ESPN 54th Annual Meeting

ESPN 2022


 
The Relationship Between Insulin Resistance and Serum Adipokine Levels in Children with Chronic Renal Disease Receiving Peritoneal Dialysis
CEREN BILGÜN 1 NURDAN YILDIZ 2 ALI YAMAN 3 GONCAGUL USTUNEL HAKLAR 3 HARIKA ALPAY 2

1- MARMARA UNIVERSITY, MEDICAL SCHOOL, DIVISION OF PEDIATRICS
2- MARMARA UNIVERSITY, MEDICAL SCHOOL, DIVISION OF PEDIATRIC NEPHROLOGY
3- MARMARA UNIVERSITY, MEDICAL SCHOOL, DIVISION OF BIOCHEMISTRY
 
Introduction:

 Adipose tissue secretes adipokines which have important metabolic and endocrine functions.In chronic kidney disease(CKD), insulin resistance (IR) and malnutrition increase morbidity and mortality by increasing the risk of cardiovascular diseases.

We aimed to evaluate IR,its relationship with adiponectin and resistin in peritoneal dialysis(PD) and predialysis stage 2-4 CKD patients, and to investigate the relationship of IR with peritoneal transport properties and body composition.

Material and methods:

 Twenty PD, 20 CKD patients and 40 healthy children were included in this prospective cohort study.Demographic, clinical and laboratory findings were recorded from the medical files. Anthropometric measurements and bioimpedance analysis were performed.Serum insulin, adiponectin and resistin levels were measured. HOMA-IR and HOMA-AD were calculated for all groups.

Results:

 The mean adiponectin levels were 281.6±74.9 ng/mL in PD, 172.3±81.2 in CKD patients and 112.2±57.8 ng/mL in controls. The mean resistin levels in PD, CKD patients and controls were 5.5±2.1, 3.8±1.5 and 1.3±0.5,respectively. Resistin and adiponectin levels were higher in PD patients compared to CKD(p=0.006 and <0.001) and controls(p=<0.001 and < 0.001). There was negative correlation between resistin and e-GFR whereas no significant relation was observed between adiponectin and e-GFR.

Insulin resistance was found in 5(%25) PD,13( %65) CKD patients and 19(%47.5) controls whose HOMA-IR>2.5. HOMA-IR were higher in CKD patients than PD(p=0.018).However, it was ​​ not different in PD and CKD patients compared to controls(p>0.05).Resistin was not associated with IR in PD and CKD patients(p>0.05). There was no significant correlation between Kt/v and anthropometric measurements, insulin, HOMA-IR, HOMA-AD, resistin, adiponectin in PD patients(p>0.05).

Conclusions:

 Insulin resistance may develop in PD patients and in the early stages of CKD, and should be closely monitored to reduce cardiovascular disease in adult life.Resistin is not a good marker to determine IR in children with PD and CKD.Studies with larger series are needed to evaluate the relationship between inflammation, IR and adipokines.