Insulin Resistance and Cardiovascular Risks in Different Groups of Hemodialysis Patients: A Multicenter Study

Biomed Res Int. 2019 Jun 11:2019:1541593. doi: 10.1155/2019/1541593. eCollection 2019.

Abstract

Background: To investigate the association between insulin resistance (IR) and cardiovascular disease (CVD) risks among hemodialysis patients.

Methods: We conducted a cross-sectional study between 2013 and 2017, on 384 hemodialysis patients from seven hospital-based-dialysis centers. HOMA-IR is classified according to median value. The CVD risks were defined by the K/DOQI Guidelines. Logistic regression analysis was used.

Results: Patients' age was 60.9 ± 11.8, 58.1% men, and 40.3% overweight/obese. The median of HOMA-IR was 5.4, 82.8% high systolic blood pressure, and 85.7% hyperhomocysteinemia. In multivariate analysis, IR was significantly associated with higher odds of low high-density lipoprotein cholesterol, high triglyceride, and impaired fasting glucose in groups of normal weight, overweight/obese, nondiabetes, diabetes, and overall sample. IR linked with elevated high-sensitive C-reactive protein in normal weight patients (odd ratio, OR=2.21, 95% confidence interval, 1.16-4.22, p < .05), with hypoalbuminemia in normal weight patients (OR=8.31, 95% CI, 2.35-29.37, p < .01), in nondiabetes patients (OR=6.59, 95% CI, 1.81-23.95, p < .01), and overall sample (OR=3.07, 1.51-6.23, p < .01).

Conclusions: The level of IR and prevalence of CVD risks were high in hemodialysis patients. IR was independently associated with CVD risks.

Publication types

  • Multicenter Study

MeSH terms

  • Blood Pressure / physiology
  • Body Mass Index
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Insulin / blood
  • Insulin Resistance / physiology*
  • Male
  • Metabolic Diseases / blood
  • Metabolic Diseases / etiology
  • Middle Aged
  • Obesity / blood
  • Obesity / complications
  • Overweight / blood
  • Overweight / complications
  • Renal Dialysis / methods
  • Risk Factors
  • Triglycerides / blood

Substances

  • Insulin
  • Triglycerides