title: Effects of oral glucose on intermediary metabolism in continuous ambulatory peritoneal dialysis patients versus healthy subjects.
abstract: OBJECTIVE
  To explore the mechanisms and metabolic consequences of the insulin resistance of patients treated by continuous ambulatory peritoneal dialysis (CAPD).
  
  
  METHODS
  CAPD patients and healthy subjects ingested a similar mean oral glucose load per kilogram of fat-free mass (FFM) [1.20+/-0.03 g/(kg FFM) vs 1.20+/-0.06 g/(kg FFM); CAPD vs healthy subjects]. Substrate oxidation was monitored over 6 hours using indirect calorimetry.
  
  
  METHODS
  Peritoneal dialysis unit of a tertiary-care institutional center.
  
  
  METHODS
  Glycemia, insulinemia, substrate oxidation.
  
  
  METHODS
  Six CAPD patients (68+/-5 yr) and 6 healthy subjects (24+/-1 yr). The CAPD patients had similar body mass index (21.4+/-1.3 vs 22.9+/-1.1 kg/m2), a higher percent fat (25.8%+/-3.7% vs 16%+/-2.2%; p < 0.05), and a lower FFM (42.2+/-2.2 kg vs 56.5+/-2.6 kg; p < 0.01) than healthy subjects.
  
  
  RESULTS
  The CAPD patients displayed a higher glycemic and insulinemic responses to glucose than did healthy subjects (p < 0.05), but similar glucose oxidation and storage. Lipid oxidation and plasma nonesterified fatty acids were not increased in CAPD patients versus healthy subjects, in spite of a higher adiposity. Fat oxidation was related to fat mass in CAPD patients (r2 = 0.77, p < 0.05) but not in healthy subjects (r2 = 0.05).
  
  
  CONCLUSIONS
  CAPD patients display an insulin-resistance not explained by an increased lipid oxidation. The maintenance of intracellular glucose utilization at the expense of higher glycemic and insulinemic responses suggests a defective glucose transport.
authors.affiliation: Clinique Médicale A et Laboratoire de Nutrition, Unité de Recherche Associée Lipides et Croissance, Hôpital Bretonneau, Tours, France.
authors.forename: J
authors.initials: J
authors.lastname: Delarue
authors.forename: C
authors.initials: C
authors.lastname: Maingourd
authors.forename: C
authors.initials: C
authors.lastname: Couet
authors.forename: S
authors.initials: S
authors.lastname: Vidal
authors.forename: P
authors.initials: P
authors.lastname: Bagros
authors.forename: F
authors.initials: F
authors.lastname: Lamisse
mesh_terms: D000368:Aged; D002153:Calorimetry, Indirect; D016022:Case-Control Studies; D004734:Energy Metabolism; D005260:Female; D005947:Glucose / Q000493:pharmacokinetics / Q000494:pharmacology*; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000378:metabolism* / Q000628:therapy; D008297:Male; D010084:Oxidation-Reduction; D010531:Peritoneal Dialysis, Continuous Ambulatory
chemical_list: D005947:Glucose