Association between serum visfatin and carotid atherosclerosis in diabetic and non-diabetic patients on maintenance hemodialysis

Authors

  • Nevine Sherif Nephrology Department, Theodor Bilharz Research Institute, Giza, Egypt

Keywords:

chronic kidney disease, visfatin, carotid intima-media thickness, hemodialysis

Abstract

Introduction: Adipose tissue releases bioactive factors termed adipokines. Visfatin is an adipokine that plays an active role promoting vascular inflammation and atherosclerosis. The purpose of this study was to determine the association between serum visfatin levels and carotid atherosclerosis in diabetic and non-diabetic patients on maintenance hemodialysis (HD) in order to clarify the role of serum visfatinas, a risk factor for cardiovascular complications in HD patients.

Methods: Forty patients on maintenance hemodialysis were enrolled in this case-control study in 2015. They were subdivided into two groups, i.e., a diabetic group (n = 20) and a non-diabetic group (n = 20). Twenty healthy subjects who were age and gender matched were included as a control group. Carotid Duplex studies were performed on all patients, and serum visfatin was determined by a competitive enzyme immunoassay.

Results: HD patients showed a highly significant increase in serum visfatin, urea, creatinine, Ca×Ph, K, fasting glucose, triglycerides, LDL levels, and a significant decrease in eGFR, Na, HDL, and Hb compared to the control group. Also, serum visfatin levels showed a highly significant increase in the diabetic HD group compared to both the non-diabetic HD and control groups. Serum visfatin showed a highly significant increase in non-diabetic HD patients compared to the control group. Carotid intima-media thickness (IMT) showed a highly significant increase in HD group compared to the control group. Serum visfatin correlated positively with serum urea, creatinine, glucose, and IMT, but it was negatively correlated with eGFR, Na, and HDL

Conclusion: We concluded that serum visfatin is increased in HD patients with and without diabetes. Moreover, its association with IMT may be involved in the pathogenesis of atherosclerosis in CRF patients.

References

De Mutsert R, Grootendorst DC, Axelsson J, Boeschoten EW, Krediet RT, Dekker FW. Excess mortality

due to interaction between protein energywasting, inflammation and cardiovascular disease in

chronicdialysis patients. Nephrol Dial Transplant. 2008; 23: 2957-64. doi: 10.1093/ndt/gfn167, PMID:

Pecoits-Filho R, Heimburger O, Barany P, Suliman M, Fehrman-Ekholm I, Lindholm B, et al. Associations

between circulating inflammatory markers and residual renal function in CRF patients. Am J Kidney Dis.

; 41: 1212-8. doi: 10.1016/S0272-6386(03)00353-6, PMID: 12776273.

Heimburger O, Stenvinkel P. Adipokines in chronic kidney disease: fat tissue gives nephrologists a

message. Perit Dial Int. 2005; 25: 340-2. PMID: 16022088.

Tedgui A, Mallat Z. Cytokines in atherosclerosis: pathogenicand regulatory pathways. Physiol Rev. 2006;

: 515-81. doi: 10.1152/physrev.00024.2005, PMID: 16601268.

Axelsson J, Bergsten A, Qureshi AR, Heimburger O, Barany P, Lonnqvist F. Elevated resistin levels in

chronic kidney disease areassociated with decreased glomerular filtration rate and inflammation, but not

with insulin resistance. Kidney Int. 2006; 69: 596-604. doi: 10.1038/sj.ki.5000089, PMID: 16395259.

Chitalia N, Raja RB, Bhandara T, et al. Serum adiponectin and cardiovascular risk in chronic kidney

disease and kidneytransplantation. J Nephrol. 2010; 23: 77-84. PMID: 20091490.

Fukuhara A, Matsuda M, Nishizawa M, Segawa K, Tanaka M, Kishimoto K, et al. Visfatin: a protein

secreted by visceral fat that mimics the effects of insulin. Science. 2005; 307: 426–30. doi:

1126/science.1097243, PMID: 15604363.

