Rosiglitazone improves glucose metabolism in nondiabetic uremic patients on CAPD

Shih H. Lin, Yuh Feng Lin, Shi W. Kuo, Yu Juei Hsu, Yi J. Hung

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: Insulin resistance, a strong risk factor for atherosclerotic vascular disease, is present in uremic patients without diabetes on continuous ambulatory peritoneal dialysis (CAPD) therapy. Amelioration of insulin resistance may reduce associated long-term cardiovascular complications. The aim of the study is to investigate the effects of rosiglitazone (ROS), an insulin sensitizer, on glucose metabolism in CAPD patients without diabetes. Methods: Fifteen uremic patients without diabetes on CAPD therapy were enrolled. All were administered ROS, 4 mg/d, for 12 weeks. A control group consisted of 15 age- and sex-matched healthy subjects. Oral glucose tolerance test (OGTT) results, fasting glucose and insulin levels, related blood biochemistry results, and C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were determined before initiation and at 4 and 12 weeks of therapy. Insulin resistance was evaluated using the homeostasis model assessment method (HOMA-IR). A whole-body insulin sensitivity index (ISI) and insulinogenic index for insulin production were calculated from OGTT results. Results: CAPD patients showed significantly greater HOMA-IR and glucose intolerance compared with healthy controls. After 4 and 12 weeks of ROS therapy, there were no significant changes in body weight, blood pressure, dialysis adequacy, hemoglobin level, hemoglobin A1c level, liver function, lipid profile, or intact parathyroid hormone, CRP, IL-6, or TNF-α levels. There was a significant decrease in HOMA-IR (3.2 ± 0.6, 2.2 ± 0.4, and 2.1 ± 0.4; P <0.05). During the OGTT, there was a significant decrease in the area under the glucose curve and a significant increase in ISI (3.5 ± 0.4, 5.0 ± 0.7, and 5.3 ± 0.7; P <0.05), but no significant change in insulinogenic index. Conclusion: ROS improved insulin resistance in CAPD patients without diabetes. Whether long-term use of ROS reduces cardiovascular risk needs further study.

Original languageEnglish
Pages (from-to)774-780
Number of pages7
JournalAmerican Journal of Kidney Diseases
Volume42
Issue number4
DOIs
Publication statusPublished - Oct 1 2003
Externally publishedYes

Fingerprint

rosiglitazone
Continuous Ambulatory Peritoneal Dialysis
Insulin Resistance
Glucose
Glucose Tolerance Test
Insulin
C-Reactive Protein
Interleukin-6
Hemoglobins
Tumor Necrosis Factor-alpha
Body Weight Changes
Glucose Intolerance
Therapeutics
Parathyroid Hormone
Vascular Diseases
Biochemistry
Area Under Curve
Dialysis
Fasting
Healthy Volunteers

Keywords

  • Continuous ambulatory peritoneal dialysis (CAPD)
  • Glucose tolerance
  • Insulin resistance
  • Rosiglitazone (ROS)
  • Uremia

ASJC Scopus subject areas

  • Nephrology

Cite this

Rosiglitazone improves glucose metabolism in nondiabetic uremic patients on CAPD. / Lin, Shih H.; Lin, Yuh Feng; Kuo, Shi W.; Hsu, Yu Juei; Hung, Yi J.

In: American Journal of Kidney Diseases, Vol. 42, No. 4, 01.10.2003, p. 774-780.

Research output: Contribution to journalArticle

Lin, Shih H. ; Lin, Yuh Feng ; Kuo, Shi W. ; Hsu, Yu Juei ; Hung, Yi J. / Rosiglitazone improves glucose metabolism in nondiabetic uremic patients on CAPD. In: American Journal of Kidney Diseases. 2003 ; Vol. 42, No. 4. pp. 774-780.
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