title: Association between serum visfatin and carotid atherosclerosis in diabetic and non-diabetic patients on maintenance hemodialysis.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Nephrology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Samia Hassan
authors.initials: SH
authors.lastname: El-Shishtawy
authors.affiliation: Nephrology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Osama
authors.initials: O
authors.lastname: Mosbah
authors.affiliation: Nephrology Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Nevine
authors.initials: N
authors.lastname: Sherif
authors.affiliation: Intensive Care Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Amna
authors.initials: A
authors.lastname: Metwaly
authors.affiliation: Cardiology Department, Aswan University, Aswan, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Hanafy
authors.affiliation: Clinical Chemistry Department, Theodor Bilharz Research Institute, Giza, Egypt.
authors.forename: Laila
authors.initials: L
authors.lastname: Kamel
keywords: carotid intima-media thickness; chronic kidney disease; hemodialysis; visfatin