{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T03:06:23Z","timestamp":1792551983892,"version":"4.5.0"},"reference-count":90,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Patients with chronic kidney disease (CKD) and dialysis have higher mortality than those without, and cardiovascular disease (CVD) is the main cause of death. As CVD is caused by several mechanisms, insulin resistance plays an important role in CVD. This review summarizes the importance and mechanism of insulin resistance in CKD and discusses the current evidence regarding insulin resistance in patients with CKD and dialysis. Insulin resistance has been reported to influence endothelial dysfunction, plaque formation, hypertension, and dyslipidemia. A recent study also reported an association between insulin resistance and cognitive dysfunction, non-alcoholic fatty liver disease, polycystic ovary syndrome, and malignancy. Insulin resistance increases as renal function decrease in patients with CKD and dialysis. Several mechanisms increase insulin resistance in patients with CKD, such as chronic inflammation, oxidative stress, obesity, and mineral bone disorder. There is the possibility that insulin resistance is the potential future target of treatment in patients with CKD.<\/jats:p>","DOI":"10.3390\/nu13124349","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T21:19:08Z","timestamp":1638479948000},"page":"4349","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":76,"title":["Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Akio","family":"Nakashima","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9197-9434","authenticated-orcid":false,"given":"Kazuhiko","family":"Kato","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Ohkido","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yokoo","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1038\/nm.4350","article-title":"Insulin action and resistance in obesity and type 2 diabetes","volume":"23","author":"Czech","year":"2017","journal-title":"Nat. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1007\/s00125-014-3383-9","article-title":"Contrasting associations of insulin resistance with diabetes, cardiovascular disease and all-cause mortality in the elderly: PROSPER long-term follow-up","volume":"57","author":"Welsh","year":"2014","journal-title":"Diabetologia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.2337\/dc11-1657","article-title":"Insulin Resistance, Cystatin C, and Mortality Among Older Adults","volume":"35","author":"Katz","year":"2012","journal-title":"Diabetes Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/nep.13147","article-title":"Insulin resistance in chronic kidney disease","volume":"22","author":"Xu","year":"2017","journal-title":"Nephrology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Hanks, L.J., Casazza, K., Judd, S.E., Jenny, N.S., and Guti\u00e9rrez, O.M. (2015). Associations of Fibroblast Growth Factor-23 with Markers of Inflammation, Insulin Resistance and Obesity in Adults. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0122885"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1126\/science.7678183","article-title":"Adipose Expression of Tumor Necrosis Factor-Alpha: Direct Role in Obesity-Linked Insulin Resistance","volume":"259","author":"Hotamisligil","year":"1993","journal-title":"Science"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"515","DOI":"10.2337\/diabetes.47.4.515","article-title":"Tumor necrosis factor-alpha acutely inhibits insulin signaling in human adipocytes: Implication of the p80 tumor necrosis factor receptor","volume":"47","author":"Liu","year":"1998","journal-title":"Diabetes"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1172\/JCI113586","article-title":"Effects of nonesterified fatty acid availability on tissue-specific glucose utilization in rats in vivo","volume":"82","author":"Jenkins","year":"1988","journal-title":"J. Clin. Investig."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"863","DOI":"10.2337\/diab.44.8.863","article-title":"Lipotoxicity in the Pathogenesis of Obesity-Dependent NIDDM: Genetic and Clinical Implications","volume":"44","author":"Unger","year":"1995","journal-title":"Diabetes"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2295","DOI":"10.2337\/db07-0460","article-title":"Metabolic Mechanisms of Failure of Intraportally Transplanted Pancreatic -Cells in Rats: Role of Lipotoxicity and Prevention by Leptin","volume":"56","author":"Lee","year":"2007","journal-title":"Diabetes"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2859","DOI":"10.1172\/JCI118742","article-title":"Mechanism of free fatty acid-induced insulin resistance in humans","volume":"97","author":"Roden","year":"1996","journal-title":"J. Clin. Investig."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1002\/hep.26672","article-title":"Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 Diabetes","volume":"59","author":"Birkenfeld","year":"2013","journal-title":"Hepatology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/apt.16066","article-title":"Circulating lipidomic alterations in obese and non-obese subjects with non-alcoholic fatty liver disease","volume":"52","author":"Jung","year":"2020","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1111\/j.1600-065X.2012.01145.x","article-title":"Inflammation links excess fat to insulin resistance: The role of the interleukin-1 family","volume":"249","author":"Tack","year":"2012","journal-title":"Immunol. