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

Cohen-Hagai, Keren; Rashid, Gloria; Einbinder, Yael; Ohana, Meital; Benchetrit, Sydney; Zitman‐Gal, Tali

doi:10.3343/alm.2017.37.2.155

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…As a biomarker of inflammation, CRP has been widely used in clinical practice [6, 12, 18, 19]. However, it cannot adequately differentiate etiologies of fever in hematologic patients due to its low specificity [20].…”

Section: Discussionmentioning

confidence: 99%

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

et al. 2019

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BackgroundSerum procalcitonin (PCT) and C-reactive protein (CRP) are biomarkers of infection. In patients with hematologic disorders with or without hematopoietic stem cell transplantation (HSCT), it is difficult to distinguish bloodstream infections from aseptic causes of febrile episodes. The objective of this study was to investigate diagnostic values of PCT and CRP in predicting systemic bacterial infection in patients with hematologic malignancies.MethodsClinical and laboratory data of 614 febrile episode cases from 511 patients were analyzed. Febrile episodes were classified into four groups: (1) culture-positive bacterial infection by Gram-positive cocci (GPC), (2) culture-positive bacterial infection by Gram-negative bacilli (GNB), (3) fungal infection, and (4) viral infection or a noninfectious etiology.ResultsOf 614 febrile cases, systemic bacterial infections were confirmed in 99 (16.1%) febrile episodes, including 38 (6.2%) GPC and 61 (9.9%) GNB infections. PCT levels were significantly higher in GNB infectious episodes than those in febrile episodes caused by fungal infection (0.58 ng/mL (95% CI: 0.26–1.61) vs. 0.22 ng/mL (0.16–0.38), P = 0.047). Bacterial infectious episodes showed higher PCT and CRP levels than non-bacterial events (PCT: 0.49 (0.26–0.93) ng/mL vs. 0.20 (0.18–0.22) ng/mL, P < 0.001; CRP: 76.6 (50.5–92.8) mg/L vs. 58.0 (51.1–66.5) mg/L, P = 0.036). For non-neutropenic febrile episodes, both PCT and CRP discriminated bacteremia from non-bacteremia. However, in neutropenic febrile episodes, PCT only distinguished bacteremia from non-bacteremia. In non-neutropenic episode, both PCT and CRP showed good diagnostic accuracy (AUC: 0.757 vs. 0.763). In febrile neutropenia, only PCT discriminated bacteremia from non-bacterial infection (AUC: 0.624) whereas CRP could not detect bacteremia (AUC: 0.500, 95% CI: 0.439–0.561, P > 0.05).ConclusionsIn this single-center observational study, PCT was more valuable than CRP for discriminating between bacteremia and non-bacteremia independent of neutropenia or HSCT.

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Section: Discussionmentioning

confidence: 99%

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

et al. 2019

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“…Lu et al [ 27 ] demonstrated increased levels of vWF in people with chronic kidney disease (CKD) compared with healthy subjects. In another study, diabetic patients with chronic hemodialysis had elevated vWF levels [ 28 ]. Several RCTs have been performed in the last decade to assess the impacts of vitamin D administration on endothelial function among patients with metabolic syndrome and related disorders.…”

Section: Discussionmentioning

confidence: 99%

The effects of vitamin D supplementation on endothelial activation among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials

