Department of Nephrology, Baskent University, Ankara, Turkey.
Ren Fail. 2012;34(6):732-7. doi: 10.3109/0886022X.2012.676493. Epub 2012 Apr 16.
BACKGROUND/OBJECTIVES: Cardiovascular abnormalities are common in patients with chronic kidney disease. Visfatin influences lipid metabolism, insulin sensitivity, and cardiovascular health. The aim of this study was to explore the relation of serum visfatin to cardiovascular risk factors in nondiabetic peritoneal dialysis (PD) patients.
Eighty-seven nondiabetic patients (mean age 48 ± 15 years, 39 males) under PD were enrolled. Weight, anthropometric measurements, blood pressure, biochemical parameters, and insulin resistance (homeostatic model assessment-insulin resistance-HOMA-IR) were measured. Visfatin was measured and left ventricular mass index (LVMI) was calculated by echocardiography.
LVMI was correlated with body mass index (BMI; r = 0.47, p = 0.01), systolic blood pressure (SBP; r = 0.62, p = 0.04), and serum visfatin levels (r = 0.49, p = 0.03). According to HOMA-IR levels patients were grouped as insulin-resistant (IR) (HOMA-IR ≥2.0, n = 35) and noninsulin-resistant (non-IR) (HOMA-IR <2.0, n = 52) groups. The IR group had longer PD duration and higher BMI, total cholesterol, uric acid, and serum visfatin levels (p < 0.05). The study patients were divided into three groups according to their serum visfatin levels. Group 1 (≤34 ng/mL, n = 22) was considered as the lowest tertile of low visfatin and group 2 (35-42 ng/mL, n = 43) and group 3 (≥43 ng/mL, n = 22) in the upper tertile. Considering the visfatin groups, group 3 patients had significantly higher BMI (p = 0.00), total cholesterol (p = 0.03), C-reactive protein (CRP) (p = 0.03), HOMA-IR (p = 0.03), and LVMI (p = 0.02). In regression analysis, SBP (β = 0.19, p < 0.05) and serum visfatin levels (β = 0.74, p < 0.05) were independent variables affecting LVMI.
Serum visfatin might be a sensitive marker than HOMA-IR evaluations for cardiac performance in nondiabetic PD patients.
背景/目的：心血管异常在慢性肾脏病患者中很常见。内脏脂肪素影响脂代谢、胰岛素敏感性和心血管健康。本研究旨在探讨非糖尿病腹膜透析（PD）患者血清内脏脂肪素与心血管危险因素的关系。
纳入 87 例非糖尿病 PD 患者（平均年龄 48 ± 15 岁，39 名男性）。测量体重、人体测量学指标、血压、生化参数和胰岛素抵抗（稳态模型评估-胰岛素抵抗-HOMA-IR）。通过超声心动图测量内脏脂肪素并计算左心室质量指数（LVMI）。
LVMI 与体重指数（BMI；r = 0.47，p = 0.01）、收缩压（SBP；r = 0.62，p = 0.04）和血清内脏脂肪素水平（r = 0.49，p = 0.03）相关。根据 HOMA-IR 水平，患者被分为胰岛素抵抗（IR）（HOMA-IR≥2.0，n = 35）和非胰岛素抵抗（非-IR）（HOMA-IR<2.0，n = 52）组。IR 组 PD 时间较长，BMI、总胆固醇、尿酸和血清内脏脂肪素水平较高（p < 0.05）。根据血清内脏脂肪素水平，将研究患者分为三组。第 1 组（≤34ng/mL，n = 22）为低内脏脂肪素最低三分位，第 2 组（35-42ng/mL，n = 43）和第 3 组（≥43ng/mL，n = 22）为高内脏脂肪素三分位。在考虑内脏脂肪素组时，第 3 组患者的 BMI（p = 0.00）、总胆固醇（p = 0.03）、C 反应蛋白（CRP）（p = 0.03）、HOMA-IR（p = 0.03）和 LVMI（p = 0.02）均显著较高。在回归分析中，SBP（β = 0.19，p < 0.05）和血清内脏脂肪素水平（β = 0.74，p < 0.05）是影响 LVMI 的独立变量。
血清内脏脂肪素可能是一种比 HOMA-IR 评估更敏感的指标，可用于评估非糖尿病 PD 患者的心脏功能。
