Details

Autor(en) / Beteiligte

• Siew, E.D.
• Pupim, L.B.
• Majchrzak, K.M.
• Shintani, A.
• Flakoll, P.J.
• Ikizler, T.A.

Titel

Insulin resistance is associated with skeletal muscle protein breakdown in non-diabetic chronic hemodialysis patients

Ist Teil von

• Kidney international, 2007-01, Vol.71 (2), p.146-152

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2007

Quelle

MEDLINE

Beschreibungen/Notizen

• Deranged protein metabolism is known to complicate uremia. Insulin resistance is evident in chronic hemodialysis (CHD) patients. We hypothesized that the degree of insulin resistance would predict protein catabolism in non-diabetic CHD patients. We examined the relationship between Homeostasis Model Assessment (HOMA) and fasting whole-body and skeletal muscle protein turnover in 18 non-diabetic CHD patients using primed-constant infusions of L-(1-13C) leucine and L-(ring-2H5) phenylalanine. Mean±s.d. fasting glucose and body mass index were 80.6±9.8mg/dl and 25.4±4.4kg/m2, respectively. Median (interquartile range) HOMA was 1.6 (1.4, 3.9). Mean±s.e.m. skeletal muscle protein synthesis, breakdown, and net balance were 89.57±11.67, 97.02±13.3, and -7.44±7.14μg/100ml/min, respectively. Using linear regression, a positive correlation was observed between HOMA and skeletal muscle protein synthesis (R2=0.28; P=0.024), and breakdown (R2=0.49; P=0.001). An inverse association between net skeletal muscle protein balance and HOMA was also noted (R2=0.20; P=0.066). After adjustment for C-reactive protein, only the relationship between HOMA and skeletal muscle protein breakdown persisted (R2=0.49; P=0.006). There were no significant associations between components of whole-body protein turnover and HOMA. This study demonstrates that insulin resistance is evident in non-diabetic dialysis patients, is associated with skeletal muscle protein breakdown, and represents a novel target for intervention in uremic wasting.