Evidence map›Paper›PMID 26526047›Full record

Trial reportPeritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

Measurement and Correlation of Indices of Insulin Resistance in Patients on Peritoneal Dialysis.

Kelli R King-Morris, Serpil Muge Deger, Adriana M Hung, Phyllis Ann Egbert, Charles D Ellis, Amy Graves, Ayumi Shintani, T Alp Ikizler

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Insulin Resistance Is Associated with Interleukin 1β (IL-1β) in Non-Diabetic Hemodialysis Patients.Medical science monitor : international medical journal of experimental and clinical research · 2018
    Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kelli R King-MorrisVanderbilt University Medical Center, Nashville, Tennessee, USA.
Serpil Muge DegerVanderbilt University Medical Center, Nashville, Tennessee, USA.
Adriana M HungVanderbilt University Medical Center, Nashville, Tennessee, USA Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Phyllis Ann EgbertVanderbilt University Medical Center, Nashville, Tennessee, USA.
Charles D EllisVanderbilt University Medical Center, Nashville, Tennessee, USA.
Amy GravesVanderbilt University Medical Center, Nashville, Tennessee, USA.
Ayumi ShintaniVanderbilt University Medical Center, Nashville, Tennessee, USA.
T Alp IkizlerVanderbilt University Medical Center, Nashville, Tennessee, USA Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee, USA alp.ikizler@Vanderbilt.Edu.

Funding

Vanderbilt Diabetes Research CenterP30DK020593 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI OWEN P MCGUINNESS · 2012 to 2026
$29.3M
Structural Biology Facility CoreP30ES000267 · NIEHS · VANDERBILT UNIVERSITY · PI GUENGERICH, F PETER · 1985 to 2014
$20.3M
Vanderbilt O'Brien Mouse Kidney Physiology and Disease CenterP30DK079341 · NIDDK · VANDERBILT UNIVERSITY · PI HARRIS, RAYMOND C. · 2008 to 2013
$4.4M
Nutrition and Metabolism in Dialysis PatientsK24DK062849 · NIDDK · VANDERBILT UNIVERSITY · PI IKIZLER, TALAT ALP · 2003 to 2012
$1.6M
Dysmetabolism of Chronic Kidney Disease and Vascular HealthI01CX000982 · VA · VETERANS HEALTH ADMINISTRATION · PI HUNG, ADRIANA · 2015 to 2018
–
CSRD VA I01 CX000982NIDDK NIH HHS K24 DK062849NIDDK NIH HHS P30 DK020593NIDDK NIH HHS P30 DK079341NIEHS NIH HHS P30 ES000267
6 · The paper itself

Abstract

unlabelled♦

backgroundInsulin resistance (IR) is common in maintenance dialysis patients and is associated with excess mortality. Hyperinsulinemic euglycemic glucose clamp (HEGC) is the gold standard for measuring IR. There are limited studies using HEGC for comparison to other indirect indices of IR in peritoneal dialysis (PD) patients, nor have there been direct comparisons between patients receiving PD and those on maintenance hemodialysis (MHD) with regard to severity of IR, methods of measurement, or factors associated with the development of IR. ♦

methodsThis is a cross-sectional, single-center study performed in 10 prevalent PD patients of median age 48 years (range 41 - 54); 50% were female and 60% were African American. Insulin resistance was assessed by HEGC (glucose disposal rate [GDR]), homeostatic model assessment of IR (HOMA-IR), HOMA-IR corrected by adiponectin (HOMA-AD), leptin adiponectin ratio (LAR), quantitative insulin sensitivity check index (QUICKI), McAuley's index, and oral glucose tolerance test (OGTT) at each time point for a total of 18 studies. Retrospective analysis compared this cohort to 12 hemodialysis patients who had previously undergone similar testing. ♦

resultsThe median GDR was 6.4 mg/kg/min (interquartile range [IQR] 6.0, 7.8) in the PD cohort compared with the MHD group, which was 5.7 mg/kg/min (IQR 4.3, 6.6). For both the PD and MHD cohorts, the best predictors of GDR by HEGC after adjusting for age, gender, and body mass index (BMI), were HOMA-AD (PD: r = -0.69, p = 0.01; MHD: r = -0.78, p = 0.03) and LAR (PD: r = -0.68, p < 0.001; MHD: r = -0.65, p = 0.04). In both groups, HOMA-IR and QUICKI failed to have strong predictive value. Eight of 10 PD patients had at least 1 abnormal OGTT, demonstrating impaired glucose tolerance. ♦

conclusionsInsulin resistance is highly prevalent in PD patients. The adipokine based formulas, HOMA-AD and LAR, correlated well in both the PD and MHD populations in predicting GDR by HEGC, outperforming HOMA-IR. The use of these novel markers could be considered for large-scale, epidemiological outcome studies.

Indexed as

Insulin ResistancePeritoneal DialysisAdultCross-Sectional StudiesDialysis SolutionsFemaleGlucansGlucoseHumansIcodextrinKidney Failure, ChronicMaleMiddle AgedPredictive Value of TestsRetrospective StudiesDialysis SolutionsGlucansGlucoseIcodextrinatherosclerosisdialysisESRDHOMA-IRinsulin resistanceleptin-adiponectin ratioMetabolism

Identifiers

PMID26526047
PMCPMC4853288

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.