Comparison of the Effects of Uremia and Metabolic Disorders on the Development of Insulin Resistance

Objective: The aim of the present study was to show the important effectof a uremic environmenton the development of insulin resistance and if insulin resistance might be reversible with the treatment of metabolic disordersin patients with hypothyroid.

Materials and Methods: Patients with stage 2, stage 3, and stage 4 chronic renal disease and dialysis treatment and patients with hypothyroid with normal renal function and thyroxine replacement treatment were included in the study. Patients with some metabolic disorders, such as obesity, dyslipidemia, anemia, and severe vitamin Ddeficiency, were excluded from the study. Insulin, fasting blood glucose, and thyroid function levels were measured. Homeostatic model assessments of insulin resistance (HOMA-IR) values were calculated.

Results: The mean age, body mass index, and distribution of gender were found to be similar in the patient groups. No statistical significance was found in HOMA-IR values between the patient groups. The important effects of chronic kidney disease and hemodialysis replacement treatment were determined to the development of insulin resistance.

Conclusion: A uremic environment might be affected by the development of insulin resistance as in the development of metabolic disorders, such asthyroid dysfunction and glucose and lipid metabolism disorders. Understanding of the molecular mechanism and effects of uremic toxins can contribute to the development of new treatment targets.