TY - JOUR
T1 - Postprandial metabolic response to a fat- and carbohydrate-rich meal in patients with chronic kidney disease
AU - Miyamoto, Tetsu
AU - Rashid Qureshi, Abdul
AU - Yamamoto, Tae
AU - Nakashima, Ayumu
AU - Lindholm, Bengt
AU - Stenvinkel, Peter
AU - Alvestrand, Anders
AU - Axelsson, Jonas
N1 - Funding Information:
Acknowledgements. We thank the patients and healthy participants in this study. We are indebted to our research staff at KBC (Ann Drei-man-Lif, Annika Nilsson and Anki Emmoth) and KFC (Björn Anderstam, Monica Eriksson and Ann-Christin Bragfors-Helin). We also thank Gerd Faxén, RD PhD, for designing the meal. We were supported by grants from the Swedish Society of Medical Research (J.A.), the Swedish Medical Research Council (P.S.) and Sanofi-Aventis (J.A.). Baxter Novum is the result of a grant to the Karolinska Institutet from Baxter Healthcare.
PY - 2011/7
Y1 - 2011/7
N2 - Background. While chronic kidney disease (CKD) is associated with dysmetabolism including a marked insulin resistance, the postprandial response has not comprehensively been studied in CKD patients.Methods. We conducted an intervention study comparing fasting and postprandial circulating biomarkers of glucose and lipid homeostasis, incretins, anabolic hormones, inflammation and oxidative stress in nine prevalent non-diabetic hemodialysis (HD) patients and 10 matched controls assessed after a standardized meal consisting of 75 g of milk fat, 80 g of carbohydrates and 6 g of proteins/m2 of body surface area.Results. Glucose and triglyceride increased in a similar manner following the meal, while insulin, C-peptide and glucose-dependent insulinotropic polypeptide increased more in HD patients. HDL and LDL cholesterol decreased slightly with no significant difference between the groups. The elevated baseline growth hormone (GH) in patients dropped, resulting in comparable levels in both groups 240 min after the meal; however, there was no change in insulin-like growth factor 1 (IGF-1) levels. No marked changes of interleukin 6 and tumor necrosis factor-α were observed in either group. An elevation in the DNA oxidative product 8-hydroxydeoxyguanosine was observed in HD patients.Conclusions. The postprandial state in CKD is characterized by impaired insulin sensitivity with increased incretin levels, along with GH/IGF-1 axis uncoupling and an elevation in an oxidative stress marker.
AB - Background. While chronic kidney disease (CKD) is associated with dysmetabolism including a marked insulin resistance, the postprandial response has not comprehensively been studied in CKD patients.Methods. We conducted an intervention study comparing fasting and postprandial circulating biomarkers of glucose and lipid homeostasis, incretins, anabolic hormones, inflammation and oxidative stress in nine prevalent non-diabetic hemodialysis (HD) patients and 10 matched controls assessed after a standardized meal consisting of 75 g of milk fat, 80 g of carbohydrates and 6 g of proteins/m2 of body surface area.Results. Glucose and triglyceride increased in a similar manner following the meal, while insulin, C-peptide and glucose-dependent insulinotropic polypeptide increased more in HD patients. HDL and LDL cholesterol decreased slightly with no significant difference between the groups. The elevated baseline growth hormone (GH) in patients dropped, resulting in comparable levels in both groups 240 min after the meal; however, there was no change in insulin-like growth factor 1 (IGF-1) levels. No marked changes of interleukin 6 and tumor necrosis factor-α were observed in either group. An elevation in the DNA oxidative product 8-hydroxydeoxyguanosine was observed in HD patients.Conclusions. The postprandial state in CKD is characterized by impaired insulin sensitivity with increased incretin levels, along with GH/IGF-1 axis uncoupling and an elevation in an oxidative stress marker.
KW - insulin resistance
KW - oxidative stress
KW - postprandial state in CKD
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U2 - 10.1093/ndt/gfq697
DO - 10.1093/ndt/gfq697
M3 - Article
C2 - 21098658
AN - SCOPUS:79959990533
VL - 26
SP - 2231
EP - 2237
JO - Proceedings of the European Dialysis and Transplant Association - European Renal Association. European Dialysis and Transplant Association - European Renal Association. Congress
JF - Proceedings of the European Dialysis and Transplant Association - European Renal Association. European Dialysis and Transplant Association - European Renal Association. Congress
SN - 0931-0509
IS - 7
ER -