et al. 2018

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Background and objectiveThe current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of vitamin D supplementation on endothelial activation among patients with metabolic syndrome and related disorders.MethodsCochrane library, Embase, PubMed, and Web of Science database were searched to identify related RCTs published before 30th April 2018. The heterogeneity among the included studies was assessed using Cochran’s Q test and I-square (I2) statistic. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as summary effect size.ResultsFourteen clinical trials that contained a total of 1253 participants were included in the current meta-analysis. Vitamin D supplementation significantly decreased von willebrand factor (vWF) (SMD -0.27; 95% CI, − 0.46, − 0.08; P = 0.006; I2:40.5%). However, we found no significant impact of vitamin D supplementation on intercellular adhesion molecule 1(ICAM-1) (SMD -1.96; 95% CI, − 4.02, 0.09; P = 0.06; I2:97.4%), vascular celladhesion molecule 1 (VCAM-1) (SMD -0.50; 95% CI, − 1.19, 0.19; P = 0.15; I2:91.2%), on E-selectin (SMD -0.04; 95% CI, − 0.36, 0.28; P = 0.81; I2:78.8%) and endothelin (SMD -0.49; 95% CI, − 1.18, 0.19; P = 0.15; I2:90.5%). The pooled data from trials of vitamin D supplementation with dosage of ≤4000 IU/day (− 0.37, 95% CI: -0.65, − 0.10, I2: 73.5%) significantly reduced vWF concentrations, while there was no effect of vitamin D supplementation on vWF concentrations among trials with the dosage of intervention > 4000 IU/day (− 0.17, 95% CI: -0.43, 0.10, I2: 0.0%). VWF concentrations significantly reduced in pooled data from trials with duration study ≤8 weeks (− 0.37, 95% CI: -0.67, − 0.07, I2: 60.6%), but there was no effect of vitamin D supplementation on vWF concentrations among trials with > 8 weeks (− 0.20, 95% CI: -0.45, 0.05, I2: 0.0%). While there was no effect of vitamin D supplementation on vWF concentrations among trials with total sample size of ≤60 patients (− 0.03, 95% CI: -0.42, 0.36, I2: 0.0%), vWF concentrations in trials with more than 60 patients decreased significantly (− 0.34, 95% CI: -0.56, − 0.12, I2: 60.9%).ConclusionsOverall, the current meta-analysis demonstrated that vitamin D supplementation to patients with metabolic syndrome and related disorders resulted in an improvement in vWF, but did not affect ICAM-1, VCAM-1, E-selectin and endothelin levels.Electronic supplementary materialThe online version of this article (10.1186/s12986-018-0320-9) contains supplementary material, which is available to authorized users.

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“…Ono et al ., 2006[ 22 ] and Cohen-Hagai et al ., 2017[ 10 ] demonstrated that higher concentrations of VWF were associated with increased breakdown of ADAMTS13. This breakdown is performed by either proteases present in plasma such as thrombin or secreted by granulocyte elastases.…”

Section: Discussionmentioning

confidence: 99%

“…VWF is the only known substrate for ADAMTS13, so deficiency and/or the presence of antibodies against ADAMTS13 may elevate UL-VWF plasma levels, thus leading to thrombosis in small vessels. [ 10 ]…”

Section: Introductionmentioning

confidence: 99%

Plasma von willebrand factor and a disintegrin and metalloproteinase with eight thrombospondin-type 1 motif levels in hemodialysis patients: Relation to vascular access thrombosis

2018

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Vascular access complications are major issues in hemodialysis (HD) patients, which increase their morbidity and lessen HD efficiency. The aim of this study was to assess von Willebrand factor (VWF), and a disintegrin and metalloproteinase with eight thrombospondin-type 1 motif (ADAMTS13) levels in HD patients and their association with vascular access thrombosis (VAT). This study included a total of 158 individuals including 128 patients undergoing HD for more than 6 months, subdivided into two groups according to the occurrence of the previous episode of VAT; 60 HD patients with VAT and 68 HD patients without VAT and 30 healthy controls. Plasma ADAMTS13 and VWF levels were assessed by enzyme-linked immunosorbent assay technique. There were higher VWF levels and lower ADAMTS13 in HD patients, compared to healthy controls. Furthermore, VWF levels were significantly higher and ADAMTS13 levels were significantly lower in HD patients with VAT than those without VAT. Further prospective studies with large number of patients are thus needed to show if there is causal relationship between higher VWF levels, lower ADAMTS13, and VAT.

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

Cited by 4 publications

References 17 publications

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

Serum procalcitonin as an independent diagnostic markers of bacteremia in febrile patients with hematologic malignancies

The effects of vitamin D supplementation on endothelial activation among patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials

Plasma von willebrand factor and a disintegrin and metalloproteinase with eight thrombospondin-type 1 motif levels in hemodialysis patients: Relation to vascular access thrombosis

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