Visfatin Serum Levels Predict Mortality in Critically Ill Patients.

Alexander Koch,Lukas Buendgens,Alexander Krusch,Christian Trautwein,Ger H Koek,Ulf Herbers,Ralf Weiskirchen,Jan Bruensing,Frank Tacke,Eray Yagmur

doi:10.1155/2018/7315356

Alexander Koch, Lukas Buendgens + Show 8 more

Open Access

https://doi.org/10.1155/2018/7315356

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Abstract

The adipokine visfatin, also termed pre-B-cell colony-enhancing factor (PBEF), is mainly derived from adipose tissue but has been implicated in the regulation of innate immune responses. We hypothesized that visfatin could be a potential circulating biomarker in critical illness and sepsis. We therefore measured serum levels of visfatin in a cohort of 229 critically ill medical patients upon admission to the intensive care unit (ICU). In comparison to 53 healthy controls, visfatin levels were significantly elevated in medical ICU patients, especially in patients with sepsis. Visfatin serum concentrations were strongly associated with disease severity and organ failure but did not differ between patients with or without obesity or type 2 diabetes. Visfatin levels correlated with biomarkers of renal failure, liver dysfunction, and other adipokines (e.g., resistin, leptin, and adiponectin) in critically ill patients. High visfatin levels at ICU admission indicated an increased mortality, both at the ICU and during long-term follow-up of approximately two years. Our data therefore demonstrate that circulating visfatin is a valuable biomarker for risk and prognosis assessment in critically ill patients. Furthermore, visfatin seems to be involved in the pathogenesis of excessive systemic inflammation, supporting further research on visfatin as a therapeutic target.

Highlights

Besides their important roles in metabolism, adipocytokines or adipokines, i.e., hormones released from adipose tissue, are increasingly recognized as important regulators of immunity [1]
Visfatin serum concentrations were strongly associated with disease severity and organ failure but did not differ between patients with or without obesity or type 2 diabetes
In critically patients, who subsequently died during the intensive care unit (ICU) treatment (n = 60), we found significantly elevated visfatin levels at admission to the ICU (Figure 3(a)), suggesting that visfatin might serve as a prognostic biomarker in critical diseases

Summary

Introduction

Besides their important roles in metabolism, adipocytokines or adipokines, i.e., hormones released from adipose tissue, are increasingly recognized as important regulators of immunity [1]. Interesting findings obtained from smaller trials demonstrated elevated visfatin serum levels in patients with respiratory diseases [12,13,14] and neonatal sepsis [15] as well as in patients with severe trauma or with critical neurological diseases [2]. Based on these findings, we analyzed circulating visfatin levels in a large cohort of 229 prospectively enrolled critically ill patients at our medical intensive care unit (ICU)

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