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学科主题: 临床医学
题名:
Validation of insulin sensitivity surrogate indices and prediction of clinical outcomes in individuals with and without impaired renal function
作者: Jia, Ting1,2; Huang, Xiaoyan1,2,3; Qureshi, Abdul R.1,2; Xu, Hong1,2,4; Arnlov, Johan5,6; Lindholm, Bengt1,2; Cederholm, Tommy7; Stenvinkel, Peter1,2; Riserus, Ulf7; Carrero, Juan J.1,2,8
关键词: chronic kidney disease ; clinical outcome ; hyperinsulinemic ; euglycemic glucose clamp ; insulin resistance ; insulin sensitivity index ; mortality
刊名: KIDNEY INTERNATIONAL
发表日期: 2014-08-01
DOI: 10.1038/ki.2014.1
卷: 86, 期:2, 页:383-391
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: HOMEOSTASIS MODEL ASSESSMENT ; ORAL GLUCOSE-TOLERANCE ; CHRONIC KIDNEY-DISEASE ; INDEPENDENT RISK-FACTOR ; CARDIOVASCULAR-DISEASE ; NONDIABETIC SUBJECTS ; CATEGORICAL-DATA ; HEART-DISEASE ; CYSTATIN-C ; RESISTANCE
英文摘要:

As chronic kidney disease (CKD) progresses with abnormalities in glucose and insulin metabolism, commonly used insulin sensitivity indices (151s) may not be applicable in individuals with CKD. Here we sought to validate surrogate ISls against the glucose disposal rate by the gold-standard hyperinsulinemic euglycemic glucose clamp (HEGC) technique in 1074 elderly men of similar age (70 years) of whom 495 had and 579 did not have CKD (estimated glomerular filtration rate (eGFR) under 60 ml/min per 1.73 m2 (median eGFR of 46 ml/min per 1.73 m2)). All ISls provided satisfactory (weighted K over 0.6) estimates of the glucose disposal rate in patients with CKD. ISls derived from oral glucose tolerance tests (OGTTs) agreed better with HEGC than those from fasting samples (higher predictive accuracy). Regardless of CKD strata, all ISls allowed satisfactory clinical discrimination between the presence and absence of insulin resistance (glucose disposal rate under 4 mg/kg/min). We also assessed the ability of both HEGC and ISls to predict all-cause and cardiovascular mortality during a 10-year follow-up. Neither HEGC nor ISIs independently predicted mortality. Adjustment for renal function did not materially change these associations. Thus, ISls can be applied in individuals with moderately impaired renal function for diagnostic purposes. For research matters, OGTT-derived ISls may be preferred. Our data do not support the hypothesis of kidney function mediating insulin sensitivity (I5)-associated outcomes nor a role for IS as a predictor of mortality

语种: 英语
项目资助者: Baxter Healthcare Corporation ; Swedish Research Council ; Swedish Heart-Lung Foundation ; Marianne and Marcus Wallenberg foundation ; Excellence of Diabetes Research in Sweden (EXODIAB) ; Westman Foundation ; Centre for Gender Medicine ; Strategic Research Programme in Diabetes at Karolinska Institutet ; China Scholarship Council
WOS记录号: WOS:000339987700024
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54382
Appears in Collections:北京大学深圳医院_肾内科_期刊论文

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作者单位: 1.Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden
2.Karolinska Inst, Ctr Mol Med, SE-14186 Stockholm, Sweden
3.Karolinska Inst, Div Renal Med, Dept Clin Sci Intervent & Technol, SE-14186 Stockholm, Sweden
4.Karolinska Inst, Div Baxter Novum, Dept Clin Sci Intervent & Technol, SE-14186 Stockholm, Sweden
5.Peking Univ, Shenzhen Hosp, Div Nephrol, Shenzhen, Peoples R China
6.Beijing Union Med Coll Hosp, Div Renal Med, Beijing, Peoples R China
7.Uppsala Univ, Dept Publ Hlth & Caring Sci, Sect Geriatr, Uppsala, Sweden
8.Uppsala Univ, Dept Publ Hlth & Caring Sci Clin Nutr & Metab, Uppsala, Sweden

Recommended Citation:
Jia, Ting,Huang, Xiaoyan,Qureshi, Abdul R.,et al. Validation of insulin sensitivity surrogate indices and prediction of clinical outcomes in individuals with and without impaired renal function[J]. KIDNEY INTERNATIONAL,2014,86(2):383-391.
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