SKIN COLOR IS ASSOCIATED WITH INSULIN RESISTANCE IN NONDIABETIC PERITONEAL DIALYSIS PATIENTS

• Published in: Peritoneal dialysis international 2009-07, Vol.29 (4), p.458-464, Article 458
• Main Authors: Chen, Hung-Yuan, Kao, Tze-Wah, Chiu, Yen-Lin, Huang, Jenq-Wen, Lai, Chun-Fu, Tsai, Tsen-Fang, Chu, Tzong-Shinn, Wu, Kwan-Dun
• Format: Article
• Language: English
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Glucose - metabolism; Cross-Sectional Studies; Emergency and intensive care: renal failure. Dialysis management; Female; Follow-Up Studies; Glomerulonephritis; Humans; Insulin - blood; Insulin Resistance - physiology; Intensive care medicine; Kidney Failure, Chronic - metabolism; Kidney Failure, Chronic - therapy; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Peritoneal Dialysis - methods; Skin Pigmentation - physiology; Treatment Outcome
• ISSN: 0896-8608; 1718-4304
• DOI: 10.1177/089686080902900413

Division of Nephrology, 1 Department of Internal Medicine, Far Eastern Memorial Hospital; Division of Nephrology, 2 Department of Internal Medicine, and Department of Dermatology, 3 National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan Correspondence to: K.D. Wu, Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei 100, Taiwan. kdwu{at}ntuh.gov.tw Background: Changes in skin color are common among dialysis patients. They are associated with urochrome pigments, hemoglobin, and changes in cutaneous vasculature. Insulin resistance (IR) is strongly linked to cutaneous vascular dysfunction and is prevalent in dialysis patients. We postulated skin color may be associated with IR in dialysis patients because of the alternation in cutaneous vasculature. Methods: 50 nondiabetic peritoneal dialysis (PD) patients were recruited for measurements of skin color by the Commission Internationale de I'Eclairage (CIE; International Commission on Illumination) system ("L" "a" "b" system). The "L" values represent skin brightness, "a" redness, and "b" yellowness. Correlation analysis between skin color, homeostatic model assessment (HOMA IR ), high-density lipoprotein cholesterol (HDL-C), and adiponectin was performed. Results: We divided patients (age 45 ± 13 years, 31 women) into 3 groups according to tertiles of HOMA IR . Patients with higher HOMA IR had a trend to have poor skin color (lower "a" and "b" values; p = 0.038 and 0.064). HOMA IR , adiponectin, and HDL-C levels were correlated with "a" and "b" values in logarithm (all p < 0.05). After adjustments for age, hemoglobin level, duration of PD, and residual renal glomerular filtration rate, only HOMA IR was associated with "a" values ( p = 0.038) and HDL-C was associated with "b" values ( p = 0.048) in logarithm. Conclusions: Skin color, measured noninvasively, is associated with HOMA IR and HDL-C. Nondiabetic PD patients that had more severe IR had worse skin color. KEY WORDS: Insulin resistance; adiponectin; skin color; HOMA IR . Received 15 March 2008; accepted 8 September 2008.