Insulin resistance in diabetic nephropathy — cause or consequence?
- 16 May 2006
- journal article
- review article
- Published by Wiley in Diabetes/Metabolism Research and Reviews
- Vol. 22 (5), 401-410
- https://doi.org/10.1002/dmrr.648
Abstract
Insulin resistance (IR) is associated with multiple risk factors for cardiovascular disease. Many studies have shown that IR is present in chronic renal failure (CRF), and recent evidence suggests that IR can also occur in the early stages of renal disease. Patients with diabetic nephropathy (DN) have an increase in cardiovascular mortality, and since IR may be a contributing factor, this emphasizes the importance of a detailed understanding of the mechanisms linking IR and renal dysfunction at different stages of DN. IR can be detected early on in DN, e.g. at the stage of microalbuminuria (MA) and this could indicate a common genetic trait for IR and DN. As DN progresses further, IR is aggravated and it may, in addition to other factors, possibly accelerate the decline in renal function toward end‐stage renal disease (ESRD). Several potentially modifiable mechanisms including circulating hormones, neuroendocrine pathways and chronic inflammation, are said to contribute to the worsening of IR. In ESRD, uremic toxins are of major importance. In this review article, we address the association between different stages of DN and IR and attempt to summarize major findings on potential mechanisms linking DN and IR. We conclude that IR is a consequence, and potentially also a cause of DN. In addition, there are probably genetic and environmental background factors that predispose to both IR and DN. Copyright © 2006 John Wiley & Sons, Ltd.Keywords
This publication has 132 references indexed in Scilit:
- Angiotensin II Type-1 Receptor Blocker Valsartan Enhances Insulin Sensitivity in Skeletal Muscles of Diabetic MiceHypertension, 2004
- Blockade of the Renin-Angiotensin System Increases Adiponectin Concentrations in Patients With Essential HypertensionHypertension, 2003
- Interactions Between Leptin and the Human Sympathetic Nervous SystemHypertension, 2003
- Editorial boardAmerican Journal of Kidney Diseases, 2002
- Leptin stimulates fatty-acid oxidation by activating AMP-activated protein kinaseNature, 2002
- Free and Total Insulin-Like Growth Factor I (IGF-I), IGF-Binding Protein-1 (IGFBP-1), and IGFBP-3 and Their Relationships to the Presence of Diabetic Retinopathy and Glomerular Hyperfiltration in Insulin-Dependent Diabetes MellitusJournal of Clinical Endocrinology & Metabolism, 1997
- Insulin-like growth factors (IGF) and IGF binding proteins in children with chronic renal failureProgress in Growth Factor Research, 1995
- Insulin resistance in family members of insulin-dependent diabetic patients with microalbuminuriaThe Lancet, 1993
- Predisposition to hypertension: Risk factor for nephropathy and hypertension in IDDMKidney International, 1992
- Microalbuminuria Predicts Clinical Proteinuria and Early Mortality in Maturity-Onset DiabetesNew England Journal of Medicine, 1984