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1172\/JCI88880","article-title":"Skeletal muscle inflammation and insulin resistance in obesity","volume":"127","author":"Wu","year":"2017","journal-title":"J. Clin. Investig."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1101\/gad.346312.120","article-title":"Chronic tissue inflammation and metabolic disease","volume":"35","author":"Lee","year":"2021","journal-title":"Genes Dev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1210\/er.2019-00002","article-title":"Inflammation in the Pathophysiology and Therapy of Cardiometabolic Disease","volume":"40","author":"Donath","year":"2019","journal-title":"Endocr. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1111\/dom.14168","article-title":"Reduced incidence of type 2 diabetes in patients with chronic hepatitis C virus infection cleared by direct-acting antiviral therapy: A prospective study","volume":"22","author":"Adinolfi","year":"2020","journal-title":"Diabetes Obes. Metab."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.atherosclerosis.2020.01.010","article-title":"Impact of hepatitis C virus clearance by direct-acting antiviral treatment on the incidence of major cardiovascular events: A prospective multicentre study","volume":"296","author":"Adinolfi","year":"2020","journal-title":"Atherosclerosis"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2345","DOI":"10.1016\/j.numecd.2021.04.016","article-title":"Impact of direct acting antivirals (DAAs) on cardiovascular events in HCV cohort with pre-diabetes","volume":"31","author":"Sasso","year":"2021","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_21","first-page":"E214","article-title":"Glucose clamp technique: A method for quantifying insulin secretion and resistance","volume":"237","author":"Tobin","year":"1979","journal-title":"Am. J. Physiol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1681\/ASN.2004090742","article-title":"Renal Insulin Resistance Syndrome, Adiponectin and Cardiovascular Events in Patients with Kidney Disease: The Mild and Moderate Kidney Disease Study","volume":"16","author":"Becker","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.diabres.2012.12.006","article-title":"Decreased estimated glomerular filtration rate is not directly related to increased insulin resistance","volume":"99","author":"Park","year":"2013","journal-title":"Diabetes Res. Clin. Pr."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Chen, S., Chen, Y., Liu, X., Li, M., Wu, B., Li, Y., Liang, Y., Shao, X., Holth\u00f6fer, H., and Zou, H. (2013). Association of Insulin Resistance with Chronic Kidney Disease in Non-Diabetic Subjects with Normal Weight. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0074058"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1642","DOI":"10.1093\/ajcn\/86.6.1642","article-title":"Body mass index and fat mass are the primary correlates of insulin resistance in nondiabetic stage 3\u20134 chronic kidney disease patients","volume":"86","author":"Trirogoff","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1291\/hypres.31.83","article-title":"Relationship between Abdominal Fat Accumulation and Insulin Resistance in Hemodialysis Patients","volume":"31","author":"Gohda","year":"2008","journal-title":"Hypertens. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1007\/s11255-018-1934-6","article-title":"Both insulin resistance and metabolic syndrome accelerate the progression of chronic kidney disease among Chinese adults: Results from a 3-year follow-up study","volume":"50","author":"Ma","year":"2018","journal-title":"Int. Urol. Nephrol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s12020-014-0242-x","article-title":"Insulin resistance is associated with the development of albuminuria in Korean subjects without diabetes","volume":"48","author":"Jang","year":"2014","journal-title":"Endocrine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/1753-0407.13010","article-title":"Insulin resistance is associated with urinary albumin-creatinine ratio in normal weight individuals with hypertension and diabetes: The REACTION study","volume":"12","author":"Gu","year":"2019","journal-title":"J. Diabetes"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12933-021-01343-1","article-title":"Efficacy and durability of multifactorial intervention on mortality and MACEs: A randomized clinical trial in type-2 diabetic kidney disease","volume":"20","author":"Sasso","year":"2021","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"c163","DOI":"10.1159\/000115329","article-title":"Glucose Metabolism, Insulin Resistance, and Renal Pathology in Non-Diabetic Chronic Kidney Disease","volume":"108","author":"Ikee","year":"2008","journal-title":"Nephron Clin. Pr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1016\/j.kint.2016.06.013","article-title":"Protection of mitochondria prevents high-fat diet\u2013induced glomerulopathy and proximal tubular injury","volume":"90","author":"Szeto","year":"2016","journal-title":"Kidney Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1093\/ndt\/gft435","article-title":"Insulin resistance in chronic kidney disease: New lessons from experimental models","volume":"29","author":"Koppe","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1038\/ki.2015.305","article-title":"Molecular mechanisms of insulin resistance in chronic kidney disease","volume":"88","author":"Thomas","year":"2015","journal-title":"Kidney Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1172\/JCI37672","article-title":"Urea-induced ROS generation causes insulin resistance in mice with chronic renal failure","volume":"120","author":"Du","year":"2010","journal-title":"J. Clin. Investig."