title: Visceral adipose tissue is associated with insulin resistance in hemodialyzed patients.
abstract: BACKGROUND
  It has not been definitively established which factors affect insulin resistance (IR) and whether dialysis decreases IR. The aim of this study was to investigate factors that may have an influence on homeostasis model assessment (HOMA-IR) in hemodialyzed patients (HDpts) and to compare IR between HDpts and healthy subjects.
  
  
  METHODS
  We examined 33 HDpts and paired 33 subjects of the control group, matched for sex, age, and BMI. We analyzed concentrations of insulin, glucose, leptin, resistin, and total and high-molecular-weight adiponectin (HMWad) in serum. Using computed tomography in HDpts, we evaluated visceral adipose tissue (VAT), concentrations of visfatin, CRP, and IL-6.
  
  
  RESULTS
  HOMA-IR (median, 1.3 vs. 1.4, P=0.19), insulin (median 6.8 vs. 6.0 µIU/mL, P=0.7), glucose (79 mg/dL vs. 93 mg/dL, P=0.001). IR in HDpts is dependent on VAT (r=0.36, P=0.04) and this relationship is stronger than the relationship of BMI and IR (r=0.3, P=0.1). In HDpts we found higher concentrations of leptin (P=0.001) and resistin (P<0.001), with no relation to IR. HMWad and its percentage in relation to total adiponectin are higher in HDpts (P=0.03 and P<0.001, respectively).
  
  
  CONCLUSIONS
  HOMA-IR in HDpts does not differ from the control group. In HDpts it depends on the quantity of VAT and this relationship is stronger than with BMI. In HDpts leptin and resistin do not influence IR. HMWad and its percentage in total adiponectin are significantly higher in HDpts.
authors.affiliation: Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Giers
authors.affiliation: Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Niemczyk
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Szamotulska
authors.affiliation: Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Romejko-Ciepielewska
authors.affiliation: Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Paklerska
authors.affiliation: Department of Endocrinology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Bartoszewicz
authors.affiliation: 2nd Department of Radiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Pacho
authors.affiliation: Department of Gastroenterology and Metabolic Diseases, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Jasik
authors.affiliation: Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Matuszkiewicz-Rowińska
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D050152:Intra-Abdominal Fat / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
chemical_list: D001786:Blood Glucose; D007328:Insulin