Malam Z, Parodo J, Waheed F, Szaszi K, Kapus A, Marshall JC. Pre-B cell colony-enhancing factor

(PBEF/Nampt/visfatin) primes neutrophilsfor augmented respiratory burst activity through partial assembly

of theNADPH oxidase. J Immunol. 2011; 186: 6474–4. doi: 10.4049/jimmunol.1003706, PMID: 21518975.

Revollo JR, Grimm AA, Imai S. The regulation of nicotinamide adenine dinucleotide biosynthesis by

Nampt/PBEF/visfatin in mammals. Curr Opin Gastroenterol. 2007; 23:164–70. doi:

1097/mog.0b013e32801b3c8f, PMID: 17268245.

Luk T, Malam Z, Marshal J. Pre-B cell colony enhancing factor (PBEF)/ visfatin: a novel mediator of

innate immunity. J LeukocBiol. 2008; 83: 804–16. doi: 10.1189/jlb.0807581, PMID: 18252866.

Axelsson J, Witasp A, Carrero JJ, Qureshi AR, Suliman ME, Heimbürger O, et al. Circulating levels of

visfatin/pre-B-cell colony-enhancing factor 1 in relation to genotype, GFR, body composition, and survival

in patients with CKD. Am J Kidney Dis. 2007; 49: 237–44. doi: 10.1053/j.ajkd.2006.11.021, PMID:

Yilmaz MI, Saglam M, Qureshi AR, Carrero JJ, Caglar K, Eyileten T. Endothelial dysfunction in type-2

diabetics with early diabetic nephropathy is associated with low circulating adiponectin. Nephrol Dial

Transplant. 2008; 23: 1621–7. doi: 10.1093/ndt/gfm828, PMID: 18175782.

Malyszko J, Malyszko S, Mysliwiec M. Visfatin, a new adipocytokine, is predominantly related to

inflammation/endothelial damage in kidney allograft recipients. Transplant Proc. 2009; 41: 150–3. doi:

1016/j.transproceed.2008.10.086, PMID: 19249500.

Yilmaz MI, Saglam M, Carrero JJ, Qureshi AR, Qureshi AR, Caglar K, et al. Serum visfatin concentration

and endothelial dysfunction in chronic kidney disease. Nephrol Dial Transplant. 2008; 23: 959–65. doi:

1093/ndt/gfm727, PMID: 17984105.

Lotfy AW, Mohammed N, El-Tokhy HM, Attia A. Serum visfatin in chronic renal failure patients on

maintenance hemodialysis: a correlation study. Egypt J Intern Med. 2013; 25: 202–8. doi: 10.4103/1110- 7782.124982.

MalyszkoJ, Malyszko JS, Mysliwiec M. Visfatin and endothelial function in dialyzed patients. Nephrology

(Carlton). 2010; 15(2): 190-6. doi: 10.1111/j.1440-1797.2009.01180.x, PMID: 20470278.

Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death,

cardiovascular events, and hospitalization. N Engl J Med. 2004; 351(13): 1296-305. doi:

1056/NEJMoa041031, PMID: 15385656.

Keller C, Katz R, Sarnak MJ, Fried LF, Kestenbaum B, Cushman M, et al. Inflammatory biomarkers and

decline in kidney function in the elderly: the Cardiovascular Health Study. Nephrol Dial Transplant. 2010;

(1): 119-24. doi: 10.1093/ndt/gfp429, PMID: 19734138, PMCID: PMC2910326.

Iglesias P, Díez JJ. Adipose tissue in renal disease: clinical significance and prognostic implications.

Nephrol Dial Transplant. 2010; 25: 2066–77. doi: 10.1093/ndt/gfq246, PMID: 20466661.

Bessa SS, Hamdy SM, El-Sheikh RG. Serum visfatin as a non-traditional biomarker of endothelial

dysfunction in chronic kidney disease: an Egyptian study. Eur J Intern Med. 2010; 21: 530–5. doi:

1016/j.ejim.2010.09.011, PMID: 21111939.

