ESPN 54th Annual Meeting

ESPN 2022


 
Insulin sensitivity in children with Autosomal Dominant Polycystic Kidney Disease
DACHY ANGéLIQUE 1 DE RECHTER STéPHANIE 2 BREYSEM LUC 3 VENNEKENS RUDI 4 MATHIEU CHANTAL 5 CASTEELS KRISTINA 6 VAN HOORENBEECK KIM 7 JOURET FRANÇOIS 8 MEKAHLI DJALILA 2

1- KU LEUVEN, DEPARTMENT OF DEVELOPMENT AND REGENERATION, PKD RESEARCH GROUP, LABORATORY OF PEDIATRIC NEPHROLOGY, KU LEUVEN, LEUVEN, BELGIUM
2- DEPARTMENT OF PEDIATRIC NEPHROLOGY, UNIVERSITY HOSPITALS LEUVEN, LEUVEN, BELGIUM
3- DEPARTMENT OF PEDIATRIC RADIOLOGY, UNIVERSITY HOSPITALS LEUVEN, LEUVEN, BELGIUM
4- LABORATORY OF ION CHANNEL RESEARCH, DEPARTMENT OF CELLULAR AND MOLECULAR MEDICINE, VIB CENTER FOR BRAIN AND DISEASE RESEARCH, KU LEUVEN, LEUVEN, BELGIUM
5- DEPARTMENT OF ENDOCRINOLOGY, UNIVERSITY HOSPITALS LEUVEN, LEUVEN, BELGIUM
6- DEPARTMENT OF PEDIATRICS, UNIVERSITY HOSPITALS LEUVEN, LEUVEN, BELGIUM
7- DEPARTMENT OF PEDIATRICS, UNIVERSITY HOSPITAL OF ANTWERP, ANTWERP, BELGIUM
8- DIVISION OF NEPHROLOGY, DEPARTMENT OF INTERNAL MEDICINE, ULIèGE ACADEMIC HOSPITAL, LIèGE, BELGIUM
 
Introduction:

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most common inherited kidney disorder. Defective glucose metabolism was identified as a key feature in ADPKD, and several ‘metabolic’ approaches are currently under evaluation in adults with ADPKD. Whether this defective glucose metabolism could be an early primary event and a potential therapeutic option in the early disease stages is still unknown. In this study, we evaluated the insulin sensitivity profile in genotyped children with ADPKD.

Material and methods:

We performed a cross-sectional study to evaluate the insulin sensitivity profile in a genotyped cohort of ADPKD children (<19 years) with preserved renal function (eGFR>60 ml/min/1.73m2). Overweight/obese children were respectively defined as body mass index (BMI) 25-30 and >30 kg/m2. The Homeostasis Model Assessment Index (HOMA-IR) was calculated: fasting insulin (μIU/ml− 1) x fasting glucose (mmol/l− 1)/22.5. The Quantitative Insulin Sensitivity Check Index (QUICKI) was calculated: 1/(log (fasting insulin μU/mL) + log(fasting glucose mg/dl)).

 

Results:

37 ADPKD patients (22 boys) were included with a mean (+/-SD) age at diagnosis of 10.3 ±4.2 years. 36 patients had PKD1 mutation (one GANAB mutation). Median BMI was 16.8 ±4.3 kg/m2. Median serum fasting glucose: 86.0 ± 9.3 mg/dl, median fasting insulin: 6.1 ±7.2 μU/ml and median serum C-peptide: 0.4 ±0.3 nmol/l. Median HOMA-IR was 1.4 ±1.7 and median QUICKI was 0.4 ±0.1. 16 patients presented a HOMA-IR>1.6 and 6 normal-weight children had a HOMA-IR >2.3. No patient displayed glucosuria. An oral glucose tolerance test was performed on 5 overweight patients, 4 of them showed insulin resistance and were treated with metformin.

Conclusions:

Even with normal BMI, ADPKD children displayed high index of insulin resistance. Further clinical studies are needed to determine whether ADPKD could be an additional risk factor for insulin resistance.