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1016\/j.biopha.2018.09.165","article-title":"Adipokines in critical illness: A review of the evidence and knowledge gaps","volume":"108","author":"Alipoor","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1096\/fj.12-226092","article-title":"The hydrolase DDAH2 enhances pancreatic insulin secretion by transcriptional regulation of secretagogin through a Sirt1-dependent mechanism in mice","volume":"27","author":"Hasegawa","year":"2013","journal-title":"FASEB J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1089\/ars.2016.6742","article-title":"Dimethylarginine Dimethylaminohydrolase 1 Protects Against High-Fat Diet-Induced Hepatic Steatosis and Insulin Resistance in Mice","volume":"26","author":"Li","year":"2017","journal-title":"Antioxid. Redox Signal."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1038\/ki.2014.348","article-title":"Insulin resistance in chronic kidney disease is ameliorated by spironolactone in rats and humans","volume":"87","author":"Hosoya","year":"2015","journal-title":"Kidney Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1161\/HYPERTENSIONAHA.119.13922","article-title":"Primary Aldosteronism Decreases Insulin Secretion and Increases Insulin Clearance in Humans","volume":"75","author":"Adler","year":"2020","journal-title":"Hypertension"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.kint.2017.04.006","article-title":"Executive summary of the 2017 KDIGO Chronic Kidney Disease\u2013Mineral and Bone Disorder (CKD-MBD) Guideline Update: What\u2019s changed and why it matters","volume":"92","author":"Ketteler","year":"2017","journal-title":"Kidney Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.2215\/CJN.10941013","article-title":"The Use of Fibroblast Growth Factor 23 Testing in Patients with Kidney Disease","volume":"9","author":"Smith","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1056\/NEJMra070553","article-title":"Vitamin D Deficiency","volume":"357","author":"Holick","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1038\/ki.2010.113","article-title":"Use of vitamin D in chronic kidney disease patients","volume":"78","author":"Sprague","year":"2010","journal-title":"Kidney Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.jsbmb.2010.03.042","article-title":"Vitamin D and diabetes","volume":"121","author":"Pittas","year":"2010","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S152","DOI":"10.1111\/j.1753-4887.2007.tb00354.x","article-title":"Obesity, Metabolic Syndrome, and Type 2 Diabetes: Inflammatory Basis of Glucose Metabolic Disorders","volume":"65","author":"Pradhan","year":"2008","journal-title":"Nutr. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1872","DOI":"10.1016\/j.celrep.2015.02.043","article-title":"Deletion of Macrophage Vitamin D Receptor Promotes Insulin Resistance and Monocyte Cholesterol Transport to Accelerate Atherosclerosis in Mice","volume":"10","author":"Oh","year":"2015","journal-title":"Cell Rep."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1002\/hep.30937","article-title":"Vitamin D Receptor Activation in Liver Macrophages Ameliorates Hepatic Inflammation, Steatosis, and Insulin Resistance in Mice","volume":"71","author":"Dong","year":"2019","journal-title":"Hepatology"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Leung, P.S. (2016). The Potential Protective Action of Vitamin D in Hepatic Insulin Resistance and Pancreatic Islet Dysfunction in Type 2 Diabetes Mellitus. Nutrients, 8.","DOI":"10.3390\/nu8030147"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.metabol.2011.09.007","article-title":"The relationship between vitamin D and the renin-angiotensin system in the pathophysiology of hypertension, kidney disease, and diabetes","volume":"61","author":"Vaidya","year":"2012","journal-title":"Metabolism"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.2337\/db08-0593","article-title":"Baseline Serum 25-Hydroxy Vitamin D Is Predictive of Future Glycemic Status and Insulin Resistance: The Medical Research Council Ely Prospective Study 1990\u20132000","volume":"57","author":"Forouhi","year":"2008","journal-title":"Diabetes"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.3945\/ajcn.110.000976","article-title":"Serum 25-hydroxyvitamin D and parathyroid hormone are independent determinants of whole-body insulin sensitivity in women and may contribute to lower insulin sensitivity in African Americans","volume":"92","author":"Ashraf","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.jnutbio.2011.12.007","article-title":"Osteocalcin and vitamin D status are inversely associated with homeostatic model assessment of insulin resistance in Canadian Aboriginal and white women: The First Nations Bone Health Study","volume":"24","author":"Weiler","year":"2013","journal-title":"J. Nutr. Biochem."