title: Effect of Vitamin D Status on Von Willebrand Factor and ADAMTS13 in Diabetic Patients on Chronic Hemodialysis.
abstract: Von Willebrand factor (vWF) is a glycoprotein with a crucial role in the formation of platelet thrombi, and ADAMTS13 is the main enzyme responsible for vWF cleavage. Both are important in the relationship between diabetic nephropathy, hypercoagulability, and cardiovascular disease. This study evaluated a potential relationship between vitamin D (vitD) levels, vWF, ADAMTS13 activity, and inflammation in diabetic patients on chronic hemodialysis (HD). Blood samples from 52 diabetic patients on chronic HD were obtained to determine vitD levels, vWF, and ADAMTS13 activity, and inflammatory markers. HD patients were grouped according to 25-hydroxyvitamin D [25(OH) VitD]<25 nmol/L (n=16) or >25 nmol/L (n=36). vWF antigen and vWF activity were elevated in both groups, with an average of 214.3±82.6% and 175.8±72.6%, respectively. Average ADAMTS13 activity was within the normal range in both groups. Blood samples from the vitD <25 nmol/L group showed a positive correlation between c-reactive protein (CRP) and vWF levels (P=0.023; r=0.564; 95% confidence interval=0.095-0.828), with a negative correlation between HbA1c and 25(OH) VitD (P=0.015; r=-0.337; 95% confidence interval=-0.337-0.19). Diabetic patients on chronic HD had elevated vWF levels and activity with no significant change in ADAMTS13 activity. The correlation between CRP and vWF levels in the 25(OH) VitD<25 nmol/L group suggests inflammatory-related endothelial dysfunction in these patients.
authors.affiliation: Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Cohen-Hagai
authors.affiliation: Medical Laboratories, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Gloria
authors.initials: G
authors.lastname: Rashid
authors.affiliation: Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Yael
authors.initials: Y
authors.lastname: Einbinder
authors.affiliation: Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.
authors.forename: Meital
authors.initials: M
authors.lastname: Ohana
authors.affiliation: Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Sydney
authors.initials: S
authors.lastname: Benchetrit
authors.affiliation: Renal Physiology Laboratory, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. tali.gal@clalit.org.il.
authors.forename: Tali
authors.initials: T
authors.lastname: Zitman-Gal
mesh_terms: D000071120:ADAMTS13 Protein / Q000378:metabolism*; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D000071120:ADAMTS13 Protein; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D014807:Vitamin D; D014841:von Willebrand Factor; C517652:hemoglobin A1c protein, human; C104450:25-hydroxyvitamin D; C099604:ADAMTS13 protein, human
keywords: ADAMTS13; Diabetes; Hemodialysis; Inflammation; Vitamin D; von Willebrand factor