Visfatin and endogenous secretory receptor for advanced glycation end-products in diabetic type 2 and non-diabetic patients undergoing intermittent hemodialysis

Abstract

Background/aims: To examine plasma levels of visfatin and endogenous secretory receptor for advanced glycation end-products (esRAGE) in diabetic and non-diabetic patients treated with intermittent hemodialysis (IHD), and to explore the possible associations between them, insulin resistance evaluated by homeostasis model assessment for insulin resistance (HOMA-IR), as well as selected biochemical and anthropometric parameters.

Methods: The study was carried out in 65 IHD patients. Type 2 diabetic patients (n = 28) were included into group I, non-diabetics (n = 37)-into group II. The reference group included 25 healthy volunteers.

Results: There were no significant differences between group I and II in plasma level of visfatin and esRAGE. HOMA-IR was higher in group I than in group II. In both groups these parameters were higher than in healthy subjects. In group I, visfatin correlated with insulin concentration (r = 0.428, P = 0.023), HOMA-IR with esRAGE (r = -0.374, P = 0.049). In group II, esRAGE correlated with waist-to-hip ratio (r = -0.343, P = 0.037), HOMA-IR with body mass index (r = 0.499, P = 0.001) and LDL cholesterol (r = -0.384, P = 0.018).

Conclusions: Serum concentrations of visfatin and esRAGE are increased in IHD patients. There is no difference in visfatin and esRAGE levels between diabetic and non-diabetic IHD patients. In diabetic IHD patients receiving insulin, lower esRAGE levels are associated with higher insulin resistance, whereas plasma visfatin level is positively related to plasma insulin concentration. Waist-to-height ratio is a significant determinant of plasma visfatin level and HOMA-IR. Insulin resistance seems to be a link between esRAGE and visfatin in IHD diabetics.