Apr 24, 2008 - groups, t test or Mann-Whitney U test was used as appropriate. HOMA-IR ..... Fox CS, Larson MG, Keyes MG, Levy D, Clouse ME, Cul- leton B ...
Coronary Artery Calcification, ADMA, and Insulin Resistance in CKD Patients Shuzo Kobayashi, Machiko Oka, Kyoko Maesato, Ryota Ikee, Tsutomu Mano, Moriya Hidekazu, and Takayasu Ohtake Department of Nephrology, and Kidney & Dialysis Center, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan Background and objectives: It is known that coronary artery calcification (CAC) develops in chronic kidney disease (CKD) before initiation of renal replacement therapy, and factors associated with CKD mineral and bone disorders (CKD-MBDs) are involved. However, little information is available about any association between plasma levels of asymmetric dimethylarginine (ADMA), insulin resistance, and CAC. Design, setting, participants, & measurements: A total of 111 CKD patients (79 men, 32 women; glomerular filtration rate [GFR] median, 33.7 ml/min per 1.73 m2), free of cardiovascular disease, were consecutively recruited along with 30 age-matched healthy subjects. Coronary artery calcification scores (CACS) were measured by multidetector-row CT according to Agatston score. Results: In CKD patients, CACS was distributed widely from 0 to 2901, while in age-matched, healthy control subjects (n ⴝ 30), CACS showed a range from 0 to 307. GFR had a significant negative correlation with CACS. Plasma ADMA levels were negatively correlated with GFR and positively correlated with CACS. When CACS was divided into quartiles (600, n ⴝ 17), the patients with CACS >600 had significantly higher values of HOMA-IR, plasma ADMA levels, and fibrinogen along with serum levels of phosphorus, compared with those in patients having CACS
