ABSTRACT
INTRODUCTION@#In patients undergoing haemodialysis, cardiovascular mortality and morbidity, characterised by accelerated atherosclerosis and increased inflammation, are elevated. Salusins are newly defined molecules in the atherosclerotic processes, and while salusin-alpha (Sal-α) acts as an antiatherogenic factor, salusin-beta (Sal-β) has a proatherogenic role. Their roles are as yet undefined in patients undergoing haemodialysis.@*METHODS@#In this cross-sectional study, salusin levels, carotid intima-media thickness (CIMT) from the common carotid artery and pulse wave velocity (PWV) were measured for 180 patients undergoing haemodialysis and 90 healthy controls.@*RESULTS@#Mean Sal-α and Sal-β levels in patients undergoing haemodialysis (Sal-α: 726.4 ± 578.7 pg/mL; Sal-β: 1,080.4 ± 757.1 pg/mL) and healthy controls (Sal-α: 325.8 ± 303.7 pg/mL; Sal-β: 268.1 ± 409.0 pg/mL) were determined. Negative correlation was observed between Sal-α levels and CIMT (patients undergoing haemodialysis: r = -0.330, p < 0.0001; healthy controls: r = -0.223, p = 0.035) and PWV (patients undergoing haemodialysis: r = -0.210, p = 0.005; healthy controls: r = -0.378, p < 0.0001) in both groups. In patients undergoing haemodialysis, positive correlation was observed between Sal-β/Sal-α ratio and CIMT (r = 0.190, p = 0.012) and PWV (r = 0.155, p = 0.041). On subgroup analysis, Sal-α levels were found to be low in patients with diabetes mellitus.@*CONCLUSION@#Patients undergoing haemodialysis have higher Sal-β and Sal-α levels, and their higher Sal-β/Sal-α ratio, in comparison with healthy controls, might have cardiovascular risk implications.
ABSTRACT
Objective: To evaluate the relationship of vitamin D status and vitamin D replacement therapy with glycemic control, serum uric acid [SUA] levels, and microalbuminuria [MAU] in patients with type 2 diabetes [T2DM] and chronic kidney disease [CKD]
Subjects and Methods: A total of 1,463 patients with T2DM and CKD [aged 14-88 years], 927 females and 536 males, were included in this study. The serum data of 25-hydroxyvitamin D, i.e., 25[OH]D, level, SUA, hemoglobin [Hb]A1[c], creatinine, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio [UACR] were obtained from the medical records. The Mann-Whitney U test, the chi[2] test, the Mantel-Haenszel test, and linear regression models were used for data analysis
Results: Vitamin D deficiency and insufficiency were evident in 770 [52.0%] and 357 [24.0%] patients, respectively. Median HbA1[c] levels [7.3 [IQR 3.9] vs. 6.5 [IQR 2.3]%; p < 0.01] were significantly higher in patients deficient in vitamin D than in those with a normal vitamin D status. A significantly low level of vitamin D was noted with a high UACR [beta -0.01; 95% CI -0.01 to -0.001; p = 0.017] and HbA1[c] [beta -1.1; 95% CI -1.6 to -0.6; p < 0.001], but with low levels of SUA [beta 1.3; 95% CI 0.5-2.2; p = 0.002]. Vitamin D replacement was associated with a significantly low level of HbA1[c] [7.4 [2.7] vs. 6.7 [1.9]%; p < 0.001]
Conclusion: In this study, there was a high prevalence of hypovitaminosis D among T2DM patients with CKD, with a higher UACR, higher HbA1[c], and lower SUA being noted as playing a role in predicting a decrease in vitamin D levels and potential benefits of vitamin D replacement therapy on glycemic control in T2DM management