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Study of markers of atherosclerosis including insulin resistance in patients with chronic renal failure

Journal of Diabetes Mellitus 2012年第2期2卷 208-213页

作者： M. V. Chandrakanth Sidhartha Das Shashi Bhusan Rout Rina Mohanty Sharat Chandra Singh Madhusmita Pattnaik bibuthi sethy Department of Nephrology Sriram Chandra Bhanj Medical College Cuttack India Postgraduate Department of Medicine Sriram Chandra Bhanj Medical College Cuttack India

Objectives: The present study was designed to assess the markers of atherosclerosis including Insulin resistance (IR) in na?ve patients with chronic renal failure (CRF). Methods: Eighty consecutive na?ve patients with CRF were taken up for study. They were divided into non-diabetic group, Group A (N = 50) and diabetic group, Group B (N = 30). Twenty healthy individuals were taken as controls, Group C (N = 20). Patients undergoing renal replacement therapy, having chronic liver disease and with concomitant acute or chronic infection were excluded from the study. Routine hemogram, fasting plasma glucose, fasting serum insulin ,lipid profile, renal function tests, C-reactive protein (CRP), serum uric acid levels, ultrasound of abdomen and ultrasound B scan for carotid intima medial thickness (CIMT) were done for all patients and control. The data collected were analyzed to inter-correlate the parameters using SPSS 16. Results: On comparing parameters between the three groups, values of HOMA-IR, CRP, uric acid, VLDL and CIMT were significantly higher in Groups A and B than Group C whereas values of HOMA-B, HDL and LDL were lower in both groups A and Bas compared to group C. HOMA-IR had significant negative correlation with creatinine clearance (Crcl) (r = -0.449, p = 0.01) in Group A and (r = -0.483, p = 0.007) in Group B. HOMA-IR had significant positive correlation with CIMT (r = 0.413, p = 0.03) in Group A and (r = 0.581, p = 0.001) in Group B. Crcl had significant negative correlation with CIMT(r = -0.375, p = 0.007) in Group A and (r = -0.705, p = 0.001) in Group B. Crclnegatively correlated with C-reactive protein (r = -0.460, p = 0.001) in Group A and (r = 0.431, p = 0.01) in Group B. HOMA-B positively correlated with Crcl (r = 0.667, p = 0.001) and also with CIMT (r = -0.531, p = 0.003) among Group B individuals. Conclusion: There is a significant increase in insulin resistance (IR) and β cell dysfunction in patients with CRF. Also IR linearly increases with red

关键词： CKD CRF CrCl Atherosclerosis HOMA-IR HOMA-B CRP CIMT

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