Insulin resistance is associated with new-onset cardiovascular events in nondiabetic patients undergoing peritoneal dialysis

Chang Yun Yoon, Mi Jung Lee, Youn Kyung Kee, Eunyoung Lee, Young Su Joo, In Mee Han, Seung Gyu Han, Hyung Jung Oh, Jung Tak Park, SeungHyeok Han, Shin-Wook Kang, TaeHyun Yoo

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Chronic exposure to high glucose-containing peritoneal dialysis solution and consequent abdominal obesity are potential sources of insulin resistance in patients requiring prevalent peritoneal dialysis. The aim of this study was to elucidate the prognostic values of insulin resistance on new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.

Methods A total of 201 nondiabetic patients undergoing prevalent peritoneal dialysis were recruited. Insulin resistance was assessed by homeostatic model assessment of insulin resistance (HOMA-IR). The primary outcome was new-onset cardiovascular events during the follow-up period. Cox proportional hazard analysis was performed to ascertain the independent prognostic value of HOMA-IR for the primary outcome.

Results The mean age was 53.1 years and male was 49.3% (n=99). The mean HOMA-IR was 2.6±2.1. In multivariate linear regression, body mass index (β=0.169, P=0.011), triglyceride level (β=0.331, P<0.001), and previous cardiovascular diseases (β=0.137, P=0.029) were still significantly associated with HOMA-IR. During a mean follow-up duration of 36.8±16.2 months, the primary outcome was observed in 36 patients (17.9%). When patients were divided into tertiles according to HOMA-IR, the highest tertile group showed a significantly higher incidence rate for new-onset cardiovascular events compared to the lower two tertile groups (P=0.029). Furthermore, multivariate Cox analysis revealed that HOMA-IR was an independent predictor of the primary outcome (hazard ratio=1.18, 95% confidence interval=1.03-1.35, P=0.014).

Conclusion Insulin resistance measured by HOMA-IR was an independent risk factor for new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.

Original languageEnglish
Pages (from-to)192-198
Number of pages7
JournalKidney Research and Clinical Practice
Volume33
Issue number4
DOIs
Publication statusPublished - 2014 Dec 1

Fingerprint

Peritoneal Dialysis
Insulin Resistance
Abdominal Obesity
Dialysis Solutions
Linear Models
Triglycerides
Body Mass Index
Cardiovascular Diseases
Multivariate Analysis
Confidence Intervals
Glucose

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Urology

Cite this

Yoon, Chang Yun ; Lee, Mi Jung ; Kee, Youn Kyung ; Lee, Eunyoung ; Joo, Young Su ; Han, In Mee ; Han, Seung Gyu ; Oh, Hyung Jung ; Park, Jung Tak ; Han, SeungHyeok ; Kang, Shin-Wook ; Yoo, TaeHyun. / Insulin resistance is associated with new-onset cardiovascular events in nondiabetic patients undergoing peritoneal dialysis. In: Kidney Research and Clinical Practice. 2014 ; Vol. 33, No. 4. pp. 192-198.
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title = "Insulin resistance is associated with new-onset cardiovascular events in nondiabetic patients undergoing peritoneal dialysis",
abstract = "Background Chronic exposure to high glucose-containing peritoneal dialysis solution and consequent abdominal obesity are potential sources of insulin resistance in patients requiring prevalent peritoneal dialysis. The aim of this study was to elucidate the prognostic values of insulin resistance on new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.Methods A total of 201 nondiabetic patients undergoing prevalent peritoneal dialysis were recruited. Insulin resistance was assessed by homeostatic model assessment of insulin resistance (HOMA-IR). The primary outcome was new-onset cardiovascular events during the follow-up period. Cox proportional hazard analysis was performed to ascertain the independent prognostic value of HOMA-IR for the primary outcome.Results The mean age was 53.1 years and male was 49.3{\%} (n=99). The mean HOMA-IR was 2.6±2.1. In multivariate linear regression, body mass index (β=0.169, P=0.011), triglyceride level (β=0.331, P<0.001), and previous cardiovascular diseases (β=0.137, P=0.029) were still significantly associated with HOMA-IR. During a mean follow-up duration of 36.8±16.2 months, the primary outcome was observed in 36 patients (17.9{\%}). When patients were divided into tertiles according to HOMA-IR, the highest tertile group showed a significantly higher incidence rate for new-onset cardiovascular events compared to the lower two tertile groups (P=0.029). Furthermore, multivariate Cox analysis revealed that HOMA-IR was an independent predictor of the primary outcome (hazard ratio=1.18, 95{\%} confidence interval=1.03-1.35, P=0.014).Conclusion Insulin resistance measured by HOMA-IR was an independent risk factor for new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.",
author = "Yoon, {Chang Yun} and Lee, {Mi Jung} and Kee, {Youn Kyung} and Eunyoung Lee and Joo, {Young Su} and Han, {In Mee} and Han, {Seung Gyu} and Oh, {Hyung Jung} and Park, {Jung Tak} and SeungHyeok Han and Shin-Wook Kang and TaeHyun Yoo",
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Insulin resistance is associated with new-onset cardiovascular events in nondiabetic patients undergoing peritoneal dialysis. / Yoon, Chang Yun; Lee, Mi Jung; Kee, Youn Kyung; Lee, Eunyoung; Joo, Young Su; Han, In Mee; Han, Seung Gyu; Oh, Hyung Jung; Park, Jung Tak; Han, SeungHyeok; Kang, Shin-Wook; Yoo, TaeHyun.

