engleski

Visfatin in diabetic and hipertensive patients on dialysis

AIM : Visfatin is an adipocytokine that has recently gained strong interest. On the cellular level visfatin binds to insulinreceptors through a region different than insulin. It was shown visfatin exerts insulin-mimetic effects in cultured cells, lowers plasma glucose, stimulates glucose uptake in adipocytes and myocytes, and inhibits glucose release from the liver. Current evidence suggests a role for visfatin in the regulation of inflammatory response. The aim of the study was to analyze visfatin levels in correlation with type 2 diabetes mellitus, markers of endothelial dysfunction and inflammation, therapy and dialysis parameters in haemodialysed patients. ME THODS: A total of 66 patients on chronic haemodialysis ( HD ) were studied. All subjects (from 27 years to 84 years, median age 68 years, 40 males, 26 females, median time on haemodialysis 30 months ) provided blood samples ( HD patients after 3 days without dialysis ). 23 patients had type 2 diabetes mellitus and 12 were on insulin therapy. 45 patients had hypertension. RESULTS: Serum visfatin was increased in the group of diabetic patients recieving insulin therapy compared to nondiabetics and diabethics without insulin therapy ( P = 0.0175228 ). Patients on insulin therapy had higher BMI compared to patients who were not treated with insulin. Patients with history of hypertension had statistically significant higher visfatin levels in serum compared to patients without hypertension ( P = 0, 010668 ). Visfatin levels did not correlate with values of blood pressure, plasma glucose, HbA1C, total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, hsCRP, creatinine, PAI, fibrinogen, and BMI. We did not find that time on dialysis and remaining diuresis influence visfatin concentrations in dialysed patients. CONCLU SION: We still face many unknowns when understanding the effects that adipokines exert in the uremic milieu. Higher visfatin levels in diabetic patients on insulin therapy are probably related to higher BMI, and probably more fat tissue in that group. The role of visfatin in hypertension is still unclear. Interventional studies are needed to move forward in this area.

visfatin; diabetes mellitus; dialysis

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