Mu J, Feng B, Ye Z, Yuan F, Zeng W, Luo Z, et al. Visfatin is related to lipid dysregulation,endothelial

dysfunction and atherosclerosis in patients with chronic kidney disease. J Nephrol. 2011; 24: 177–84. doi:

5301/JN.2010.3488, PMID: 20602330.

Carrero JJ, Witasp A, Stenvinkel P, Qureshi AR, Heimbürger O, Bárány P, et al. Visfatin is increased in

chronic kidney disease patients withpoor appetite and correlates negatively with fasting serum amino

acidsand triglyceride levels. Nephrol Dial Transplant. 2010; 25: 901–6. doi: 10.1093/ndt/gfp587, PMID:

Mahmood N, Junejo AM, Jamal Q, Awan R. Association of visfatin withchronic kidney disease in a cohort

of patients with and without diabetes. J Pak Med Assoc. 2010; 60: 922–6. PMID: 21375196.

Nüsken KD, Petrasch M, Rauh M, Stöhr W, Nüsken E, Schneider H, et al. Reduced plasma visfatin in end

stage renal disease is associated with reduced body fat mass and elevatedserum insulin. Exp Clin

Endocrinol Diabetes. 2007; 115: P01–052. doi: 10.1055/s-2007-972308.

Song H, Lee M, Kim B, Park Y, Ko G, and Kang Y. Visfatin: a new player in mesangial cell physiology

and diabetic nephropathy. Am J Physiol Renal Physiol. 2008; 295: 1485–94. doi:

1152/ajprenal.90231.2008, PMID: 18768589.

Tang X, Chen M, Zhang W. Association between elevated visfatin and carotid atherosclerosis inpatients

with chronic kidney disease. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013; 38(6): 553-9. doi:

3969/j.issn.1672-7347.2013.06.002, PMID: 23828708.

O’Keefe JH, Bell DS. Postprandial hyperglycemia/hyperlipidemia (postprandial dysmetabolism) is a

cardiovascular riskfactor. Am J Cardiol. 2007; 100: 899-904. doi: 10.1016/j.amjcard.2007.03.107, PMID:

Liu SW, Qiao SB, Yuan JS, Liu DQ. Association of plasma visfatinlevels with inflammation,

atherosclerosis, and acute coronary syndromes in humans. ClinEndocrinol (Oxf). 2009; 71: 202-7. doi:

1111/j.1365-2265.2008.03453.x, PMID: 19178507.

Takebayashi K, Suetsugu M, Wakabayashi S, Aso Y, Inukai T, Association between plasma visfatin and

vascular endothelial function in patients with type 2 diabetes mellitus. Metabolism. 2007; 56: 451-8. doi:

1016/j.metabol.2006.12.001, PMID: 17378999.

Teoh H, Lovren F, Verma S, Vascular dysfunction: a Janus face of visfatin in diabetes? Metabolism. 2007;

: 459-61. doi: 10.1016/j.metabol.2006.12.002, PMID: 17379000.

Zhang T, Berrocal JG, Frizzell KM. Enzymes in the NAD+ salvage pathway regulate SIRT1 activity at

target gene promoters. J Biol Chem. 2009; 284: 20408-17. doi: 10.1074/jbc.M109.016469, PMID:

, PMCID: PMC2740465.

Van der Veer E, Nong Z, O’Neil C, Urquhart B, Freeman D, Pickering JG. Pre-B-cell colony-enhancing

factor regulates NAD+- dependent protein deacetylase activity and promotes vascular smooth muscle cell

maturation. Circ Res. 2005; 97: 25-34. doi: 10.1161/01.RES.0000173298.38808.27, PMID: 15947248.

Adya R, Tan BK, Punn A, Chen J, Randeva HS. Visfatin induces human endothelial VEGF and MMP-2/9

production via MAPK and PI3K/Aktsignalling pathways: novel insights into visfatininduced angiogenesis.

Cardiovasc Res. 2008; 78: 356-65. doi: 10.1093/cvr/cvm111, PMID: 18093986.

Published

2022-02-21