Susceptibility to hyperglycemia in patients with chronic kidney disease.
BACKGROUND
Patients with chronic kidney disease (CKD) are susceptible to hyperglycemia.


OBJECTIVE
To study the prevalence of pre-diabetes in CKD patients and determine the contribution of insulin resistance (IR) versus beta-cell dysfunction in patients with CKD.


METHODS
45 consecutive nondiabetic CKD patients and 40 healthy subjects were included. Patients were divided into a normoglycemic (NG) and a pre-diabetic (PDM) group. IR was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and beta-cell function was assessed by proinsulin/insulin ratio and beta-cell%.


RESULTS
The prevalence of PDM was 40%. The prevalence of high HOMA-IR was 22.2 and 77.8% in the NG and PDM groups. Compared to NG patients, the PDM group showed higher fasting plasma glucose, HOMA-IR, insulin, and proinsulin, while the prevalence of beta-cell dysfunction of 22.2% was lower than the 37% present in the NG group.


CONCLUSIONS
Increased IR, rather than beta-cell dysfunction, is the primary mechanism of PDM in CKD patients.
Shehab-Eldin
Walid
W
Department of Internal Medicine, Faculty of Medicine, Menofia University, Cairo, Egypt.
Zaki
Ali
A
Gazareen
Sanaa
S
Shoker
Ahmed
A
D052242:Adiponectin / Q000097:blood; D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000209:etiology*; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017382:Reactive Oxygen Species / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology; D012525:Saskatchewan / Q000453:epidemiology
D052242:Adiponectin; D017382:Reactive Oxygen Species