The Relationship of Visfatin Levels with Insulin Resistance and Left Ventricular Hypertrophy in Peritoneal Dialysis Patients

Background/objectives: Cardiovascular abnormalities are common in patients with chronic kidney disease. Visfatin influences lipid metabolism, insulin sensitivity, and cardiovascular health. The aim of this study was to explore the relation of serum visfatin to cardiovascular risk factors in nondiabetic peritoneal dialysis (PD) patients. Patients and methods: Eighty-seven nondiabetic patients (mean age 48 ± 15 years, 39 males) under PD were enrolled. Weight, anthropometric measurements, blood pressure, biochemical parameters, and insulin resistance (homeostatic model assessment-insulin resistance—HOMA-IR) were measured. Visfatin was measured and left ventricular mass index (LVMI) was calculated by echocardiography. Results: LVMI was correlated with body mass index (BMI; r = 0.47, p = 0.01), systolic blood pressure (SBP; r = 0.62, p = 0.04), and serum visfatin levels (r = 0.49, p = 0.03). According to HOMA-IR levels patients were grouped as insulin-resistant (IR) (HOMA-IR ≥2.0, n = 35) and noninsulin-resistant (non-IR) (HOMA-IR <2.0, n = 52) groups. The IR group had longer PD duration and higher BMI, total cholesterol, uric acid, and serum visfatin levels (p < 0.05). The study patients were divided into three groups according to their serum visfatin levels. Group 1 (≤34 ng/mL, n = 22) was considered as the lowest tertile of low visfatin and group 2 (35–42 ng/mL, n = 43) and group 3 (≥43 ng/mL, n = 22) in the upper tertile. Considering the visfatin groups, group 3 patients had significantly higher BMI (p = 0.00), total cholesterol (p = 0.03), C-reactive protein (CRP) (p = 0.03), HOMA-IR (p = 0.03), and LVMI (p = 0.02). In regression analysis, SBP (β = 0.19, p < 0.05) and serum visfatin levels (β = 0.74, p < 0.05) were independent variables affecting LVMI. Conclusion: Serum visfatin might be a sensitive marker than HOMA-IR evaluations for cardiac performance in nondiabetic PD patients.     

Angiotensin inhibition stimulates PPARγ and the release of visfatin

Background Angiotensin converting enzyme inhibitors (ACE‐I) and angiotensin receptor blockers (ARB) exhibit beneficial antidiabetic effects in patients with type 2 diabetes independent of their blood pressure‐lowering effects. Some antidiabetic properties of ARB and ACE‐I might by exerted by activation of peroxisome proliferator‐activated receptor gamma (PPARγ). However, it is not clear whether this action is drug specific. Materials and methods The binding affinity of telmisartan, valsartan, lisinopril, rosiglitazone and angiotensin II to PPARγ was assessed in a cell‐free assay system. PPARγ signalling was studied in isolated skeletal muscle cells using Western blot analysis of phosphorylated protein kinase B (pAKT) and phosphorylated insulin like growth factor‐1 receptor (pILGF‐1R). Further, the ability of the drugs under study to stimulate the release of the adipocytokine visfatin was investigated in isolated human adipocytes, skeletal muscle cells, and umbilical vein endothelial cells (HUVEC). Results The binding affinity to PPARγ was highest for telmisartan with a half‐maximal effective concentration of 463 nM, followed by lisinopril (2·9 µM) and valsartan (6·2 µM). In skeletal muscle cells phosphorylation of ILGF‐1R was 2‐fold increased after incubation with telmisartan or valsartan and 1·7‐fold with lisinopril. pAKT expression was enhanced after incubation with telmisartan, valsartan and with lisinopril. The release of visfatin from adipocytes was 1·6‐fold increased after treatment with lisinopril and about 2·0‐fold increased with telmisartan and valsartan. Similar results were obtained in skeletal muscle cells and HUVEC. Conclusions Our data confirm agonism of telmisartan, valsartan and lisinopril on PPARγ. Pharmacokinetic differences may explain different potencies of PPARγ stimulation by drugs acting on the renin‐angiotensin system in clinical settings.     