In: Kidney Research and Clinical Practice, Vol. 33, No. 4, 01.12.2014, p. 192-198.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Insulin resistance is associated with new-onset cardiovascular events in nondiabetic patients undergoing peritoneal dialysis

AU - Yoon, Chang Yun

AU - Lee, Mi Jung

AU - Kee, Youn Kyung

AU - Lee, Eunyoung

AU - Joo, Young Su

AU - Han, In Mee

AU - Han, Seung Gyu

AU - Oh, Hyung Jung

AU - Park, Jung Tak

AU - Han, SeungHyeok

AU - Kang, Shin-Wook

AU - Yoo, TaeHyun

PY - 2014/12/1

Y1 - 2014/12/1

N2 - Background Chronic exposure to high glucose-containing peritoneal dialysis solution and consequent abdominal obesity are potential sources of insulin resistance in patients requiring prevalent peritoneal dialysis. The aim of this study was to elucidate the prognostic values of insulin resistance on new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.Methods A total of 201 nondiabetic patients undergoing prevalent peritoneal dialysis were recruited. Insulin resistance was assessed by homeostatic model assessment of insulin resistance (HOMA-IR). The primary outcome was new-onset cardiovascular events during the follow-up period. Cox proportional hazard analysis was performed to ascertain the independent prognostic value of HOMA-IR for the primary outcome.Results The mean age was 53.1 years and male was 49.3% (n=99). The mean HOMA-IR was 2.6±2.1. In multivariate linear regression, body mass index (β=0.169, P=0.011), triglyceride level (β=0.331, P<0.001), and previous cardiovascular diseases (β=0.137, P=0.029) were still significantly associated with HOMA-IR. During a mean follow-up duration of 36.8±16.2 months, the primary outcome was observed in 36 patients (17.9%). When patients were divided into tertiles according to HOMA-IR, the highest tertile group showed a significantly higher incidence rate for new-onset cardiovascular events compared to the lower two tertile groups (P=0.029). Furthermore, multivariate Cox analysis revealed that HOMA-IR was an independent predictor of the primary outcome (hazard ratio=1.18, 95% confidence interval=1.03-1.35, P=0.014).Conclusion Insulin resistance measured by HOMA-IR was an independent risk factor for new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.

AB - Background Chronic exposure to high glucose-containing peritoneal dialysis solution and consequent abdominal obesity are potential sources of insulin resistance in patients requiring prevalent peritoneal dialysis. The aim of this study was to elucidate the prognostic values of insulin resistance on new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.Methods A total of 201 nondiabetic patients undergoing prevalent peritoneal dialysis were recruited. Insulin resistance was assessed by homeostatic model assessment of insulin resistance (HOMA-IR). The primary outcome was new-onset cardiovascular events during the follow-up period. Cox proportional hazard analysis was performed to ascertain the independent prognostic value of HOMA-IR for the primary outcome.Results The mean age was 53.1 years and male was 49.3% (n=99). The mean HOMA-IR was 2.6±2.1. In multivariate linear regression, body mass index (β=0.169, P=0.011), triglyceride level (β=0.331, P<0.001), and previous cardiovascular diseases (β=0.137, P=0.029) were still significantly associated with HOMA-IR. During a mean follow-up duration of 36.8±16.2 months, the primary outcome was observed in 36 patients (17.9%). When patients were divided into tertiles according to HOMA-IR, the highest tertile group showed a significantly higher incidence rate for new-onset cardiovascular events compared to the lower two tertile groups (P=0.029). Furthermore, multivariate Cox analysis revealed that HOMA-IR was an independent predictor of the primary outcome (hazard ratio=1.18, 95% confidence interval=1.03-1.35, P=0.014).Conclusion Insulin resistance measured by HOMA-IR was an independent risk factor for new-onset cardiovascular events in nondiabetic patients undergoing prevalent peritoneal dialysis.

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U2 - 10.1016/j.krcp.2014.10.002

DO - 10.1016/j.krcp.2014.10.002

M3 - Article

VL - 33

SP - 192

EP - 198

JO - Kidney Research and Clinical Practice

JF - Kidney Research and Clinical Practice

SN - 2211-9132

IS - 4

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