The association of Visfatin levels with metabolic parameters and inflammation in diabetic nephropathy

INTRODUCTION: To investigate the visfatin levels at different stages of diabetic nephropathy(DNP), changes in visfatin levels according to stages of DNP, and the association of visfatin levels with other anti-inflammatory parameters including high sensitivity C-reactive protein(hsCRP), interleukin-6(IL-6), and tumor necrosis factor alpha(TNFα).
METHODS: Patients were stratified into 4 groups based on the glomerular filtration rate(GFR) and albuminuria as follows; Group I: albuminuria<30 mg/day and GFR>60ml/min, Group II: albuminuria 30 to 300 mg/day and GFR>60ml/min, Group III: albuminuria>300mg/day and GFR>60ml/min, and Group IV: albuminuria>300 mg/day and GFR<60 ml/min.
RESULTS: Of the 141 patients included in the study, 83(58.8%) were female. The mean age of patients was 55.3±8.2 years. Microalbuminuria was found to be 10.1±9.8 mg/day in group I, 89.4±68.2 mg/day in group II, 525.1±280.7 mg/day in group III, and 1034±1893 mg/day in group IV, showing a statistically significant difference between the groups(p<0.001). When the correlation analysis was repeated separately in each group, there was a positive correlation between Visfatin and IL-6 levels in only group III (r=0.926; p<0.001). When the patients in group III and IV were combined in a single group and considered as macro-albuminuric, multivariate analysis showed that visfatin had a positive correlation with IL-6 (r=0.380, p=0.006)
DISCUSSION AND CONCLUSION: In this study, we could not determine any association between visfatin levels and other anti-inflammatory markers(IL-6, TNFα, and hsCRP). However, we found a close relationship between visfatin levels and IL-6 which is one of the most important markers of inflammation in diabetic patients with overt nephropathy, namely macro-albuminuric patients.