Association between elevated visfatin and carotid atherosclerosis in patients with chronic kidney disease

To determine the levels of visfatin in patients with chronic kidney disease (CKD) and to explore the relationship between visfatin levels and caroid atherosclerosis in CKD patients.

A total of 180 CKD patients (102 non-dialyzed patients and 78 dialysis patients) and 42 healthy subjects enrolled in this study. The serum levels of visfatin, IL-6, and high sensitive C-reactive protein (hsCRP) were measured by ELISA. Common carotid arteries intima-media thickness (CCA-IMT), cross-sectional calculated intima-media thickness (c IMT) area and atherosclerotic plaque were detected by non-invasive high-resolution B-mode ultrasonography.

The serum levels of visfatin, IL-6 and hsCRP were significantly increased in CKD patients compared with age matched healthy subjects (P<0.01). The serum levels of visfatin, IL-6 and hsCRP in the dialyzed patients were significantly higher than those in non-dialyzed patients (P<0.05). Visfatin levels increased with the progression of renal dysfunction and inversely related to creatinine clearance (Ccr) in non-dialyzed patients (r=-0.415, P<0.05). Patients with carotid artery plaques showed significantly higher levels of visfatin[(34.22±7.96) ng/mL)] compared with those without plaques [(28.24±6.18) ng/mL, P<0.05]. The serum levels of visfatin were closely correlated with IL-6 (r=0.548, P<0.001), hsCRP (r=0.430, P<0.001), CCA-IMT (r=0.462, P<0.05), and c IMT area (r=0.411, P<0.05). After adjusting for GFR, age, gender, and other risk factors associated with atherosclerosis, multiple stepwise regression analysis showed that serum visfatin is a independent risk factor for CCA-IMT (β=0.433, P<0.01) and c IMT area (β=0.412, P<0.01).

The serum level of visfatin increase with the progression of CKD and should be considered to be a new risk factor for atherosclerosis in CKD.