Association of insulin resistance with arterial stiffness in nondiabetic peritoneal dialysis patients

Abstract

Insulin resistance is a risk factor for cardiovascular morbidity and mortality in the general and end-stage renal disease populations. In this study, we investigated the association between insulin resistance and arterial stiffness in nondiabetic peritoneal dialysis (PD) patients. Fifty-three patients were enrolled. Patients were divided into 2 groups as homeostasis model assessment of insulin resistance (HOMA-IR) ≤ 2.97 (low) and >2.97 (high). Carotid-femoral pulse wave velocity (c-f PWV) analysis and intima-media thickness of the carotid artery were measured. Mean age was 46 ± 12 years and HOMA-IR was 2.97 ± 1.77 (0.77-8.88). Mean c-f PWV was 7.6 ± 1.7 m/s. HOMA-IR was positively correlated with age, body mass index, and c-f PWV and negatively with serum HDL cholesterol and parathormone. In linear regression analysis, age and mean arterial pressure were predictors for c-f PWV. When patients were divided into 2 groups according to median age as ≤ 49 and >50, mean arterial pressure, male gender, and age were predictors for c-f PWV in patients aged ≤ 49, whereas HOMA-IR was the only predictor for c-f PWV in patients aged >50 years. Insulin resistance is an independent risk factor for arterial stiffness in PD patients older than 50 years. IR is not associated with carotid intima-media thickness.