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dc.creatorSakkas, G. K.en
dc.creatorKaratzaferi, C.en
dc.creatorZintzaras, E.en
dc.creatorGiannaki, C. D.en
dc.creatorLiakopoulos, V.en
dc.creatorLavdas, E.en
dc.creatorDamani, E.en
dc.creatorLiakos, N.en
dc.creatorFezoulidis, I.en
dc.creatorKoutedakis, Y.en
dc.creatorStefanidis, I.en
dc.date.accessioned2015-11-23T10:46:48Z
dc.date.available2015-11-23T10:46:48Z
dc.date.issued2008
dc.identifier10.1152/ajpregu.00935.2007
dc.identifier.issn0363-6119
dc.identifier.urihttp://hdl.handle.net/11615/32783
dc.description.abstractSakkas 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.en
dc.sourceAmerican Journal of Physiology-Regulatory Integrative and Comparative Physiologyen
dc.source.uri<Go to ISI>://WOS:000261559700001
dc.subjectinsulin sensitivity index by Matsudaen
dc.subjecthomeostasis assessment model ofen
dc.subjectinsulin resistanceen
dc.subjectfunctional capacityen
dc.subjectoral glucose insulinen
dc.subjectsensitivityen
dc.subjectquality of lifeen
dc.subjectquantitative insulin-sensitivity checken
dc.subjectindexen
dc.subjectTYPE-2 DIABETES-MELLITUSen
dc.subjectSTAGE RENAL-DISEASEen
dc.subjectPATIENTS RECEIVINGen
dc.subjectHEMODIALYSISen
dc.subjectMETABOLIC RISK-FACTORSen
dc.subjectQUALITY-OF-LIFEen
dc.subjectSKELETAL-MUSCLEen
dc.subjectPHYSICAL-ACTIVITYen
dc.subjectGLYCEMIC CONTROLen
dc.subjectAPNEA SYNDROMEen
dc.subjectASSOCIATIONen
dc.subjectPhysiologyen
dc.titleLiver fat, visceral adiposity, and sleep disturbances contribute to the development of insulin resistance and glucose intolerance in nondiabetic dialysis patientsen
dc.typejournalArticleen


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