Serpil Muge Deger, MD, and colleagues in the Division of Nephrology at Vanderbilt University Medical Center in Nashville studied 12 African-American patients with end-stage renal disease (ESRD) on MHD to examine the association between phosphorus levels and insulin resistance by using the hyperinsulinemic euglycemic clamp (HEGC), considered to be the gold standard procedure. Two-thirds of the patients were male and 42% had diabetes.
“Insulin resistance is common in MHD patients and recent data suggest a potential role of phosphorus homeostasis insulin resistance in non-dialyzed patients,” they noted in their study abstract.
Insulin resistance was measured as glucose disposal rate (GDR) in the last 30 minutes of the clamp.
Serum phosphorus levels in these patients independently predicted GDR after adjusting for age, gender, parathyroid hormones and calcium.
“These findings represent a novel pathway for mineral bone disorder-associated cardiovascular disease and all-cause mortality in ESRD patients,” the authors concluded.