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Insulin resistance and lower plasma adiponectin increase malignancy risk in nondiabetic continuous ambulatory peritoneal dialysis patients

 Jung Tak Park  ;  Tae-Hyun Yoo  ;  Tae Ik Chang  ;  Dong Hyung Lee  ;  Joo Hyun Lee  ;  Jung Eun Lee  ;  Hoon Young Choi  ;  Shin-Wook Kang  ;  Dae-Suk Han  ;  Dong-Ryeol Ryu 
 Metabolism: Clinical and Experimental, Vol.60(1) : 121-126, 2011 
Journal Title
 Metabolism: Clinical and Experimental 
Issue Date
Adiponectin/blood* ; Adult ; Aged ; C-Reactive Protein/analysis ; Female ; Follow-Up Studies ; Humans ; Insulin Resistance* ; Kidney Failure, Chronic/complications* ; Male ; Middle Aged ; Neoplasms/etiology* ; Peritoneal Dialysis, Continuous Ambulatory* ; Prospective Studies
End-stage renal disease patients have a higher risk for developing cancer. Although several causes for this increased risk have been proposed, the risk factors for cancer development in this population have not been elucidated. The aim of this study was to determine whether metabolic derangements, including insulin resistance and altered adipokines, increase the risk of developing malignancies in peritoneal dialysis (PD) patients, who are vulnerable to metabolic disorders because of excessive glucose absorbed from the dialysate. Study subjects comprised 106 nondiabetic PD patients who had been on PD for a minimum of 3 months with no overt malignancy. Baseline anthropometry, fasting glucose, insulin, and adiponectin were measured. The development of malignancy was evaluated during the follow-up period. During the mean follow-up of 47.0 ± 23.7 months, malignancy occurred in 15 patients (14.2%). The most common site of cancer was the kidney (26.7%), followed by thyroid (13.3%) and stomach (13.3%). Baseline insulin levels and homeostasis model assessment of insulin resistance were significantly higher, whereas plasma adiponectin levels were significantly lower, in patients who developed malignancy. Cox proportional hazards analysis revealed that insulin levels, homeostasis model assessment of insulin resistance, and lower adiponectin were independent predictors of malignancy. These findings demonstrate that insulin resistance and lower adiponectin levels could be risk factors for malignancy in nondiabetic PD patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Lee, Dong Hyoung(이동형)
Lee, Jung Eun(이정은) ORCID logo https://orcid.org/0000-0003-0917-2872
Lee, Joo Hyun(이주현)
Chang, Tae Ik(장태익)
Han, Dae Suk(한대석)
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