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Perit Dial Int 29(4): 458-464
2009
© 2009 International Society for Peritoneal Dialysis
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Clinical

SKIN COLOR IS ASSOCIATED WITH INSULIN RESISTANCE IN NONDIABETIC PERITONEAL DIALYSIS PATIENTS

Hung-Yuan Chen1,2, Tze-Wah Kao2, Yen-Lin Chiu1,2, Jenq-Wen Huang2, Chun-Fu Lai1,2, Tsen-Fang Tsai3, Tzong-Shinn Chu2 and Kwan-Dun Wu2

Division of Nephrology,1 Department of Internal Medicine, Far Eastern Memorial Hospital; Division of Nephrology,2 Department of Internal Medicine, and Department of Dermatology,3 National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Correspondence to: K.D. Wu, Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7 Chung-Shan South Road, Taipei 100, Taiwan. kdwu{at}ntuh.gov.tw

{diamondsuit} Background: Changes in skin color are common among dialysis patients. They are associated with urochrome pigments, hemoglobin, and changes in cutaneous vasculature. Insulin resistance (IR) is strongly linked to cutaneous vascular dysfunction and is prevalent in dialysis patients. We postulated skin color may be associated with IR in dialysis patients because of the alternation in cutaneous vasculature.

{diamondsuit} Methods: 50 nondiabetic peritoneal dialysis (PD) patients were recruited for measurements of skin color by the Commission Internationale de I'Eclairage (CIE; International Commission on Illumination) system ("L" "a" "b" system). The "L" values represent skin brightness, "a" redness, and "b" yellowness. Correlation analysis between skin color, homeostatic model assessment (HOMAIR), high-density lipoprotein cholesterol (HDL-C), and adiponectin was performed.

{diamondsuit} Results: We divided patients (age 45 ± 13 years, 31 women) into 3 groups according to tertiles of HOMAIR. Patients with higher HOMAIR had a trend to have poor skin color (lower "a" and "b" values; p = 0.038 and 0.064). HOMAIR, adiponectin, and HDL-C levels were correlated with "a" and "b" values in logarithm (all p < 0.05). After adjustments for age, hemoglobin level, duration of PD, and residual renal glomerular filtration rate, only HOMAIR was associated with "a" values (p = 0.038) and HDL-C was associated with "b" values (p = 0.048) in logarithm.

{diamondsuit} Conclusions: Skin color, measured noninvasively, is associated with HOMAIR and HDL-C. Nondiabetic PD patients that had more severe IR had worse skin color.

KEY WORDS: Insulin resistance; adiponectin; skin color; HOMAIR.

Received 15 March 2008; accepted 8 September 2008.






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