Irisin and Visfatin Predicts Severity of Diabetic Nephropathy

  • Ramalingam Mageswari
  • M. G. Sridhar
  • H. Nandeesha
  • Sreejith Parameshwaran
  • K. V. Vinod
Original Research Article


Although the roles of irisin and visfatin have been well established in diabetes mellitus, there are limited studies about their association in diabetic nephropathy. The present study was designed to assess the levels of irisin and visfatin and their association with the severity of diabetic nephropathy. 43 diabetic nephropathy cases and 43 diabetic subjects without nephropathy were enrolled in the study. Serum levels of irisin and visfatin were compared in both the groups. Irisin and visfatin were significantly increased in diabetic nephropathy cases when compared with diabetes subjects without nephropathy. eGFR was negatively correlated with visfatin (r = −0.323, p = 0.034), irisin (r = −0.324, p = 0.034), urine albumin (r = −0.443, p = 0.003) and albumin creatinine ratio (r = −0.419, p = 0.005) in patients with diabetic nephropathy. Visfatin was significantly elevated in stage IV nephropathy compared with stage III nephropathy. We conclude that irisin and visfatin are elevated in diabetic nephropathy and can be an index of its severity.


Diabetes mellitus Nephropathy Irisin Visfatin Adiponectin 



End stage renal disease


Glomerular filtration rate


Chronic kidney disease


Albumin creatinine ratio



This work was supported by a intramural grant from JIPMER, Puducherry to the corresponding author.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Gross JL, de Azevedo MJ, Silveiro SP, Canani LH, Caramori ML, Zelmanovitz T. Diabetic nephropathy: diagnosis, prevention, and treatment. Diabetes Care. 2005;28(1):164–76.CrossRefPubMedGoogle Scholar
  2. 2.
    Ayodele OE, Alebiosu CO, Salako BL. Diabetic nephropathy—a review of the natural history, burden, risk factors and treatment. J Natl Med Assoc. 2004;96(11):1445.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Unnikrishnan R, Rema M, Pradeepa R, Deepa M, Shanthirani CS, Deepa R, et al. Prevalence and risk factors of diabetic nephropathy in an urban South Indian population: the Chennai Urban Rural Epidemiology Study (CURES 45). Diabetes Care. 2007;30(8):2019–24.CrossRefPubMedGoogle Scholar
  4. 4.
    Gurel A, Atli H, Duzenci D, Aydin S, Dogukan A. Plasma and saliva irisin levels of patients with diabetic nephropathy and non-diabetic proteinuria. Turk Nephrol Dial Transplant. 2015;24(3):302–6.CrossRefGoogle Scholar
  5. 5.
    Moreno-Navarrete JM, Ortega F, Serrano M, Guerra E, Pardo G, Tinahones F, et al. Irisin is expressed and produced by human muscle and adipose tissue in association with obesity and insulin resistance. J Clin Endocrinol Metab. 2013;98:769–78.CrossRefGoogle Scholar
  6. 6.
    Xin C, Liu J, Zhang J, Zhu D, Wang H, Xiong L, et al. Irisin improves fatty acid oxidation and glucose utilization in type 2 diabetes by regulating the AMPK signaling pathway. Int J Obes. 2016;40(3):443–51.CrossRefGoogle Scholar
  7. 7.
    Espes D, Lau J, Carlsson PO. Increased levels of irisin in people with long-standing Type 1 diabetes. Diabet Med J Br Diabet Assoc. 2015;32(9):1172–6.CrossRefGoogle Scholar
  8. 8.
    García-Fontana B, Reyes-García R, Morales-Santana S, Ávila-Rubio V, Muñoz-Garach A, Rozas-Moreno P, et al. Relationship between myostatin and irisin in type 2 diabetes mellitus: a compensatory mechanism to an unfavourable metabolic state? Endocrine. 2016;52(1):54–62.CrossRefPubMedGoogle Scholar
  9. 9.
    Zhang C, Ding Z, Lv G, Li J, Zhou P, Zhang J. Lower irisin level in patients with type 2 diabetes mellitus: a case–control study and meta-analysis. J Diabetes. 2016;8(1):56–62.CrossRefPubMedGoogle Scholar
  10. 10.
    Belviranli M, Okudan N, Çelik F. Association of circulating irisin with insulin resistance and oxidative stress in obese women. Horm Metab Res. 2016;48(10):653–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Huh JH, Ahn SV, Choi JH, Koh SB, Chung CH. High serum irisin level as an independent predictor of diabetes mellitus: a longitudinal population-based study. Medicine (Baltimore). 2016;95(23):e3742.CrossRefGoogle Scholar
  12. 12.
