Circulating Alpha-Tocopherol and Insulin Sensitivity Among Older Men With Chronic Kidney Disease
2016 (English)In: Journal of renal nutrition (Print), ISSN 1051-2276, E-ISSN 1532-8503, Vol. 26, no 3, 177-182 p.Article in journal (Refereed) PublishedText
Objective: Insulin resistance is common in individuals with chronic kidney disease (CKD) and may be partly explained by modifiable risk factors. In the general population, vitamin E supplementation has been suggested to improve both insulin sensitivity and secretion. We here explore the potential role of vitamin E as a modifiable risk factor for insulin resistance among individuals with CKD. Design: Observational study. Setting: A total of 273 nondiabetic men aged 70 to 71 years with CKD defined as either cystatin C estimated glomerular filtration rate, < 60 mL/minute/1.73 m(2) or urinary albumin excretion rate >= 20 mg/minute from the third examination cycle of Uppsala Longitudinal Study of Adult Men. Subjects: A total of 273 nondiabetic men aged 70 to 71 years with CKD defined as either cystatin C estimated glomerular filtration rate, 60 mL/minute/1.73 m(2) or urinary albumin excretion rate >= 20 mu g/minute. Methods: Serum alpha-, beta-, and gamma-tocopherol concentrations were measured by high-performance liquid chromatography and expressed as mmol/total serum cholesterol and triglycerides (in mmol). Dietary vitamin E intake was estimated from 7-day food records. Main Outcome Measure: Insulin sensitivity index (M/I ratio) was measured by hyperinsulinemic-euglycemic glucose clamps. Univariate and multivariate regression models were fitted to assess the association between M/I and circulating concentrations of tocopherols. Results: The mean serum concentration of alpha-, beta-, and gamma- was 37.4 +/- 6.58, 0.89 +/- 0.23, and 4.32 +/- 1.69 mu mol/mmol, respectively. Median dietary vitamin E intake was 6.14 (interquartile range, 5.48-6.82) mg/day. In crude and fully-adjusted multivariate regression analyses, serum alpha-tocopherol levels were directly and strongly associated with M/I (standard beta = 0.17, P = .003). No such association was observed for dietary vitamin E, serum beta-, and gamma-tocopherol concentrations. Conclusions: Serum a-tocopherol concentration associates with insulin sensitivity in nondiabetic older men with CKD.
Place, publisher, year, edition, pages
2016. Vol. 26, no 3, 177-182 p.
Nutrition and Dietetics Urology and Nephrology
IdentifiersURN: urn:nbn:se:uu:diva-299611DOI: 10.1053/j.jrn.2015.11.005ISI: 000377983600009PubMedID: 26776598OAI: oai:DiVA.org:uu-299611DiVA: diva2:949849
FunderSwedish Research CouncilSwedish Heart Lung FoundationThe Karolinska Institutet's Research Foundation