Association between HOMA-IR with ketoacidosis and lipid profile markers in diabetic nephropathy patients

Zrar Saleem Kareem Almarzany

doi:10.21271/ZJPAS.33.2.6

Authors

Zrar Saleem Kareem Almarzany Department of Biology, Faculty of Science and Health, Koya University Koya KOY45, Kurdistan Region – F.R. Iraq

DOI:

https://doi.org/10.21271/ZJPAS.33.2.6

Keywords:

Insulin resistance, ketoacidosis, hyperlipidemia, NIDDM, ESRD, Diabetic nephropathy.

Abstract

The study designed to study the relationship between the homeostatic model assessment of insulin resistance (HOMA-IR) with ketoacidosis markers and hyperlipidemia in patients with non-insulin-dependent diabetes mellitus (NIDDM) and chronic kidney disease at end-stage renal disease (ESRD). Disturbance of the mechanisms which maintain normal blood pH and lipid profiles is a defining feature of chronic metabolic diseases such as diabetes and kidney failure. The present research included 90 patients and 30 healthy subjects. Serum insulin, fasting blood sugar (FBS), glycated hemoglobin % (HbA1c %) and HOMA-IR levels, lipid profile parameters and ketoacidosis markers were estimated in all groups. Statistical analysis showed that high HOMA-IR was significantly associated with lipid profiles and ketoacidosis markers in patients' groups when compared with control. Receiver operating characteristic (ROC) curve analysis investigated HOMA-IR as a significant risk factor for diabetic nephropathy (DN) in ESRD patients. The present finding regarding ROC curve analysis observed that IR is dependently associated with ketoacidosis and lipid profile abnormalities in NIDDM, ESRD and DN patients. Also, the study suggested HOMA-IR as a consequence and risk factor in DN at ESRD.

References

BIANCHI, S., BARONTI, A., COMINOTTO, R. & BIGAZZI, R. 2016. Lipid metabolism abnormalities in Chronic Kidney Disease. Giornale italiano di nefrologia. organo ufficiale della Societa italiana di nefrologia. 33(68).40-47.

CHEN, S., CHEN, Y., LIU, X., LI, M., WU, B., LI, Y., LIANG, Y., SHAO, X., HOLTHOFER, H. & ZOU, H. 2013. Association of insulin resistance with chronic kidney disease in non-diabetic subjects with normal weight. Plos One. 8 (9): 58-66.

CHEN, W. & ABRAMOWITZ, M.K. 2014. Metabolic acidosis and the progression of chronic kidney disease. BMC Nephrology. 15 (1): 55-61.

DOBRE, M., RAHMAN, M. & HOSTETTER, T.H. 2015. Current status of bicarbonate in CKD. Journal of the American Society of Nephrology. 26 (3): 515 - 523.

DOMINGUETI, C.P., DUSSE, L.M.S.A., DAS-GRACAS, S., CARVALHO, M., DE-SOUSA, L.P., GOMMES, K.B. & FRNANDES, A.P. 2016. Diabetes mellitus: the linkage between oxidative stress, inflammation, hypercoagulability and vascular complications. Journal of Diabetes and Its Complications. 30 (4): 738-745.

FILIPPONE, E.J., GUPTA, A. & FARBER, J.L. 2014. Normoglycemic diabetic nephropathy: the role of insulin resistance. Case Reports in Nephrology and Dialysis. 4(2): 137-143.

GUTHOFF, M., WAGNER, R., VOSSELER, D., PETER, A., NADALIN, S., HARIMG, H.U., FRITSCHE, A. & HEYNE, N. 2017. Impact of end-stage renal disease on glucose metabolism-a matched cohort analysis. Nephrology Dialysis Transplantation.32 (4): 670-676.

MAJEED, Z.R., FIRAS, K. Q., & HEDY, A. H. 2019. Hypotensive action of pomegranate seed extract and zinc chloride in hypertensive rats. The official scientific journal of Salahaddin University-Erbil. ZANCO Journal of Pure and Applied Sciences. 31(5):44-52.

MIKOLASEVIC, I., ZUTELIJA, M., MAVRINAC, V. & ORLIC, L. 2017. Dyslipidemia in patients with chronic kidney disease: etiology and management. International Journal of Nephrology and Renovascular Disease. 10 (3): 35-46.

MOTTALIB, A., TOMAH, S., HAFIDA, S., ELSEAIDY, T., KASETTY, M., ASHRAFZADEH, S. & HAMDY, O. 2019. Intensive multidisciplinary weight management in patients with type 1 diabetes and obesity: A one‐year retrospective matched cohort study. Diabetes, Obesity and Metabolism. 21 (1): 37-42.

ROSENSTOCK, J. & FERRANNINI, E. 2015. Euglycemic diabetic ketoacidosis: a predictable, detectable, and preventable safety concern with SGLT2 inhibitors. Diabetes Care. 38 (9): 1638-1642.

SCHAAPYELD-DAVIS, C.M., NEGRETE, A.L., HUDSON, J.Q., SAIKUMAR, J., FINCH, C.K., KOCCAK, M., HU, P. & VAN-BERKEL, M.A. 2017. End-Stage Renal Disease Increases Rates of Adverse Glucose Events When Treating Diabetic Ketoacidosis or Hyperosmolar Hyperglycemic State. Clinical Diabetes.35 (4): 202-208.

SCHEMBOLAN, M., KATUNA, B.A. & ARTEAGA, E. 2011. Aldosteronel hormone secretory response to chronic NH4Cl-stimulated acidosis. American Journal physiology.294 (5): 324–331.

SCHRAUBEN, S.J., JEPSON, C., HSU, J.Y., WILSON, F.P., ZHANG, X., LASH, J.P., ROBINSON, B.M., TOWNSEND, R.R., CHEN, J., FOGELFELD, L. & KAO, P. 2019. Insulin resistance and chronic kidney disease progression, cardiovascular events, and death: findings from the chronic renal insufficiency cohort study. BMC Nephrology. 20(1), pp.1-11.

SHANG, J., YU, D., CAI, Y., WANG, Z., ZHAO, B., ZHAO, Z. & SIMMONS, D. 2019. The triglyceride glucose index can predict newly diagnosed biopsy-proven diabetic nephropathy in type 2 diabetes: A nested case control study. Medicine. 98(46).

SHEKHANE, B. S. I. & MUSLIH, A. I. 2019. The Influence of carbimazole on serum leptin hormone and insulin resistance in patients with hyperthyroidism. The official scientific journal of Salahaddin University-Erbil. ZANCO Journal of Pure and Applied Sciences. 31 (4): 23-35

YU, X., ZHANG, S. & ZHANG, L. 2018. Newer perspectives of mechanisms for euglycemic diabetic ketoacidosis. International Journal of Endocrinology. 16 (6): 323-332.

ZHANG, L., YUAN, Z., CHEN, W., CHEN, S., LIU, X., LIANG, Y., SHAO, X. & ZOU, H. 2014. Serum lipid profiles, lipid ratios and chronic kidney disease in a Chinese population. International Journal of Environmental Research and Public Health. 11 (8): 7622-7635.

ZHOU, C., MOORE, L., YOOL, A., JAUNZEMS, A. & BYARD, R.W. 2015. Renal tubular epithelial vacuoles-a marker for both hyperlipidemia and ketoacidosis at autopsy. Journal of Forensic Sciences. 60(3), pp.638-641.