ABSTRACT
Introduction: Insulin resistance is more frequent atprogressively declining glomerular filtration rate levels and isalmost universal in end-stage kidney failure. Multiple studieshave also demonstrated that 1,25(OH)2D administrationimproves glucose metabolism in patients with chronic kidneydisease (CKD). The present study was carried out with an aimto assess insulin resistance and to find an association betweeneGFR, insulin resistance, and vitamin D levels in patients withchronic kidney disease.Material and Methods: This Cross-sectional study wasconducted in a tertiary care academic hospital. Subjects withage ≥18 years; and estimated GFR <60 mL/min/1.73m2 wererecruited. CKD was characterized as an estimated glomerularfiltration rate (eGFR) <60 mL/min/1.73m2 using a CockcroftGault equation. Insulin Resistance was assessed using theHOMA: HOMA-IR. Quantitative measurement of 25-OHvitamin D in serum and plasma samples was done usingChemiflex.Results: Among sixty-four enrolled subjects, 53.1% hadinsulin resistance. Insulin resistance showed an inverserelationship with eGFR (r= -0.50, p< 0.001), and metabolicacidosis (r= -0.39, p<0.001) while, it has no relation withvitamin D levels (r= -0.01, p<0.90). The study also showsthat BMI (OR 1.43, 95% CI 0.99-2.07, p=0.05), waistcircumference (OR 1.37, 95% CI 1.10-1.72, p=0.005), andmetabolic acidosis (OR 5.71, 95% CI 1.85-17.61, p=0.002)were independently related to insulin resistance.Conclusion:The present study shows that eGFR and metabolicacidosis has an inverse association with insulin resistancein CKD patients. The study also shows that BMI, waistcircumference, and metabolic acidosis were independentlyrelated to insulin resistance.
ABSTRACT
Kisspeptins are peptide products of Kiss-1 gene and have been substantially associated with the initiation of puberty by virtue of their ability to cause pulsatile release of GnRH. Kisspeptin consists of 54 amino acids domain called metastin and its biological activity may be localized to the C-terminal (C-10, C-13, and C-14) segments. Kisspeptin binds to its cognate receptor GPR54 in the hypothalamic neurons and it is a G-coupled membrane receptor. This study is an attempt to understand the tentative conformation of the peptides in its native membrane mimicking environment. A 14 amino-acid derivative of kisspeptin (Asp-58-Val59-Ser60-Ala61-Tyr62-Asn63-Trp64-Asn65-Ser66-Phe67-Gly68-Leu69-Arg70-Tyr71NH2) was synthesized by f-moc (9-fluorenyl methoxy carbonyl) solid phase synthesis strategy. The synthetic peptide was cleaved and purified by Reverse phase-HPLC. CD spectroscopic analysis of secondary structure of the peptide revealed random coil disordered conformation in the aqueous environment. However, the peptide adopted more ordered β-sheet conformation in the solvents such as TFE and HFIP.