Thiol/Disulfide Ratios, HOMA Score, and Quality of Sleep in Renal Transplant Recipients Without Diabetes.

Abstract

Thiols play an important role in defense against reactive oxygen species. We aimed to evaluate the relation between oxidative stress, glucose tolerance, and sleep quality in kidney transplant recipients without diabetes. We enrolled 95 kidney transplant recipients without diabetes from living and deceased donors with stable allograft function and 60 healthy controls. We included recipients who received a kidney from a living donor with a first-degree relation. Insulin resistance was determined using the Homeostasis Model Assessment score. Native thiol, total thiol, and disulfide levels were measured, and disulfide versus native thiol/total thiol ratios were calculated from all patients. We used the Pittsburg Sleep Quality Index to assess sleeping patterns. According to standard cutoff value of the index (≤5 indicates good quality sleep; >5 indicates poor sleep quality), we stratified kidney transplant recipients as group 1 (Pittsburg Sleep Quality Index ≤5; n = 41) and group 2 (Pittsburg Sleep Quality Index >5; n = 54). In correlation analysis, Pittsburg Sleep Quality Index was positively correlated with age, the Homeostasis Model Assessment score, body mass index, serum disulfide levels, disulfide/total thiol ratio, and native/total thiol ratio. The Pittsburgh Sleep Quality Index was negatively correlated with total thiol levels. In subgroup analysis, the Homeostasis Model Assessment score, disulfide levels, and disulfide/total thiol and native/total thiol ratios were significantly lower in group 1; however, total thiol level was significantly higher in this group. In multivariate regression analysis, age, the Homeostasis Model Assessment score, disulfide/total thiol ratio, and renal resistivity index were detected as predictors of sleep quality score. Sleep quality moderates oxidative stress identified by thiol-disulfide homeostasis and insulin resistance in renal transplant recipients without diabetes.