Journal of Cachexia, Sarcopenia and Muscle (JCSM) - Abstract


Tissue sodium accumulation and peripheral insulin sensitivity in maintenance hemodialysis patients


Serpil Muge Deger, Ping Wang, Rachel Fissell, Charles D. Ellis, Cindy Booker, Feng Sha1, Jennifer L. Morse, Thomas G. Stewart, John C. Gore, Edward D. Siew, Jens Titze, Talat Alp Ikizler

 

Background

Recent data suggest that sodium (Na+) is stored in the muscle and skin without commensurate water retention in maintenance hemodialysis (MHD) patients. In this study, we hypothesized that excessive Na+ accumulation would be associated with abnormalities in peripheral insulin action.

Methods

Eleven MHD patients and eight controls underwent hyperinsulinemic–euglycemic–euaminoacidemic clamp studies to measure glucose (GDR) and leucine disposal rates (LDR), as well as lower left leg 23Na magnetic resonance imaging to measure Na+ concentration in the muscle and skin tissue.

Results

The median GDR and LDR levels were lower, and the median muscle Na+ concentration was higher in MHD patients compared with controls. No significant difference was found regarding skin Na+ concentration between group comparisons. Linear regression revealed inverse relationships between muscle Na+ concentration and GDR and LDR in MHD patients, whereas no relationship was observed in controls. There was no association between skin Na+ content and GDR or LDR in either MHD patients or controls.

Conclusions

These data suggest that excessive muscle Na+ content might be a determinant of IR in MHD patients, although the causality and mechanisms remain to be proven.

 

Deger, S. M., Wang, P., Fissell, R., Ellis, C. D., Booker, C., Sha, F., Morse, J. L., Stewart, T. G., Gore, J. C., Siew, E. D., Titze, J., and Ikizler, T. A. (2017) Tissue sodium accumulation and peripheral insulin sensitivity in maintenance hemodialysis patients. Journal of Cachexia, Sarcopenia and Muscle, 8: 500–507. doi: 10.1002/jcsm.12217.




 

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