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Insulin resistance in children with primary nephrotic syndrome and normal renal function

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Abstract

Background

Insulin resistance (IR) is an independent risk factor for atherosclerosis or cardiovascular events and renal function impairment. The aim of this study was to investigate IR in children with primary nephrotic syndrome (NS).

Methods

One-hundred and nineteen primary NS patients with normal renal function and 125 normal controls were studied. Fasting blood glucose, fasting serum insulin, and fasting serum C-peptide were measured. The Homa index of insulin resistance (HOMA-IR), Islet B cell function, and insulin sensitivity index were calculated. Correlations were assessed between HOMA-IR, fasting serum C-peptide, blood pressure, blood lipids, renal function, coagulation, clinical disease type, pathology and the early therapeutic effectiveness of high-dose glucocorticoids.

Results

There was no evidence of IR in the primary NS group. Although levels of fasting blood glucose, fasting serum insulin and fasting serum C-peptide were all within the normal ranges, fasting serum C-peptide was significantly higher compared to the controls. There was no disorder of carbohydrate metabolism in different hormone therapy efficacy and pathological diagnosis. Although IR was not detected, a significant increase in blood pressure, uric acid, blood lipids and coagulability was observed in the primary NS group.

Conclusion

A correlation observed between HOMA-IR, age, blood pressure, serum creatinine (Cr) and triglyceride may suggest that insulin sensitivity will emerge as renal disease progresses. Fasting serum C-peptide levels were increased in the primary NS group, suggesting that fasting serum C-peptide may be a protective factor.

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Authors and Affiliations

  1. Department of Nephrology, Nanjing Children’s Hospital, Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210029, Jiangsu Province, People’s Republic of China

    Jiaping Jin, Bo Jin, Songming Huang, Yanggang Yuan, Guixia Ding, Huaying Bao, Ying Chen, Yuan Han, Fei Zhao & Aihua Zhang

  2. Institute of Pediatrics, Nanjing Medical University, Nanjing, China

    Songming Huang, Yanggang Yuan & Aihua Zhang

Authors
  1. Jiaping Jin
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  2. Bo Jin
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  3. Songming Huang
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  4. Yanggang Yuan
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  5. Guixia Ding
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  6. Huaying Bao
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  7. Ying Chen
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  8. Yuan Han
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  9. Fei Zhao
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  10. Aihua Zhang
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Corresponding authors

Correspondence to Songming Huang or Aihua Zhang.

Additional information

Jiaping Jin and Bo Jin contributed equally to the work.

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Jin, J., Jin, B., Huang, S. et al. Insulin resistance in children with primary nephrotic syndrome and normal renal function. Pediatr Nephrol 27, 1901–1909 (2012). https://doi.org/10.1007/s00467-012-2190-0

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  • DOI: https://doi.org/10.1007/s00467-012-2190-0

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