly in HD subjects with an insulin resistance state in patients on HD [ 40 ]. Insulin and IGF-1 have a similar pathway in muscle metabolism.…”

Section: Discussionmentioning

confidence: 99%

Association between Sarcopenia and Insulin-Like Growth Factor-1, Myostatin, and Insulin Resistance in Elderly Patients Undergoing Hemodialysis

Widajanti

Soelistijo

Hadi

et al. 2022

Journal of Aging Research

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Sarcopenia is common in hemodialysis patients, especially in the elderly patients undergoing hemodialysis. Various factors may contribute to the occurrence of sarcopenia, such as anabolic and catabolic imbalance. This study aims to investigate the correlation of insulin-like growth factor-1 (IGF-1) levels as an anabolic factor, myostatin levels, and insulin resistance as catabolic factors with sarcopenia in the pathogenesis of sarcopenia in elderly patients undergoing hemodialysis. A total of 40 subjects aged 60 years or more who undergoing hemodialysis in Dr. Soetomo Hospital Surabaya were included in this cross-sectional study. Sarcopenia was diagnosed according to Asian Working Group Sarcopenia 2019 criteria. IGF-1, myostatin, and insulin resistance levels were measured once before hemodialysis. Subjects with sarcopenia diagnosis were 33 (82.5%), that is, 19 (47.5%) men and 14 (35%) women. There were 28 (70%) of the subjects diagnosed with severe sarcopenia. Furthermore, there were significant differences in the characteristics and geriatric parameters between the sarcopenia and nonsarcopenia groups. There were differences between the two groups in hemoglobin levels, IGF-1 levels, myostatin levels, homeostasis model assessment-insulin resistance (HOMA-IR) levels, muscle mass, handgrip strength, body mass index status, mini nutritional assessment status, and physical activity scale for elderly status (all p < 0.05). Correlation analyses showed that IGF-1 levels negatively correlated with sarcopenia status in elderly patients undergoing hemodialysis ( p < 0.05). On the contrary, myostatin and HOMA-IR levels were positively correlated with sarcopenia status in elderly patients undergoing hemodialysis (all p < 0.05). Based on this recent study, IGF-1, myostatin, and insulin resistance were significantly correlated with sarcopenia in elderly patients undergoing hemodialysis.

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Insulin resistance is a significant determinant of sarcopenia in advanced kidney disease

Cited by 25 publications

References 24 publications

Glucose tolerance in patients with and without type 2 diabetes mellitus during hemodialysis

Glucose tolerance in patients with and without type 2 diabetes mellitus during hemodialysis

Elevated TyG Index Predicts Incidence of Contrast-Induced Nephropathy: A Retrospective Cohort Study in NSTE-ACS Patients Implanted With DESs

Association between Sarcopenia and Insulin-Like Growth Factor-1, Myostatin, and Insulin Resistance in Elderly Patients Undergoing Hemodialysis

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