title: Serum visfatin concentration and endothelial dysfunction in chronic kidney disease.
abstract: BACKGROUND
  Endothelial dysfunction (ED) is common in patients with moderate to advanced chronic kidney disease (CKD). Recently, visfatin, a protein with insulin-mimetic properties, was shown to be associated with sVCAM-1. Thus, we hypothesised that visfatin may be a marker of ED in CKD.
  
  
  METHODS
  We studied 406 patients with different stages of non-diabetic CKD (50% males, 46 +/- 12 years), testing the relationship between flow-mediated dilatation (FMD), assessed by high resolution brachial ultrasonography, and plasma adiponectin and visfatin concentrations. Eighty healthy volunteers (50% males, 46 +/- 11 years) served as matched controls.
  
  
  RESULTS
  Compared to healthy controls, ED was observed in all stages of CKD (Stages 1-5) and correlated strongly with the reduction in estimated glomerular filtration rate (eGFR). Whereas visfatin concentrations were found to be increased in all but CKD stages 1 and 2, adiponectin levels were found to be increased in all patients but CKD stage 1. Visfatin and adiponectin levels were strongly correlated with eGFR (rho = -0.62 and rho = -0.72, respectively, P < 0.001 for both). FMD levels were negatively correlated with both visfatin and adiponectin levels (rho = -0.53 and, rho = -0.57, respectively, P < 0.001 for both). In a multiple regression model, eGFR levels (Beta = 0.74, P < 0.001), visfatin (Beta = -0.15, P < 0.001), age (Beta = 0.06, P < 0.01), adiponectin (Beta = 0.09, P < 0.05), HOMA-IR (Beta = 0.07, P < 0.05) and hsCRP (Beta = -0.08, P < 0.05) were all found to be significantly related to FMD.
  
  
  CONCLUSIONS
  We conclude that the circulating levels of visfatin and adiponectin are associated with ED in all stages of CKD, independently of inflammation and insulin resistance.
authors.affiliation: Department of Nephrology, Gülhane School of Medicine, 06018 Etlik-Ankara, Turkey. mahmutiyilmaz@yahoo.com
authors.forename: Mahmut Ilker
authors.initials: MI
authors.lastname: Yilmaz
authors.forename: Mutlu
authors.initials: M
authors.lastname: Saglam
authors.forename: Juan Jesus
authors.initials: JJ
authors.lastname: Carrero
authors.forename: Abdul Rashid
authors.initials: AR
authors.lastname: Qureshi
authors.forename: Kayser
authors.initials: K
authors.lastname: Caglar
authors.forename: Tayfun
authors.initials: T
authors.lastname: Eyileten
authors.forename: Alper
authors.initials: A
authors.lastname: Sonmez
authors.forename: Erdinc
authors.initials: E
authors.lastname: Cakir
authors.forename: Mujdat
authors.initials: M
authors.lastname: Yenicesu
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Peter
authors.initials: P
authors.lastname: Stenvinkel
authors.forename: Jonas
authors.initials: J
authors.lastname: Axelsson
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002908:Chronic Disease; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D007674:Kidney Diseases / Q000097:blood* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D012720:Severity of Illness Index; D014664:Vasodilation / Q000502:physiology
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D054409:Nicotinamide Phosphoribosyltransferase