Abstract
Adipose tissue produces a number of adipokines that have metabolic effect. Visfatin is a recently discovered adipokine whose concentration in plasma increases in obesity. It is also a proinflammatory mediator that promotes atherosclerosis and plays a role in plaque destabilization. The aim of this study was to evaluate an assay for the determination of visfatin in human plasma and to investigate its clinical relevance as a marker of acute coronary syndrome (ACS) in a young population (Men under 45 y, Women under 55 y). We clinically tested a sandwich ELISA assay in young individuals with acute myocardial infarction (n=36) vs. a control group (n=21). The control sample was a healthy proband without inflammation, hepatic or renal injury and under 55 years of age. Visfatin in plasma was able to differentiate the control group from young patients with acute myocardial infarction (5 vs. 27 ng/L). Visfatin in the plasma of acute myocardial infarction (AMI) probands, correlated in individuals with acute coronary syndrome was related to plasma glucose (r=0.47; P=0.01), type 2 diabetes mellitus (r=0.65; P=0.01), plasma creatinine concentration (r=0.3, P=0.02), hsCRP (r=0.29; P=0.03), BMI values (r=0.18; P=0.04), triglycerides (r=0.5; P=0.01) and NT-proBNP (r=0.21; P=0.04). In healthy subjects, these relations were not found. ROC analysis: visfatin cut-off concentration was 20 ng/L with a sensitivity of 84% and a specificity of 90%. The area under the curve (AUC) of cTNI was 0.96, the AUC of visfatin was 0.96. Thus, there was no difference. We conclude that visfatin in serum may be a new independent potential marker of AMI.
Highlights
Visfatin is a protein present in several mammals and expressed highly in visceral fat. It is a peptide with many functions. It has a role in the hypoglycaemic effect, causing insulin to decrease rapidly in the blood by lowering blood glucose and improving insulin sensitivity as an insulin receptor activator[1]
Adipokines play a role in obesity, insulin resistance, metabolic syndrome, beta-cell dysfunction, atherosclerosis, and endothelial dysfunction[2]
Visfatin in produced in reponse to inflammatory signals.The latter possesses anti-apoptotic effect on neutrophils in a clinical model of sepsis, it is increased in acute pulmonary lesions, being useful as a marker of this condition
Summary
Visfatin is a protein present in several mammals and expressed highly in visceral fat. It is a peptide with many functions. It has a role in the hypoglycaemic effect, causing insulin to decrease rapidly in the blood by lowering blood glucose and improving insulin sensitivity as an insulin receptor activator[1]. Increased visfatin levels correlate positively with portal inflammation. These observations could suggest an association of visfatin with inflammation. Negative correlation of visfatin with creatinine clearance and positive correlation with urinary albumin excretion has been demonstrated, suggesting that visfatin affects renal function[2]
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