    Kang YS, Cha DR. The role of visfatin in diabetic nephropathy. Chonnam Med J. 2011;47:139–43.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Lewandowski KC, Stojanovic N, Press M, Tuck SM, Szosland K, Bienkiewicz M, et al. Elevated serum levels of visfatin in gestational diabetes: a comparative study across various degrees of glucose tolerance. Diabetologia. 2007;50:1033–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Chen MP, Chung FM, Chang DM, Tsai JC, Huang HF, Shin SJ, et al. Elevated plasma level of visfatin/pre-B cell colony-enhancing factor in patients with type 2 diabetes mellitus. J Clin Endocrinol Metab. 2006;91:295–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Yilmaz MI, Saglam M, Carrero JJ, Qureshi AR, Caglar K, Eyileten T, et al. Serum visfatin concentration and endothelial dysfunction in chronic kidney disease. Nephrol Dial Transplant. 2008;23:959–65.CrossRefPubMedGoogle Scholar
  16. 16.
    Kanga YS, Lee MH, Songa HK, Kima JU, Gheea JY, Chaa JJ, et al. Chronic administration of visfatin ameliorated diabetic nephropathy in type 2 diabetic mice. Kidney Blood Press Res. 2016;41:311–24.CrossRefGoogle Scholar
  17. 17.
    Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Qiu S, Cai X, Yin H, Zügel M, Sun Z, Steinacker JM, et al. Association between circulating irisin and insulin resistance in non-diabetic adults: a meta-analysis. Metabolism. 2016;65(6):825–34.CrossRefPubMedGoogle Scholar
  19. 19.
    Wang H, Zhang X, Chen W, Huang Q, Chen Q. Relationship between serum irisin levels and urinary albumin excretion in patients with type 2 diabetes. J Diabetes Complicat. 2015;29(3):384–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Shelbaya S, Abushady MM, Nasr MS, Bekhet MM, Mageed YA, Abbas M. Study of irisin hormone level in type 2 diabetic patients and patients with diabetic nephropathy. Curr Diabetes Rev. 2017. Scholar
  21. 21.
    Khidr EG, Ali SS, Elshafey MM, Fawzy OA. Association of irisin and FNDC5 rs16835198 G > T gene polymorphism with type 2 diabetes mellitus and diabetic nephropathy. An Egyptian pilot study. Gene. 2017;626:26–31.CrossRefPubMedGoogle Scholar
  22. 22.
    Liu J-J, Liu S, Wong MDS, Tan CSH, Tavintharan S, Sum CF, et al. Relationship between circulating irisin, renal function and body composition in type 2 diabetes. J Diabetes Complicat. 2014;28(2):208–13.CrossRefPubMedGoogle Scholar
  23. 23.
    Ebert T, Focke D, Petroff D, Wurst U, Richter J, Bachmann A, et al. Serum levels of the myokine irisin in relation to metabolic and renal function. Eur J Endocrinol. 2014;170(4):501–6.CrossRefPubMedGoogle Scholar
  24. 24.
    Hu W, Wang R, Li J, Zhang J, Wang W. Association of irisin concentrations with the presence of diabetic nephropathy and retinopathy. Ann Clin Biochem. 2016;53(Pt 1):67–74.CrossRefPubMedGoogle Scholar
  25. 25.
    Kang YS, Song HK, Lee MH, Ko GJ, Han JY, Han SY, et al. Visfatin is upregulated in type-2 diabetic rats and targets renal cells. Kidney Int. 2010;78:170–81.CrossRefPubMedGoogle Scholar
  26. 26.
    El Samahi MH, Ismail NA, Matter RM, Selim A, Ibrahim AA, Nabih W. Study of visfatin level in type 1 diabetic children and adolescents. Open Access Maced J Med Sci. 2017;5(3):299–304.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Kang YS, Lee MH, Song HK, Kim JE, Ghee JY, Cha JJ, et al. Chronic administration of visfatin ameliorated diabetic nephropathy in type 2 diabetic mice. Kidney Blood Press Res. 2016;41(3):311–24.CrossRefPubMedGoogle Scholar
  28. 28.
    Rodrigues KF, Pietrani NT, Bosco AA, Ferreira CN, Sandrim VC, Gomes KB. Visfatin levels are decreased in advanced stages of diabetic nephropathy. Ren Fail. 2015;37(9):1529–30.CrossRefPubMedGoogle Scholar
  29. 29.
    Tsioufis C, Dimitriadis K, Chatzis D, Vasiliadou C, Tousoulis D, Papademetriou V, et al. Relation of microalbuminuria to adiponectin and augmented C-reactive protein levels in men with essential hypertension. Am J Cardiol. 2005;96(7):946–51.CrossRefPubMedGoogle Scholar
  30. 30.
    Yano Y, Hoshide S, Ishikawa J, Hashimoto T, Eguchi K, Shimada K, et al. Differential impacts of adiponectin on low-grade albuminuria between obese and nonobese persons without diabetes. J Clin Hypertens Greenwich Conn. 2007;9(10):775–82.CrossRefGoogle Scholar
  31. 31.
    Looker HC, Krakoff J, Funahashi T, Matsuzawa Y, Tanaka S, Nelson RG, et al. Adiponectin concentrations are influenced by renal function and diabetes duration in Pima Indians with type 2 diabetes. J Clin Endocrinol Metab. 2004;89(8):4010.CrossRefPubMedGoogle Scholar

Copyright information

© Association of Clinical Biochemists of India 2018

Authors and Affiliations

  • Ramalingam Mageswari
    • 1
  • M. G. Sridhar
    • 1
  • H. Nandeesha
    • 1
  • Sreejith Parameshwaran
    • 1
  • K. V. Vinod
    • 1
  1. 1.Department of Biochemistry, Medicine and NephrologyJawaharlal Institute of Postgraduate Medical Education and ResearchPuducherryIndia

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