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3945\/an.113.003731","article-title":"A Novel Approach Localizes the Association of Vitamin D Status with Insulin Resistance to One Region of the 25-Hydroxyvitamin D Continuum12","volume":"4","author":"Heaney","year":"2013","journal-title":"Adv. Nutr."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"745","DOI":"10.2215\/CJN.05450513","article-title":"Biomarkers of Vascular Calcification and Mortality in Patients with ESRD","volume":"9","author":"Scialla","year":"2014","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1056\/NEJMoa0706130","article-title":"Fibroblast Growth Factor 23 and Mortality among Patients Undergoing Hemodialysis","volume":"359","author":"Mannstadt","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1681\/ASN.2010121224","article-title":"FGF-23 Associates with Death, Cardiovascular Events, and Initiation of Chronic Dialysis","volume":"22","author":"Kendrick","year":"2011","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1161\/ATVBAHA.110.214619","article-title":"Circulating Fibroblast Growth Factor-23 Is Associated With Fat Mass and Dyslipidemia in Two Independent Cohorts of Elderly Individuals","volume":"31","author":"Mirza","year":"2011","journal-title":"Arter. Thromb. Vasc. Biol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3168","DOI":"10.1016\/j.transproceed.2020.03.030","article-title":"High Serum Fibroblast Growth Factor 23 Level Is Associated with Metabolic Syndrome in Kidney Transplantation Patients","volume":"520","author":"Chen","year":"2020","journal-title":"Transplant Proc."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1111\/cen.12759","article-title":"Inflammation but not obesity or insulin resistance is associated with increased plasma fibroblast growth factor 23 concentration in the elderly","volume":"82","author":"Holecki","year":"2015","journal-title":"Clin. Endocrinol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1080\/0886022X.2018.1455594","article-title":"Fibroblast growth factor-23 is a strong predictor of insulin resistance among chronic kidney disease patients","volume":"40","author":"Fayed","year":"2018","journal-title":"Ren. Fail."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1073\/pnas.98.2.502","article-title":"A family of tissue-specific resistin-like molecules","volume":"98","author":"Steppan","year":"2001","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"13999","DOI":"10.1038\/s41598-018-32432-z","article-title":"Association between resistin and fibroblast growth factor 23 in patients with type 2 diabetes mellitus","volume":"8","author":"Nakashima","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"4050","DOI":"10.1172\/JCI129194","article-title":"The gut microbiome and metabolic syndrome","volume":"129","author":"Dabke","year":"2019","journal-title":"J. Clin. Investig."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1038\/s41575-020-0269-9","article-title":"Gut microbiota and human NAFLD: Disentangling microbial signatures from metabolic disorders","volume":"17","author":"Vigliotti","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.ebiom.2021.103208","article-title":"Circulating exosomes and gut microbiome induced insulin resistance in mice exposed to intermittent hypoxia: Effects of physical activity","volume":"64","author":"Khalyfa","year":"2021","journal-title":"EBioMedicine"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1126\/science.aao5774","article-title":"Gut bacteria selectively promoted by dietary fibers alleviate type 2 diabetes","volume":"359","author":"Zhao","year":"2018","journal-title":"Science"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1038\/nrendo.2010.121","article-title":"Behavioral and pharmacologic therapies for obesity","volume":"6","author":"Vetter","year":"2010","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"4460","DOI":"10.2174\/09298673113209990143","article-title":"Thiazoles and Thiazolidinones as Antioxidants","volume":"20","author":"Pitta","year":"2013","journal-title":"Curr. Med. Chem."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.bioorg.2017.10.014","article-title":"Synthetic and medicinal perspective of thiazolidinones: A review","volume":"75","author":"Manjal","year":"2017","journal-title":"Bioorganic Chem."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/S0140-6736(05)67528-9","article-title":"Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): A randomised controlled trial","volume":"366","author":"Dormandy","year":"2005","journal-title":"Lancet"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2572","DOI":"10.1001\/jama.296.21.joc60158","article-title":"Effect of Pioglitazone Compared with Glimepiride on Carotid Intima-Media Thickness in Type 2 Diabetes","volume":"296","author":"Mazzone","year":"2006","journal-title":"JAMA"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1038\/s41569-020-0406-8","article-title":"SGLT2 inhibitors: Mechanisms of cardiovascular benefit beyond glycaemic control","volume":"17","author":"Cowie","year":"2020","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1002\/hep.30429","article-title":"Modulation