caa a22 4500 445354747 CHVBK 20180317142856.0 cr unu---uuuuu 170323e20110901xx s 000 0 eng 10.1007/s10238-010-0119-0 doi (NATIONALLICENCE)springer-10.1007/s10238-010-0119-0 Complete correction of anemia by erythropoiesis-stimulating agents is associated with insulin resistance in hemodialysis patients [Elektronische Daten] [Gianni Biolo, Gianfranco Guarnieri, Rocco Barazzoni, Giovanni Panzetta] Insulin resistance and anemia secondary to erythropoietin deficiency characterize patients with end-stage kidney disease. In a cross-sectional analysis, we examined the relationship between erythropoietin-mediated correction of anemia and insulin sensitivity in nondiabetic hemodialysis patients. Insulin sensitivity (euglycemic-hyperinsulinemic clamp) and endogenous glucose production (primed-continuous infusion of [6,6-2H2]glucose) were determined in two groups of patients with normal hemoglobin (n:8; mean hemoglobin: 14.0±0.3g/dl) or with mild anemia (n:10; mean hemoglobin: 12.1±0.9g/dl). The patients with normal hemoglobin were receiving higher (P<0.05) erythropoietin doses than those with mild anemia (171±73 and 91±39Ukg−1wk−1, respectively). The two groups were matched for all other potential determinants of insulin resistance. Endogenous glucose production was similar in the two groups of patients in the postabsorptive state and was completely suppressed by insulin infusion. During the hyperinsulinemic clamp, the rate of glucose infusion to maintain euglycemia was significantly lower (P<0.01) in the patients with normal hemoglobin levels [166±31mg(m2)−1min−1] than in those with mild anemia [251±49mg(m2)−1min−1] and in a group of matched controls [275±68mg(m2)−1min−1]. In pooled patients, individual values of hemoglobin concentrations inversely correlated with the rates of insulin-mediated glucose infusion, both as absolute values (r=−0.58; P<0.05) and as values normalized by steady-state plasma insulin concentration (r=−0.74; P<0.001). In conclusion, this exploratory study indicates that complete correction of anemia by erythropoietin treatment in patients with end-stage kidney disease on hemodialysis is associated with impaired insulin sensitivity. Springer-Verlag, 2010 Anemia nationallicence Euglycemic-hyperinsulinemic clamp nationallicence Erythropoietin nationallicence Hemodialysis nationallicence Insulin resistance nationallicence Stable isotopes nationallicence Biolo Gianni Department of Medical, Technological and Translational Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy aut Guarnieri Gianfranco Department of Medical, Technological and Translational Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy aut Barazzoni Rocco Department of Medical, Technological and Translational Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy aut Panzetta Giovanni Renal Unit, Ospedali Riuniti di Trieste, Trieste, Italy aut Clinical and Experimental Medicine Springer Milan 11/3(2011-09-01), 181-187 1591-8890 11:3<181 2011 11 10238 https://doi.org/10.1007/s10238-010-0119-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10238-010-0119-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Biolo Gianni Department of Medical, Technological and Translational Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy aut NATIONALLICENCE 700 1- Guarnieri Gianfranco Department of Medical, Technological and Translational Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy aut NATIONALLICENCE 700 1- Barazzoni Rocco Department of Medical, Technological and Translational Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy aut NATIONALLICENCE 700 1- Panzetta Giovanni Renal Unit, Ospedali Riuniti di Trieste, Trieste, Italy aut NATIONALLICENCE 773 0- Clinical and Experimental Medicine Springer Milan 11/3(2011-09-01), 181-187 1591-8890 11:3<181 2011 11 10238 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer