Ann Lab Med 2017; 37(2): 155-158  https://doi.org/10.3343/alm.2017.37.2.155
Effect of Vitamin D Status on Von Willebrand Factor and ADAMTS13 in Diabetic Patients on Chronic Hemodialysis
Keren Cohen-Hagai, M.D.1, Gloria Rashid, Ph.D.2, Yael Einbinder, M.D.1,3, Meital Ohana, M.S.1, Sydney Benchetrit, M.D.1,3, and Tali Zitman-Gal, Ph.D.1,3
Renal Physiology Laboratory1, Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba; Medical Laboratories2, Meir Medical Center, Kfar Saba; Sackler Faculty of Medicine3, Tel Aviv University, Tel Aviv, Israel
Correspondence to: Tali Zitman-Gal
Renal Physiology Laboratory Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba 44281, Israel
Tel: +972-9-7472401 Fax: +972-9-7416918 E-mail: tali.gal@clalit.org.il
Received: July 11, 2016; Revised: August 29, 2016; Accepted: December 8, 2016; Published online: March 1, 2017.
© The Korean Society for Laboratory Medicine. All rights reserved.

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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.
Keywords: von Willebrand factor, ADAMTS13, Hemodialysis, Diabetes, Vitamin D, Inflammation


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