title: Mild renal dysfunction is associated with insulin resistance in chronic glomerulonephritis.
abstract: BACKGROUND
  Insulin resistance is associated with advanced and moderate chronic renal failure (CRF). However, insulin resistance in chronic glomerulonephritis (CGN) before onset of frank renal dysfunction is not fully evaluated. We attempted to investigate the association of insulin resistance with mild renal dysfunction and with abnormal calcium homeostasis.
  
  
  METHODS
  Eighteen young, lean non-diabetic male patients with biopsy-proven CGN (age 30 +/- 7 years, body mass index 23.0 +/- 2.5 kg/m2) were enrolled. Insulin sensitivity was estimated by the glucose infusion rate (M value) during euglycemic hyperinsulinemic clamping for 60 to 120 min. Calcium-related parameters including intracellular calcium concentrations ([Ca2+]i) in platelets were also measured. Renal function was normal or slightly impaired (serum creatinine, 1.0 +/- 0.2 mg/dl; glomerular filtration rate (GFR), 68 to 131 ml/min/1.48 m2). We divided subjects into an insulin-sensitive (IS) group (M value > 7.3 mg/kg/min, the overall mean) and an insulin-resistant (IR) group (M value < 7.3 mg/kg/min).
  
  
  RESULTS
  During a 75 g oral glucose tolerance test, the plasma glucose concentration at 120 min after glucose loading and the immunoreactive insulin concentration at 60 min were significantly higher in the IR group. GFR was notably lower in the IR group than in the IS group (p = 0.0003), and was significantly correlated with insulin sensitivity (p < 0.02, r = 0.58). The basal [Ca2+]i was significantly higher in the IR than in the IS group (39 +/- 9 vs. 30 +/- 9 nM, p < 0.05).
  
  
  CONCLUSIONS
  Mild renal dysfunction and elevated basal [Ca2+]i are associated with insulin resistance in CGN.
authors: Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors: Y
authors: Y
authors: Kato
authors: M
authors: M
authors: Hayashi
authors: Y
authors: Y
authors: Ohno
authors: T
authors: T
authors: Suzawa
authors: T
authors: T
authors: Sasaki
authors: T
authors: T
authors: Saruta
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000737:chemistry; D002118:Calcium / Q000378:metabolism; D002908:Chronic Disease; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000150:complications / Q000503:physiopathology*; D015309:Glucose Clamp Technique; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology*; D017595:Renal Plasma Flow
chemical_list: D007328:Insulin; D002118:Calcium