Liver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patients
Autor
Sakkas, G. K.; Karatzaferi, C.; Zintzaras, E.; Giannaki, C. D.; Liakopoulos, V.; Lavdas, E.; Damani, E.; Liakos, N.; Fezoulidis, I.; Koutedakis, Y.; Stefanidis, I.Fecha
2008Materia
Resumen
Sakkas GK, Karatzaferi C, Zintzaras E, Giannaki CD, Liakopoulos V, Lavdas E, Damani E, Liakos N, Fezoulidis I, Koutedakis Y, Stefanidis I. Liver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patients. Am J Physiol Regul Integr Comp Physiol 295: R1721-R1729, 2008. First published October 1, 2008; doi:10.1152/ajpregu.00935.2007.-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, O-2 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.
Colecciones
Ítems relacionados
Mostrando ítems relacionados por Título, autor o materia.
-
Effect of fully automated closed-loop insulin delivery using faster aspart versus standard aspart on gluco-regulatory hormones in type 2 diabetes
Herzig D., Studer D., Nakas C.T., Kuenzli C., Stauffer T.P., Hovorka R., Bally L. (2021)We retrospectively assessed gluco-regulatory hormones over 10 h (including two meals) of fully automated closed-loop insulin delivery using faster (FA) versus standard insulin aspart (IAsp) in adults with type 2 diabetes ... -
Pharmacokinetics of Faster and Standard Insulin Aspart during Fully Closed-Loop Insulin Delivery in Type 2 Diabetes
Herzig D., Dehais J., Prost J.-C., Nakas C.T., Stettler C., Bally L., Hovorka R. (2020)Background: Faster insulin aspart is a novel formulation of insulin aspart aiming to accelerate its subcutaneous absorption. The aim of this study was to compare pharmacokinetics of faster insulin aspart versus standard ... -
Effect of nutrition on postprandial glucose control in hospitalized patients with type 2 diabetes receiving fully automated closed-loop insulin therapy
Banholzer N., Herzig D., Piazza C., Álvarez-Martínez M., Nakas C.T., Kosinski C., Feuerriegel S., Hovorka R., Bally L. (2021)Fully automated closed-loop insulin delivery may offer a novel way to manage diabetes in hospital. However, postprandial glycaemic control remains challenging. We aimed to assess the effect of nutritional intake on ...