Study indicates links between specific adipose tissue, insulin resistance and CKD
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PHILADELPHIA — Compared with controls, patients with chronic kidney disease showed greater accumulation of intermuscular adipose tissue that has a strong association with insulin resistance, according to data presented at ASN Kidney Week.
The study, conducted using a sample of 46 patients (25 of which had stage 3-5 CKD), showed that patients with CKD had greater quadriceps intermuscular adipose tissue (IMAT) accumulation. Greater IMAT accumulation was associated with both higher insulin resistance and increased levels of tumor necrosis factor-alpha (TNF-a).
“The IMAT accumulation causes the insulin resistance in CKD patients, and if we decrease the insulin resistance in these patients, we can decrease their IMAT accumulation and help them increase their functional capacity,” Ragibe Gulsah Dilaver, MD, a postdoctoral researcher at the Vanderbilt University Medical Center, told Healio.
Dilaver noted that insulin resistance is commonly observed in patients with CKD and often causes protein energy wasting. The study showed higher insulin resistance was associated with higher IMAT accumulation (P < .001) and that higher IMAT accumulation was linked with increased TNF-a levels ( P = .005).
“We found a correlation with their insulin resistance and intramuscular adipose tissue. There’s a strong positive correlation between them,” Dilaver said. “It all affected their muscles’ functional capacity. That’s why we wanted to compare these two. And we found significant correlation between them. And then we checked the IMAT and in inflammation parameters, and we also found out that there’s a strong correlation between them too.”
Dilaver said that he hopes the findings from the study can provide a jumping-off point for further scholarship into the association between IMAT accumulation and CKD, specifically with inflammation and skeletal muscle insulin resistance.
“[IMAT accumulation] may contribute to skeletal muscle insulin resistance by promoting the inflammatory space in it, but we need to find out if the inflammation affects the IMAT or if IMAT affects the inflammation,” Dilaver said. “So, to understand the correlation, we need to do clinical interventional studies. And for this, since they all connected with the insulin resistance, we can use diabetic medicines in CKD patients to decrease their insulin resistance and see the effect of IMAT and inflammation.”
Reference:
- Dilaver RG, et al. Insulin resistance and intermuscular adipose tissue (IMAT) in patients with CKD. Presented at: ASN Kidney Week; Nov. 2-5, 2023; Philadelphia.
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