title: Determinants of visfatin in type 2 diabetes patients with diabetic kidney disease: Relationship to inflammation, adiposity and undercarboxylated osteocalcin.
abstract: BACKGROUND
  Visfatin is a proinflammatory molecule with possible actions on glucose metabolism. Interactions to bone metabolism and undercarboxylated osteocalcin (uOC) in diabetic patients (T2DP) with diabetic kidney disease (DKD) have not been reported.
  
  
  METHODS
  We included 51 incident T2DP with DKD. History, laboratory evaluation, anthropometry, visfatin, uOC were obtained. Fifteen T2DP without DKD were used as controls.
  
  
  RESULTS
  Visfatin was similar in DKD patients and controls: 1.56(0.97-3.03) versus 2.04(1.08-3.21) ng/mL, p = 0.51. In controls, visfatin positively correlated with diabetes duration (r = 0.63, p = 0.01) and negatively with uOC (r = -0.57, p = 0.03). In multivariate regression, diabetes duration remained significant (p = 0.01). In patients with DKD, visfatin was positively linked to C reactive protein (r = 0.27, p = 0.05), tricipital skin fold (TSF) (r = 0.41, p = 0.004) and leukocytes (r = 0.37, p = 0.01); the latter two parameters predicted visfatin in multivariate model (p = 0.001). In normoalbuminuric patients, visfatin was linked to body mass index (r = 0.32, p = 0.04), waist circumference (r = 0.42, p < 0.0001), LDL cholesterol (r = 0.33, p = 0.03), serum glucose (r = 0.36, p = 0.03) and glycated hemoglobin (r = 0.41, p = 0.007); there was a trend towards negative correlation to uOC (r = -0.28, p = 0.07); only glycaemia remained significant in multivariate analysis (p = 0.04). Albuminuric patients displayed a positive correlation of visfatin to waist to hip ratio (r = 0.41, p = 0.04) and leukocytes (r = 0.56, p = 0.04); the latter remained significant in multivariate regression (p = 0.005).
  
  
  CONCLUSIONS
  The main determinant of visfatin in T2D patients with DKD is inflammation; in normoalbuminuric patients, a positive link to adiposity and altered glycemic control and a trend towards a negative correlation to uOC was observable; the latter relationship was evident in patients without DKD.
authors.affiliation: a University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj , Cluj Napoca ;
authors.forename: Alex C
authors.initials: AC
authors.lastname: Kacso
authors.affiliation: b Department of Informatics and Biostatistics , University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj , Cluj Napoca , Romania ;
authors.forename: Cosmina I
authors.initials: CI
authors.lastname: Bondor
authors.affiliation: c Department of Nephrology , University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj , Cluj Napoca , Romania ;
authors.forename: Anca L
authors.initials: AL
authors.lastname: Coman
authors.affiliation: c Department of Nephrology , University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj , Cluj Napoca , Romania ;
authors.forename: Alina R
authors.initials: AR
authors.lastname: Potra
authors.affiliation: d Department of Endocrinology , University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj , Cluj Napoca , Romania.
authors.forename: Carmen E
authors.initials: CE
authors.lastname: Georgescu
mesh_terms: D050154:Adiposity; D000368:Aged; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000097:blood* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D015675:Osteocalcin / Q000097:blood*
chemical_list: D016207:Cytokines; D015675:Osteocalcin; D054409:Nicotinamide Phosphoribosyltransferase; C085455:nicotinamide phosphoribosyltransferase, human
keywords: Adipokines; albuminuria; glomerular filtration rate; glucose metabolism disorders; inflammation; kidney disease