THE ROLE OF HYPERINSULINEMIA AND INSULIN RESISTANCE IN DEVELOPMENT OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH METABOLIC SYNDROME


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Abstract

Aim. To examine relations between hyperinsulinemia, insulin resistance (IR), components of metabolic syndrome (MS) and predisposition to renal damage. Material and methods. A total of 94 MS patients (64 males and 30 females, age 30-67 years, mean age 52±9 years) entered the study. The examination included measurement of waist and hip circumference, body mass index (BMI), HOMA index, estimation of lipids and immunoreactive insulin concentrations. Renal damage was assessed by glomerular filtration rate and urinary excretion of albumin. The patients were divided into groups by IR and BMI. Results. A strong correlation was found between IR markers and lipid metabolism disorders, hemodynamic parameters. Statistics show that IR is an independent unfavourable factor of renal damage in MS patients. Conclusion. IR is an essential component of MS and an independent factor of development of chronic kidney disease in MS patients.

About the authors

I M Kutyrina

Research Institute of Uronephrology and Human Reproductive Health

вед. науч. сотр., проф. отд. нефрологии

A A Kryachkova

Research Institute of Uronephrology and Human Reproductive Health

Email: kryaka82@mail.ru
лаборант-исследователь отд. нефрологии

S A Savelieva

I.M. Sechenov First Moscow Medical University

аспирант, каф. нефрологии и гемодиализа ФППОВ

References

  1. Beddhu S., Kimmel P., Nirupama R., Cheung A. Associations of metabolic syndrome with inflammation in CKD: Results from the third national health and nutrition examination survey (nHANES III). Am. J. Kidney Dis. 2005; 46: 577—586.
  2. Chen J., Muntner P., Hamm L. L. Insulin resistance and risk of chronic kidney disease in nondiabetic US adults. J. Am. Soc. Nephrol. 2003; 14: 469—477.
  3. Cseh K., Winkler G., Melczer Z. The role of tumor necrosis factor (TNF)-a resistance in obesity and insulin resistance. Diabetologia 2000; 43 (4): 525.
  4. Dandona P., Aljada A., Chaudhuri A. Metabolic syndrome: а comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005; 11: 1448—1454.
  5. Diez J. J., Iglesias P. The role of the novel adipocyte-derived hormone adiponectin in human disease. Eur. J. Endocrinol. 2003; 148: 293— 300.
  6. Eddy A. A. Plasminogen activator inhibitor-1 and kidney. Am. J. Physiol. Renal Physiol. 2002; 283: 209—220.
  7. Sakura H. Sequence variations in the human Kir6.2 gene, a subunit of the beta-cell ATP sensitive K-channel: no association with NID-DM in white Caucasian subjects or evidence of abnormal function when expressed in vitro. Diabetologia 1996; 39: 1233—1236.
  8. Кутырина И. М., Мухин Н. А., Моисеев С. В. и др.Эндотелиальная дисфункция и поражение почек при ожирении. Вестн. РАМН 2006; 12: 25—31.
  9. Майоров А. Ю. Состояние инсулинорезистентности в эволюции СД 2-го типа: Автореф. дис.. д-ра. мед. наук. М.; 2009.
  10. Мухин Н. А., Фомин В. В., Сагинова Е. А. Эндотелиальная дисфункция и поражение почек при ожирении. Вестн. РАМН. 2006; 12: 25—31.
  11. Чеботарева Н. В., Бобкова И. Н., Козловская Л. В. Молекулярные механизмы интерстициального фиброза при прогрессирующих заболеваниях почек (Обзор литературы). Нефрология и диализ 2006; 8: 26—36.
  12. Abrass C. K., Spicer D., Raugi G. J. Insulin induces a change in extracellular matrix glycoproteins synthesized by rat mesangial cells in culture. Kidney Int. 1994; 46: 613—620.
  13. Adelman R. D., Restaino I. G., Alon U. S., Blowey D. L. Proteinuria and focal segmental glomerulosclerosis in severely obese adolescents. J. Pediatr. 2001; 138: 481—485.
  14. Bagby S.P. Obesity-initiated metabolic syndrome and the kidney: A recipe for chronic kidney disease? J. Am. Soc. Nephrol. 2004; 15: 2775—2791.
  15. Becker B., Kronenberg F., Kielstein J. T. MMKD Study Group. Renal insulin resistance syndrome, adiponectin and cardiovascular events in patients with kidney disease: The Mild and Moderate Kidney Disease Study. J. Am. Soc. Nephrol. 2005; 16: 1091-1098.
  16. Chdek J., Adamczak M., Nieszporek T. Adipose tissue as an endocrine organ-а nephrologistists perspective. Obesity and kidney 2006; 151: 70—90.
  17. Kasiske B. L., Crosson J. T. Renal disease in patients with massive obesity. Arch. Intern. Med. 1986; 46: 1105—1109.
  18. Kershaw E. E., Flier J. S. Adipose tissue as an endocrine organ. J. Clin. Endocrinol. 2004; 89: 2548—2556.
  19. Kramer H., Luke A., Bidani A. Obesity and prevalent and incident CKD: the Hypertension Detection and Follow-Up Program. Am. J. Kidney Dis. 2005; 46 (4): 587—594.
  20. Schindler С. The metabolic syndrome as endocrine disease: is there an effective pharmacotherapeutic strategy optimally targering the pathogenesis. Ther. Advanc. Cardiovasc. Dis. 2007; 1 (1): 7—26.
  21. Thomas M. C., Tikellis C., Burns W. C. Reduced tubular cation transport in diabetes: prevented by ACE inhibition. Kidney Int. 2003; 63 (6): 2152—2161.
  22. Tucker B. J., Rasch R., Blantz R. C. Glomerular filtration and tubular reabsorption of albumin in preproteinuric and proteinuric diabetic rats. J. Clin. Invest. 1993; 92 (2): 686—694.

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