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Published on: October 12, 2017
Relationship between High-density Lipoprotein Cholesterol and Insulin Resistance in Non-diabetic Chronic Kidney
Yasser Abdel-Monem El-Hendy1, Mabrouk Ibrahim Ismail1, Maher Mohamed Borai2
1Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Insights
Insulin resistance is linked to cardiovascular disease (CVD) in chronic kidney disease (CKD) patients. Lower high-density lipoprotein cholesterol (HDL-C) is associated with higher insulin resistance, suggesting potential CVD prevention strategies.
Area of Science:
- Nephrology
- Cardiology
- Metabolic Syndrome
Background:
- Insulin resistance is a known risk factor for cardiovascular disease (CVD), a leading cause of mortality in chronic kidney disease (CKD).
- CKD disrupts high-density lipoprotein (HDL) metabolism, impairing its anti-inflammatory and cardioprotective functions.
- The interplay between HDL, insulin resistance, and inflammation in non-diabetic CKD patients requires further investigation.
Purpose of the Study:
- To investigate the relationship between HDL-C, insulin resistance, and inflammation in non-diabetic CKD patients across different treatment modalities.
- To compare these parameters between CKD patients and healthy controls.
Main Methods:
- Prospective, cross-sectional comparative study involving 80 participants: 20 healthy controls, 15 predialysis CKD patients, 10 peritoneal dialysis patients, and 35 hemodialysis patients.
- Data collection included medical history, physical examination, and laboratory investigations from June 2018 to June 2019.
Main Results:
- CKD patient groups exhibited significantly lower HDL-C levels and higher serum insulin compared to the control group.
- HDL-C showed a significant negative correlation with the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR).
- A strong inverse association was observed between HDL-C and insulin resistance in the studied CKD population.
Conclusions:
- Insulin resistance is significantly associated with reduced HDL-C in non-diabetic CKD patients.
- Targeting lifestyle modifications and dyslipidemia management in CKD patients may mitigate cardiovascular event risk.
- These interventions could be beneficial even in non-diabetic, non-obese CKD individuals.
Abstract:
Insulin resistance is linked to cardiovascular disease (CVD), even in non-diabetic patients. Therefore, insulin resistance contributes to the development of CVDs, which are the most important cause of morbidity and mortality in chronic kidney disease (CKD) and patients receiving dialysis replacement therapy. Furthermore, CKD greatly affects the enzyme activities responsible for the metabolism of high-density lipoprotein (HDL), causing an abnormal composition and function of HDL, which results in the loss of the anti-inflammatory effect of HDL and its protective effect against CVD. The study aimed to find the relationship between HDL-C, inflammation, and insulin resistance in nondiabetic CKD patients undergoing different modalities of treatment. This prospective cross-sectional comparative study included 80 subjects divided into the control group (20 healthy participants), Group 1 (15 predialysis CKD patients on conservative treatment), Group 2 (10 peritoneal dialysis patients), and Group 3 (35 hemodialysis patients). A full history, medical examination, and a laboratory investigation were carried out on all subjects from June 2018 to June 2019. The patient groups had significantly lower HDL and higher serum insulin than the control group. HDL was negatively correlated with the Homeostatic Model Assessment of Insulin Resistance. There was a strong negative association between HDL and insulin resistance in CKD patients. Therefore, lifestyle modifications and dyslipidemia treatment in CKD might help to prevent cardiovascular events even in nondiabetic nonobese CKD patients.
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