Leptin, pre-existing vascular disease, and increased arteriovenous fistula maturation failure in dialysis patients Jwa-Kyung Kim, MD, Sun Ryoung Choi,

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Leptin, pre-existing vascular disease, and increased arteriovenous fistula maturation failure in dialysis patients Jwa-Kyung Kim, MD, Sun Ryoung Choi, MD, Won Yong Lee, MD, PhD, Mi Jin Park, PhD, Hyung Suk Lee, MD, Young Rim Song, MD, Hyung Jik Kim, MD, PhD, Sung Gyun Kim, MD, PhD Journal of Vascular Surgery Volume 64, Issue 2, Pages 402-410.e1 (August 2016) DOI: 10.1016/j.jvs.2016.03.011 Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 1 Anatomic differences of intima (I) and media (M) according to leptin tertiles. Upper, Hematoxylin and eosin staining. Lower, Trichrome staining. Significant differences in intimal hyperplasia and medial thickening were observed across tertiles. Similarly, medial fibrosis was most severe in the highest tertile. Journal of Vascular Surgery 2016 64, 402-410.e1DOI: (10.1016/j.jvs.2016.03.011) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 2 Cellular phenotype difference according to leptin tertiles. In the most specimens across the three tertiles of leptin, the majority of cells in the intima were α-smooth muscle actin (SMA)-positive, vimentin-positive, desmin-negative myofibroblasts. Particularly in the lowest tertile of leptin, desmin-positive smooth muscle cells were more frequently observed than in the two upper tertiles of leptin. Journal of Vascular Surgery 2016 64, 402-410.e1DOI: (10.1016/j.jvs.2016.03.011) Copyright © 2016 Society for Vascular Surgery Terms and Conditions

Fig 3 Leptin receptor (ObR) staining in intima (I) of cephalic vein. Immunohistochemical (IHC) staining of leptin receptor showed significant inverse relationship with serum leptin tertiles, indicating downregulation of leptin receptors in higher leptin tertiles. Journal of Vascular Surgery 2016 64, 402-410.e1DOI: (10.1016/j.jvs.2016.03.011) Copyright © 2016 Society for Vascular Surgery Terms and Conditions