Journal
AMERICAN JOURNAL OF KIDNEY DISEASES
Volume 42, Issue 1, Pages 62-66Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/S0272-6386(03)00409-8
Keywords
insulin resistance; glomerular filtration rate (GFR); renal disease; resistin; uremia
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Background: Resistin is a newly discovered insulin inhibitor secreted by adipocytes. We explored the potential role of resistin in the pathophysiological process of insulin resistance encountered in patients with renal disease. Methods: Resistin blood concentrations, insulin sensitivity index (by intravenous glucose tolerance test), and glomerular filtration rate (GFR; by inulin clearance) were asses. sed in 30 male patients with immunoglobulin A glomeruloneporitis in different stages of renal disease. Results: Patients with increased resistin blood concentrations had more advanced. renal failure and were significantly older. Plasma resistin levels correlated significantly with GFR (r = -0.82; P < 0.0001), Plasma homocysteine concentration (r = 0.68; P < 0.091), and age (r = 0.42; P = 0.05), but not with fasted plasma insulin (r = -0.34; P = 0.12), glucose (r = 0.25; P = 0.19), and leptin (r = -0.24; P = 6.21) concentrations; body mass index (r = -0.06; P = 0.75), waist-hip ratio (r = 0.09; P = 0.63), or insulin sensitivity (r = -0.05; P = 0.79). In multiple regression analysis, GFR was the only independent predictor of plasma resistin concentrations in renal patients (r = -0.812; P < 0.0001). Conclusion: Resistin blood concentrations increase with progressive impairment of renal function. Thus, the kidney seems to be an important site of resistin elimination. However, the greater than 5-fold increase in resistin blood levels apparently is not associated with deterioration in insulin sensitivity in patients with renal disease. (C) 2003 by the National Kidney Foundation, Inc.
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