Ann Lab Med.  2017 Mar;37(2):155-158. 10.3343/alm.2017.37.2.155.

Effect of Vitamin D Status on Von Willebrand Factor and ADAMTS13 in Diabetic Patients on Chronic Hemodialysis

• Cohen-Hagai K
• Rashid G
• Einbinder
• Ohana M
• Benchetrit S
• Zitman-Gal T

• KMID: 2373634
• DOI: http://doi.org/10.3343/alm.2017.37.2.155

Abstract

Von Willebrand factor (vWF) is a glycoprotein with a crucial role in the formation of platelet thrombi, and ADAMTS13 is the main enzyme responsible for vWF cleavage. Both are important in the relationship between diabetic nephropathy, hypercoagulability, and cardiovascular disease. This study evaluated a potential relationship between vitamin D (vitD) levels, vWF, ADAMTS13 activity, and inflammation in diabetic patients on chronic hemodialysis (HD). Blood samples from 52 diabetic patients on chronic HD were obtained to determine vitD levels, vWF, and ADAMTS13 activity, and inflammatory markers. HD patients were grouped according to 25-hydroxyvitamin D [25(OH) VitD]<25 nmol/L (n=16) or >25 nmol/L (n=36). vWF antigen and vWF activity were elevated in both groups, with an average of 214.3±82.6% and 175.8±72.6%, respectively. Average ADAMTS13 activity was within the normal range in both groups. Blood samples from the vitD <25 nmol/L group showed a positive correlation between c-reactive protein (CRP) and vWF levels (P=0.023; r=0.564; 95% confidence interval=0.095-0.828), with a negative correlation between HbA1c and 25(OH) VitD (P=0.015; r=-0.337; 95% confidence interval=-0.337-0.19). Diabetic patients on chronic HD had elevated vWF levels and activity with no significant change in ADAMTS13 activity. The correlation between CRP and vWF levels in the 25(OH) VitD<25 nmol/L group suggests inflammatory-related endothelial dysfunction in these patients.

Keyword

von Willebrand factor; ADAMTS13; Hemodialysis; Diabetes; Vitamin D; Inflammation

MeSH Terms

ADAMTS13 Protein/*metabolism
Aged
C-Reactive Protein/analysis
Diabetes Mellitus, Type 2/complications/*diagnosis/metabolism
Female
Hemoglobin A, Glycosylated/analysis
Humans
Male
Middle Aged
Renal Dialysis
Renal Insufficiency, Chronic/complications/*diagnosis/metabolism
Vitamin D/*analogs & derivatives/blood
von Willebrand Factor/*metabolism
ADAMTS13 Protein
C-Reactive Protein
Hemoglobin A, Glycosylated
Vitamin D
von Willebrand Factor

Figure

• 

  Fig. 1 Positive correlation between CRP and vWF in hemodialysis patients with 25(OH) VitD <25 nmol/L (P=0.023; r=0.564). Regression line: y=7.52x+175.88Abbreviations: CRP, c- reactive protein; vWF, von Willebrand factor; Ag, antigen.

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