ความชุกของภาวะดื้อต่ออินสูลินในผู้ป่วยโรคไตเรื้อรังที่ไม่ได้เป็นเบาหวานชาวไทย

Abstract

Background: Insulin resistance may predispose to renal injury by worsening renal hemodynamics through the elevation of glomerular filtration fraction (GFR). However there are sparse data on the prevalence of insulin resistancein non-diabetes chronic kidney disease (CKD) among Thai population. Methods: The authors screened 79 non-diabetic CKD patients according to the K/DOQI definitions and the patients were enrolled into the study (CKD stages 2-4  GFR between 15 and 90 ml/min/1.73 m2). Insulin resistance was evaluated by homeostasis model assessment (HOMA-IR). Fasting plasma glucose and insulin levels were collected. Results: The mean age of patients were 59 years. Most patients were male (69.8%). The major cause of CKD in the present study was hypertension (63.3%). The mean HOMA-IR and fasting plasma insulin levels were 2.27 ± 2.12 and 10.10 ± 10.12 mU/mL, respectively. Insulinresistance was found in 52/79 patients (65.82%). Prevalence of insulin resistance in non diabetes CKD stage 2 (GFR60-89 mL/min/1.73 m2), stage 3 (GFR 30-59 mL/min/1.73 m2) and stage 4 (GFR 15-29 mL/min/1.73 m2) were 80.00% 67.70% and 65.10% respectively. Conclusion: The present study showed the high prevalence of insulin resistancein non-diabetic CKD patients of Thai population. Thus this data is a useful for the further studies to prevent theprogression of renal function in non diabetes CKD patients.