SP305THE RELATIONSHIP BETWEEN VISFATIN AND CAROTID ATHEROSCLEROSIS IN PATIENTS WITH ADVANCED CHRONIC KIDNEY DISEASE

Abstract

Introduction and Aims: There are many mediators of inflammation in adults with chronic kidney disease (CKD), including atherosclerosis and cytokines. Inflammation contributes to the progression of CKD by inducing the release of cytokines, and also causes mortality from cardiovascular disease by contributing to the development of vascular calcifications and endothelial dysfunction. Visfatin is a newly identified cytokine that released especially in inflammation from adipose tissue. Recent studies indicated that visfatin may have potential proinflammatory effect. In this study we investigated whether serum visfatin levels is altered in patients with CKD, and compared inflammation markers between patients with and without carotid atherosclerosis. Methods: A total of 50 non-dialyzed patients with CKD stage 4 or 5 and 31 healthy subjects enrolled in this study. We measured serum triglycerides, total cholesterol, high-density lipoprotein (HDL) cholesterol and low-density lipoprotein (LDL) cholesterol, visfatin, procalcitonin (PCT) and high sensitive C-reactive protein (hsCRP) levels. Common carotid arteries intima-media thickness (IMT) and atherosclerotic plaque were detected by non-invasive high-resolution B-mode ultrasonography. Results: Compared with healthy controls, patients with CKD had same gender distribution (22 vs. 18 female), older age (median 46.5 vs. 32 years), lower albumin (median 3.75 vs. 4.2 g/dL), HDL (37.3±12.4 vs. 46.7±8.7 mg/dL), estimated glomerular filtration rate (eGFR) and hemoglobin levels, and higher body mass index (BMI) (29.3 ±2.8 vs. 25.5±4.6 kg/m2), trygliceride (median 184 vs. 98 mg/dL), visfatin (median 30.9 vs. 19 ng/mL), hsCRP (0.34 vs. 0.33 ng/mL) and PCT (0.23 vs. 0.05 ng/mL) (p<0.001). Also the carotid IMT in patients with CKD was higher than control groups (median 0.8 vs. 0.5 mm, p<0.001). In all study population, carotid IMT was positively correlated with age, BMI, visfatin, hsCRP, PCT, trygliceride and ferritin levels, and negatively correlated with eGFR, hemoglobin and HDL levels. Serum visfatin, hsCRP and PCT levels of 30 persons with carotid atherosclerosis were higher than those of 50 persons without carotid atherosclerosis (38.2±14.6 vs. 22.1±10.5 ng/mL, 1.88±3.31 vs. 0.49 ±0.39 ng/mL and 0.38±0.49 vs. 0.13±0.16 ng/mL, respectively, p<0.001). Serum visfatin of 28 CKD patients with carotid atherosclerosis were higher than those of 22 CKD patients without carotid atherosclerosis (37.8±15 vs. 25.6±14.3 ng/mL, p<0.001), but not hsCRP and PCT levels. Conclusions: Our results showed that serum visfatin, PCT and hsCRP levels was increased in non-dialyzed with CKD stage 4 or 5 and healthy persons who had carotid atherosclerosis. Visfatin may be an inflammatory marker of CKD patients with atherosclerosis.