Insulin resistance is associated with skeletal muscle protein breakdown in non-diabetic chronic hemodialysis patients.

Deranged protein metabolism is known to complicate uremia. Insulin resistance is evident in chronic hemodialysis (CHD) patients. We hypothesized that the degree of insulin resistance would predict protein catabolism in non-diabetic CHD patients. We examined the relationship between Homeostasis Model Assessment (HOMA) and fasting whole-body and skeletal muscle protein turnover in 18 non-diabetic CHD patients using primed-constant infusions of L-(1-(13)C) leucine and L-(ring-(2)H(5)) phenylalanine. Mean+/-s.d. fasting glucose and body mass index were 80.6+/-9.8 mg/dl and 25.4+/-4.4 kg/m(2), respectively. Median (interquartile range) HOMA was 1.6 (1.4, 3.9). Mean+/-s.e.m. skeletal muscle protein synthesis, breakdown, and net balance were 89.57+/-11.67, 97.02+/-13.3, and -7.44+/-7.14 microg/100 ml/min, respectively. Using linear regression, a positive correlation was observed between HOMA and skeletal muscle protein synthesis (R(2)=0.28; P=0.024), and breakdown (R(2)=0.49; P=0.001). An inverse association between net skeletal muscle protein balance and HOMA was also noted (R(2)=0.20; P=0.066). After adjustment for C-reactive protein, only the relationship between HOMA and skeletal muscle protein breakdown persisted (R(2)=0.49; P=0.006). There were no significant associations between components of whole-body protein turnover and HOMA. This study demonstrates that insulin resistance is evident in non-diabetic dialysis patients, is associated with skeletal muscle protein breakdown, and represents a novel target for intervention in uremic wasting.

Color mixing in dental porcelain.

For esthetic reasons, pigments and opacifiers are added to porcelains used in restorative dentistry. The purpose of this study was to use Kubelka-Munk theory (Kubelka and Munk, 1931) to predict and analyse the colors of porcelains modified by the addition of two pigments and an opacifying agent. The base porcelain was composed of 88% potassium feldspar, 6% quartz and 6% kaolin. The porcelain was modified by the addition of a yellow (Pr-Zr-Si) or a brown (Fe-Cr-Zn) stain and an opacifier (10% SnO in base porcelain). After firing at 1200 degrees C for 30 min, reflectance spectra of the various combinations were obtained with a spectrophotometer. Reflectance spectra, except at low wavelengths, were influenced by increased scattering due to the addition of the opacifier. Calculated values from Kubelka-Munk theory for absorption coefficients and scattering coefficients with appropriate correction factors were compared with the values from the reflectance spectra of the combinations. In general, good agreement was obtained if the scattering coefficient of the opacifier is set equal to 1.0. Using the L*a*b* transform of the CIE color space, it was found that this transform provided uniform color intervals for equal changes in pigment concentration.