title: Insulin resistance and left ventricular mass in non-diabetic hemodialysis patients.
abstract: BACKGROUND
  Insulin resistance (IR) is frequently recognized in patients with uremia, and it is thought that IR has a basic role in the pathogenesis of cardiovascular disease.
  
  
  OBJECTIVE
  To evaluate the effect of IR on cardiovascular risk in non-diabetic patients receiving hemodialysis (HD).
  
  
  METHODS
  We performed a cross-sectional observational study that comprised 186 non-diabetic patients receiving HD (95 men; mean [SD] age, 46.4 [10.8] years; age range, 35-60 years) who had been receiving HD for 7.3 (3.5) years. Demographic variables and laboratory values were recorded. Insulin resistance was determined using the Homeostatic Model Assessment (HOMA), and the left ventricular mass index (LVMI) was calculated via echocardiography.
  
  
  RESULTS
  According to HOMA-IR levels, patients were categorized as having IR (HOMA-IR score ≥2.5; n = 53) or not having IR (HOMA-IR score <2.5; n = 133). Insulin resistance was determined in 28.4% of study patients. Compared with the non-IR group, the IR group had been receiving HD longer; had greater body mass index; and had higher serum creatinine, uric acid, triglyceride, insulin, and C-reactive protein concentrations, leukocyte count, and LVMI (P < 0.05). Patients with increased LVMI had significantly higher body mass index, systolic blood pressure, serum cholesterol and C-reactive protein concentrations, and HOMA score. At multivariate analysis, systolic blood pressure (β = 0.22; P = 0.03) and HOMA score (β = 0.26; P = 0.01) affected LVMI.
  
  
  CONCLUSIONS
  Insulin resistance and hypertension are independent risk factors for left ventricular hypertrophy in non-diabetic patients with uremia who are receiving HD. Further studies are needed to indicate the benefits of improving IR for cardiovascular mortality in this subgroup of patients with uremia.
authors.affiliation: Department of Nephrology, Baskent University, Ankara, Turkey.
authors.forename: Sebnem
authors.initials: S
authors.lastname: Karakan
authors.affiliation: Department of Nephrology, Baskent University, Ankara, Turkey.
authors.forename: Siren
authors.initials: S
authors.lastname: Sezer
authors.affiliation: Department of Nephrology, Baskent University, İstanbul, Turkey.
authors.forename: F Nurhan
authors.initials: FN
authors.lastname: Ozdemir Acar
keywords: hemodialysis; insulin resistance; ventricular hypertrophy