of Insulin Resistance in Nonalcoholic Fatty Liver Disease","volume":"70","author":"Khan","year":"2018","journal-title":"Hepatology"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.2337\/db16-1410","article-title":"Correcting Postprandial Hyperglycemia in Zucker Diabetic Fatty Rats with an SGLT2 Inhibitor Restores Glucose Effectiveness in the Liver and Reduces Insulin Resistance in Skeletal Muscle","volume":"66","author":"Jenkins","year":"2017","journal-title":"Diabetes"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.numecd.2017.11.010","article-title":"Vitamin D receptor activation by paricalcitol and insulin resistance in CKD","volume":"28","author":"Spoto","year":"2018","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2999","DOI":"10.1016\/j.clnu.2020.11.037","article-title":"A randomized controlled clinical trial comparing calcitriol versus cholecalciferol supplementation to reduce insulin resistance in patients with non-alcoholic fatty liver disease","volume":"40","author":"Mahmoudi","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.clnu.2019.03.007","article-title":"Effects of vitamin D supplementation on metabolic and endocrine parameters in healthy premenopausal women: A randomized controlled trial","volume":"39","author":"Trummer","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1038\/ki.2012.311","article-title":"Paricalcitol does not improve glucose metabolism in patients with stage 3\u20134 chronic kidney disease","volume":"83","author":"Sachs","year":"2013","journal-title":"Kidney Int."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1093\/ajcn\/nqz171","article-title":"Effect of vitamin D3 supplementation on insulin resistance and \u03b2-cell function in prediabetes: A double-blind, randomized, placebo-controlled trial","volume":"110","author":"Wallace","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"3557","DOI":"10.1210\/jc.2012-2126","article-title":"Vitamin D3Supplementation Has No Effect on Conventional Cardiovascular Risk Factors: A Parallel-Group, Double-Blind, Placebo-Controlled RCT","volume":"97","author":"Wood","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_82","first-page":"475","article-title":"Effect of vitamin D supplementation on fasting plasma glucose, insulin resistance and prevention of type 2 diabetes mellitus in non-diabetics: A systematic review and meta-analysis","volume":"8","author":"He","year":"2018","journal-title":"Biomed. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1210\/js.2017-00472","article-title":"Vitamin D Supplementation, Glycemic Control, and Insulin Resistance in Prediabetics: A Meta-Analysis","volume":"2","author":"Mirhosseini","year":"2018","journal-title":"J. Endocr. Soc."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"\u0141agowska, K., Bajerska, J., and Jamka, M. (2018). The Role of Vitamin Oral Supplementation in Insulin Resistance in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients, 10.","DOI":"10.3390\/nu10111637"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1111\/j.1365-2265.2011.04299.x","article-title":"FGF23 contributes to insulin sensitivity in obese adolescents\u2014Preliminary results","volume":"77","author":"Wojcik","year":"2011","journal-title":"Clin. Endocrinol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1111\/j.1523-1755.2005.00600.x","article-title":"Effects of sevelamer and calcium on coronary artery calcification in patients new to hemodialysis","volume":"68","author":"Block","year":"2005","journal-title":"Kidney Int."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1053\/j.ajkd.2010.10.055","article-title":"Effect of Sevelamer and Calcium-Based Phosphate Binders on Coronary Artery Calcification and Accumulation of Circulating Advanced Glycation End Products in Hemodialysis Patients","volume":"57","author":"Kakuta","year":"2011","journal-title":"Am. J. Kidney Dis."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"216","DOI":"10.5414\/CN107257","article-title":"Effect of lanthanum carbonate vs. calcium carbonate on serum calcium in hemodialysis patients: A crossover study","volume":"78","author":"Toida","year":"2012","journal-title":"Clin. Nephrol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1159\/000351811","article-title":"Effect of a Non-Calcium-Based Phosphate Binder on Fibroblast Growth Factor 23 in Chronic Kidney Disease","volume":"123","author":"Spatz","year":"2013","journal-title":"Nephron Clin. Pr."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2383","DOI":"10.1093\/ndt\/gft203","article-title":"A comparison of calcium acetate\/magnesium carbonate and sevelamer-hydrochloride effects on fibroblast growth factor-23 and bone markers: Post hoc evaluation from a controlled, randomized study","volume":"28","author":"Covic","year":"2013","journal-title":"Nephrol. Dial. Transplant."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/12\/4349\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:38:53Z","timestamp":1760168333000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/12\/4349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,2]]},"references-count":90,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["nu13124349"],"URL":"https:\/\/doi.org\/10.3390\/nu13124349","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,2]]}}}