Skin color is associated with insulin resistance in nondiabetic peritoneal dialysis patients.
BACKGROUND
Changes in skin color are common among dialysis patients. They are associated with urochrome pigments, hemoglobin, and changes in cutaneous vasculature. Insulin resistance (IR) is strongly linked to cutaneous vascular dysfunction and is prevalent in dialysis patients. We postulated skin color may be associated with IR in dialysis patients because of the alternation in cutaneous vasculature.


METHODS
50 nondiabetic peritoneal dialysis (PD) patients were recruited for measurements of skin color by the Commission Internationale de I'Eclairage (CIE; International Commission on Illumination) system ("L" "a" "b" system). The "L" values represent skin brightness, "a" redness, and "b" yellowness. Correlation analysis between skin color, homeostatic model assessment (HOMA(IR)), high-density lipoprotein cholesterol (HDL-C), and adiponectin was performed.


RESULTS
We divided patients (age 45 +/- 13 years, 31 women) into 3 groups according to tertiles of HOMA(IR). Patients with higher HOMA(IR) had a trend to have poor skin color (lower "a" and "b" values; p = 0.038 and 0.064). HOMA(IR), adiponectin, and HDL-C levels were correlated with "a" and "b" values in logarithm (all p < 0.05). After adjustments for age, hemoglobin level, duration of PD, and residual renal glomerular filtration rate, only HOMA(IR) was associated with "a" values (p = 0.038) and HDL-C was associated with "b" values (p = 0.048) in logarithm.


CONCLUSIONS
Skin color, measured noninvasively, is associated with HOMA(IR) and HDL-C. Nondiabetic PD patients that had more severe IR had worse skin color.
Chen
Hung-Yuan
HY
Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
Kao
Tze-Wah
TW
Chiu
Yen-Lin
YL
Huang
Jenq-Wen
JW
Lai
Chun-Fu
CF
Tsai
Tsen-Fang
TF
Chu
Tzong-Shinn
TS
Wu
Kwan-Dun
KD
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000379:methods*; D012880:Skin Pigmentation / Q000502:physiology*; D016896:Treatment Outcome
D001786:Blood Glucose; D007328:Insulin