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Relationship between Abdominal Fat Accumulation and Insulin Resistance in Hemodialysis Patients

Hypertension Research volume 31, pages 83–88 (2008)Cite this article

Abstract

It is well known that obesity and insulin resistance are closely related to the development of type 2 diabetes. However, the exact pathogenic mechanism underlying the insulin resistance in renal disease has not been clarified. The purpose of the present study was to clarify the contribution of abdominal (visceral and subcutaneous) fat accumulation to insulin resistance and various clinical parameters, including C-reactive protein (CRP), in hemodialysis (HD) patients. Visceral and subcutaneous fat areas (VFA and SFA) were evaluated at the umbilical level by CT. Insulin resistance was estimated by the homeostasis model assessment−insulin resistance index (HOMA-IR) in 80 HD patients. Insulin resistance and CRP seemed to be closely correlated with fat-related parameters such as body mass index (BMI), VFA and SFA. HOMA-IR was positively correlated with BMI, VFA, SFA, triglycerides (TG), remnant-like particle (RLP)-cholesterol and CRP in simple regression analysis. In multiple stepwise regression analysis, SFA and RLP-cholesterol were predominant determinants of HOMA-IR in HD patients. Furthermore, CRP was positively correlated with BMI, VFA, SFA, TG, high-density lipoprotein (HDL)-cholesterol, atherosclerosis index (AI), immunoreactive insulin (IRI) and HOMA-IR in simple regression analysis. In multiple stepwise regression analysis, VFA and HDL-cholesterol were predominant determinants of CRP in HD patients. In conclusion, insulin resistance and CRP were related to fat-related parameters such as BMI, VFA and SFA in HD patients. Furthermore, the contribution of SFA to insulin resistance was much higher than that of VFA, while the opposite relation was recognized for CRP. (Hypertens Res 2008; 31: 83−88)

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Affiliations

  1. Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Tokyo, Japan

    Tomohito Gohda, Hiromichi Gotoh, Mitsuo Tanimoto, Michiko Sato, Hiroaki Io, Kayo Kaneko, Chieko Hamada & Yasuhiko Tomino

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  1. Tomohito Gohda
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  2. Hiromichi Gotoh
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  4. Michiko Sato
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  5. Hiroaki Io
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  8. Yasuhiko Tomino
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Correspondence to Yasuhiko Tomino.

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Gohda, T., Gotoh, H., Tanimoto, M. et al. Relationship between Abdominal Fat Accumulation and Insulin Resistance in Hemodialysis Patients. Hypertens Res 31, 83–88 (2008). https://doi.org/10.1291/hypres.31.83

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  • DOI: https://doi.org/10.1291/hypres.31.83

Keywords

  • abdominal adipose tissue
  • obesity
  • insulin resistance
  • C-reactive protein
  • hemodialysis

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