The variation of lipid in maintenance hemodialysis and the relationship with insulin resistance

Abstract

Objective To observe the fasting glucose,serum insulin and lipid level in maintenance hemodialysis,calculate the insulin resistance index(HOMA-IR) and the insulin sensitivity index(ISI) to evaluate the relationship with insulin resistance(IR),to carry out correlation analysis with the corresponding index of 30 health examinations.Methods Forty-eight maintenance hemodialysis patients(observation group) and 30 healthy volunteers(control group) were included in this study.Fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),fasting insulin(FIns),blood urea nitrogen(BUN),creatinine(Cr),uric acid(UA) and lipid indexes were measured,and the relationship of them analyzed.Results BUN,Cr,UA,FIns,HbA1c,FPG and HOMA-IR were significantly higher in patients than in controls,but total cholesterol(TC),high density lipid protein cholesterol(HDL-C) and low density lipid protein cholesterol(LDL-C) were significantly lower in controls,BUN(24.9±5.8) mmol/L vs(5.0±1.6) mmol/L(P0.05);Cr(820±222) μmol/L vs(73± 17) μmol/L(P0.05);UA(397±96) μmol/L vs(298±79) μmol/L(P0.05);FIns(16±11) mU/L vs(11± 5) mU/L(P0.05);FPG(6.1±1.6) mmol/L vs(5.1±0.6) mmol/L(P0.05);HOMA-IR 4.3±3.2 vs 2.4±1.2(P0.05);TC(4.2±1.2) mmol/L vs(5.3±1.1) mmol/L(P0.05);HDL-C(1.3±0.5) mmol/L vs(1.6±0.4) mmol/L(P0.01);LDL-C(3.0±1.0) mmol/L vs(4.1±1.1) mmol/L(P0.05).TC was negative correlated with FPG(r=-0.3482,P0.05).HDL-C was negative correlated with FIns(r=-0.2603,P0.05).LDL-C was negative correlated with FPG(r=-0.3289,P0.05),triglyceride was positively correlated with FPG and HOMA-IR(r=0.371,0.368,P0.05).Conclusion Lipid metabolic disorder existed in maintenance hemodialysis patients,HOMA-IR may participate in them.