Association of insulin resistance with arterial stiffness in nondiabetic peritoneal dialysis patients

Int Urol Nephrol. 2012 Feb;44(1):255-62. doi: 10.1007/s11255-011-9984-z. Epub 2011 Jun 4.

Abstract

Background: Insulin resistance is a risk factor for cardiovascular morbidity and mortality in the general and end-stage renal disease populations. In this study, we investigated the association between insulin resistance and arterial stiffness in nondiabetic peritoneal dialysis (PD) patients.

Methods: Fifty-three patients were enrolled. Patients were divided into 2 groups as homeostasis model assessment of insulin resistance (HOMA-IR) ≤ 2.97 (low) and >2.97 (high). Carotid-femoral pulse wave velocity (c-f PWV) analysis and intima-media thickness of the carotid artery were measured.

Results: Mean age was 46 ± 12 years and HOMA-IR was 2.97 ± 1.77 (0.77-8.88). Mean c-f PWV was 7.6 ± 1.7 m/s. HOMA-IR was positively correlated with age, body mass index, and c-f PWV and negatively with serum HDL cholesterol and parathormone. In linear regression analysis, age and mean arterial pressure were predictors for c-f PWV. When patients were divided into 2 groups according to median age as ≤ 49 and >50, mean arterial pressure, male gender, and age were predictors for c-f PWV in patients aged ≤ 49, whereas HOMA-IR was the only predictor for c-f PWV in patients aged >50 years.

Conclusion: Insulin resistance is an independent risk factor for arterial stiffness in PD patients older than 50 years. IR is not associated with carotid intima-media thickness.

MeSH terms

  • Adult
  • Age Factors
  • Blood Flow Velocity
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Carotid Intima-Media Thickness*
  • Cholesterol, HDL / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Insulin Resistance*
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / physiopathology*
  • Kidney Failure, Chronic / therapy
  • Linear Models
  • Male
  • Middle Aged
  • Peritoneal Dialysis, Continuous Ambulatory
  • Pulsatile Flow
  • Risk Factors
  • Sex Factors
  • Vascular Stiffness*

Substances

  • Cholesterol, HDL