The Relationship Between Serum Adipokines and Glucose Homeostasis in Normal-Weight and Obese Patients on Hemodialysis: A Preliminary Study Publisher Pubmed

Summary: Insulin resistance in hemodialysis patients linked to adipokines. This study highlights ZAG and ATGL's roles in glucose management. How can this inform treatment strategies? #Diabetes #RenalHealth

Alipoor E^{1, 2} ; Yaseri M³ ; Mehrdadi P² ; Mahdavimazdeh M⁴ ; Murphy T⁵ ; Hosseinzadehattar MJ^{1, 6}
Source: International Urology and Nephrology Published:2020

Abstract

Purpose: Insulin resistance (IR) is a prevalent disorder in advanced renal failure irrespective of diabetes. Adipokines might play a role in IR, which has not been well-documented in uremic conditions. This study investigated the relationship of Zinc-α2-glycoprotein (ZAG), adipose triglyceride lipase (ATGL), and adipolin with glucose–insulin homeostasis in normal weight (NW) and obese (OB) patients with hemodialysis. Methods: In this cross-sectional study, 59 patients (29 NW; 18.5 ≤ BMI < 25 kg/m2, and 30 OB; BMI ≥ 30 kg/m2) were studied. Anthropometries, circulating ZAG, adipolin, ATGL, free fatty acids (FFAs), fasting blood glucose (FBG), insulin, and homeostasis model assessment of IR (HOMA)-IR were assessed. Results: There were no significant differences in age, gender, hemodialysis duration, dialysis adequacy and diabetes between the two groups. ZAG (100.9 ± 37.1 vs. 107.5 ± 30.5 ng/mL, P = 0.03) and adipolin (12.4 ± 1.6 vs. 13.2 ± 2.8 ng/mL, P = 0.002) concentrations were significantly lower, and FFAs (228.1 ± 112.6 vs. 185 ± 119 ng/mL, P = 0.014) were significantly higher in the OB than NW group. No significant differences were observed in ATGL, FBG, insulin and HOMA-IR between the two groups. Patients with lower IR had higher ZAG (112.9 ± 31.7 vs. 94.9 ± 34.5 ng/mL; P = 0.046), lower FFAs (167.8 ± 98.4 vs. 249.9 ± 120.8 ng/mL; P = 0.004), and marginally lower ATGL (9.1 ± 5.2 vs. 12.3 ± 9.6 mIU/mL; P = 0.079) concentrations than those with higher IR. ZAG was negatively (r = − 0.323, P = 0.018 and r = − 0.266, P = 0.054) and FFAs were positively (r = 0.321, P = 0.019 and r = 0.353, P = 0.009) correlated with insulin and HOMA-IR, respectively. ATGL was directly correlated with FFAs (r = 0.314, P = 0.018). Conclusions: Novel adipokines, ZAG and ATGL, might contribute to glucose–insulin homeostasis in hemodialysis. Understanding potential causative, diagnostic or therapeutic roles of adipokines in IR require further studies. © 2020, Springer Nature B.V.