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Glucose intolerance: is it a risk factor for cardiovascular disease in children with chronic kidney disease?

Nur Canpolat1, Salim Caliskan, Lale Sever

  • 1Department of Pediatric Nephrology, Cerrahpasa Faculty of Medicine, Istanbul University, 34098 Istanbul, Turkey. ncanpolat2000@hotmail.com

Pediatric Nephrology (Berlin, Germany)
|October 11, 2011
PubMed

Insights

Children with chronic kidney disease (CKD) face high risks of abnormal glucose metabolism and subclinical cardiovascular disease (CVD). However, glucose intolerance is not an independent risk factor for increased carotid artery intima-media thickness or left ventricular hypertrophy.

Area of Science:

  • Pediatrics
  • Nephrology
  • Endocrinology

Background:

  • Chronic kidney disease (CKD) in children and adolescents is associated with metabolic and cardiovascular complications.
  • Early detection of glucose metabolism abnormalities and subclinical cardiovascular disease (CVD) is crucial in pediatric CKD patients.

Purpose of the Study:

  • To investigate the prevalence of glucose and insulin metabolism abnormalities in children and adolescents with CKD.
  • To assess the association between these metabolic abnormalities and early markers of CVD, specifically carotid artery intima-media thickness (IMT) and left ventricular hypertrophy (LVH).

Main Methods:

  • Sixty-six children and adolescents with CKD (20 pre-dialysis, 46 dialysis) were evaluated.
  • Oral glucose tolerance tests assessed glucose intolerance; homeostasis model assessment of insulin resistance (HOMA-IR) estimated insulin resistance.
  • Carotid artery IMT and LVH were measured as CVD markers.

Main Results:

  • Abnormal glucose tolerance was observed in 34 patients (51.5%), while 10 patients (15.2%) had insulin resistance.
  • Elevated carotid artery IMT was found in 15% of pre-dialysis and 74% of dialysis patients.
  • LVH was present in 35% of pre-dialysis and 74% of dialysis patients, with severe LVH more common in pre-dialysis patients with glucose intolerance (p=0.042).
  • Multivariate analyses did not identify serum glucose or HOMA-IR as predictors of carotid artery IMT or LVH.

Conclusions:

  • Children and adolescents with CKD exhibit a high prevalence of glucose intolerance and subclinical CVD.
  • Glucose intolerance did not emerge as an independent risk factor for increased carotid artery IMT or LVH in this cohort.
  • Further research is needed to elucidate the complex interplay between CKD, metabolic disturbances, and cardiovascular risk in pediatric populations.

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