Lmfb. Gouveia et al., PERIPHERAL GLUCOSE-METABOLISM IN PATIENTS WITH CHRONIC-RENAL-FAILURE, Brazilian journal of medical and biological research, 28(2), 1995, pp. 201-207
The present study was designed to determine the effect of chronic rena
l failure on forearm muscle glucose uptake and oxidation during the po
stabsorptive state and after an oral glucose challenge. Twelve normal
subjects and sixteen patients with chronic renal failure were studied
after an overnight fast (12-14 h) and for 3 h after the ingestion of 7
5 g of glucose. Peripheral glucose metabolism was analyzed by the fore
arm technique to estimate muscle exchange of substrate combined with i
ndirect calorimetry. Decreased forearm glucose uptake was observed in
uremic patients compared to normal subjects (91.5 +/- 11.4 vs 154.8 +/
- 7.8 mg 100 ml forearm(-1) 3 h(-1)) with diminished nonoxidative gluc
ose metabolism (69.4 +/- 12.1 vs 117.2 +/- 12.8 mg 100 ml forearm(-1)
3 h(-1)). Muscle glucose oxidation did not differ significantly betwee
n groups. Both serum free fatty acid levels and lipid oxidation rates
were similar in the normal subjects and the uremic patients, and decli
ned in a similar fashion after glucose ingestion. Basal serum insulin
levels did not differ significantly between normal and uremic patients
, whereas the insulinemic response to glucose load was greater among t
he patients with chronic renal failure. These data show that insulin r
esistance occurring in patients with chronic renal failure is accompan
ied by impaired muscle glucose uptake and nonoxidative glucose metabol
ism.