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Hyperglycemia, Hyperlipidemia and Insulin Resistance in Chronic Renal Failure in Relation to Hemodialysis

机译:高血糖,高脂血症和胰岛素抵抗慢性肾功能衰竭与血液透析的关系

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The studies have focussed on three aspects of abnormal carbohydrate and lipid metabolism in uremia. The data indicated that acute uremia leads to marked changes in insulin metabolism in perfused rat muscle, resulting in a defect in insulin catabolism and a loss of normal insulin sensitivity. Since perfused liver from acutely uremic rats behaved normally in both of these regards, these results suggest that the hyperinsulinemia and insulin resistance of the uremic state is at least due in part to abnormal muscle metabolism. The insulin resistance and hyperinsulinemia in uremia was the focus of a second line of investigation, in which the author studied the effects of a decrease in dietary carbohydrate intake on plasma triglyceride (TG) levels in patients receiving chronic hemodialysis. The results indicated that the dietary manipulation led to a fall in plasma insulin levels, very low density lipoprotein production rates, and plasma TG levels. Finally, studies were carried out in acutely uremic rats which highlighted the potential role of the kidney as a gluconeogenic organ.

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