Assessment of Insulin Resistance and its Correlation with 25-OH Vitamin D in Chronic Kidney Disease

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.