汉族、维吾尔族和哈萨克族人群内脏脂肪素水平与尿酸、脂代谢指标的相关性

摘要：目的：分析新疆地区汉族、维吾尔族（维族）和哈萨克族（哈族）内脏脂肪素（visfatin）水平与尿酸（UA）、脂代谢指标的相关性。 方法：2011年于新疆少数民族聚居区采集汉族、维族和哈族人群血液标本,检测血清UA和三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）等脂代谢指标,用ELISA法检测血清内脏脂肪素含量,分析内脏脂肪素与UA、脂代谢指标的相关性。 结果：汉族、维族和哈族血清内脏脂肪素水平分别为（38.42±33.60）、（32.68±26.87）和（86.36±17.68）ng/mL,哈族高于汉族和维族（P均＜0.05）。汉族UA升高组、TG升高组、HDL-C降低组及肥胖组内脏脂肪素水平均升高（P均＜0.05）。维族UA升高组、TG升高组内脏脂肪素水平均升高（P均＜0.05）,哈族UA升高组、肥胖组内脏脂肪素水平均升高（P均＜0.05）。3个民族内脏脂肪素与UA均呈正相关（r汉=0.305,P＜0.01;r维=0.130,P＜0.05;r哈=0.137,P＜0.05）。汉族和维族血清内脏脂肪素与TG均呈正相关（r汉=0.260,P＜0.01;r维=0.178,P＜0.01）,汉族内脏脂肪素与HDL-C呈负相关（r汉=－0.105,P＜0.05）。 结论：血内脏脂肪素水平存在民族差异,且在UA代谢和脂代谢紊乱过程中有改变。     

High visfatin expression predicts poor prognosis of upper tract urothelial carcinoma patients

Visfatin, a newly discovered adipocytokine, is a pro-inflammatory cytokine. This study aimed to evaluate the predictive value of visfatin on prognosis of patients with upper tract urothelial carcinoma. One-hundred and five patients (median age=64, range=24-84 years) were included in this study. Visfatin expression in upper tract urothelial carcinoma tissues was analyzed by immunohistochemistry. Visfatin expression was correlated with clinicopathologic variables using the χ² test. The prognostic value of visfatin for recurrence-free and cancer-specific survival was evaluated by Kaplan-Meier estimates, and the significance of differences between curves was evaluated by the log-rank test. Cox regression model was also used to evaluate the hazard ratios of visfatin on survival. High visfatin expression in upper tract urothelial carcinoma tissues was significantly correlated with tumor stage (P=0.001), grade (P=0.007) and p53 expression (P=0.07). High visfatin expression was associated with poor recurrence-free and cancer-specific survival. Cox regression analysis also revealed that visfatin is an independent predictor of recurrence-free (HR=3.22, P=0.009) and cancer-specific survival (HR=5.74, P=0.023). Our findings indicated that higher visfatin expression is a potential biomarker to predict patient survival. Further study is necessary to investigate the role of visfatin in the carcinogenesis of upper tract urothelial carcinoma.     

亚临床甲状腺功能减退症对心血管疾病相关影响因素的临床研究

目的：探讨亚临床甲状腺功能减退症（SCH）患者血脂、血尿酸（UA）、内脂素（visfatin）、同型半胱氨酸（HCY）、超敏C反应蛋白（hs‐CRP）的变化及意义。方法将100例 SCH 患者根据促甲状腺激素（TSH ）水平分为观察 A 组（5 mIU／L ≤TSH＜10 mIU／L ,60例）和观察B组（TSH≥10 mIU／L ,40例）;对照组为健康体检者（100例）。检测患者血清 TSH、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL‐C）、低密度脂蛋白胆固醇（LDL‐C）、UA、HCY、hs‐CRP、visfatin水平并进行分析。结果观察A组患者血TG、visfatin水平与对照组比较,差异均有统计学意义（P＜0．05）;观察B组患者血 TG、visfatin、LDL‐C、UA、HCY、hs‐CRP水平均较与对照组明显增高（P＜0．05）,并以 TG、visfatin升高最为显著（P＜0．01）。但A、B两组患者血HDL‐C水平与对照组比较,差异均无统计学意义（P＞0．05）。结论 SCH患者脂质代谢紊乱和高尿酸血症可能是促发动脉粥样硬化的重要危险因素;HCY、hs‐CRP、visfatin可作为SCH患者动脉粥样硬化程度的预测指标。     

Can adipokine visfatin be a novel marker of pregnancy‐related disorders in women with obesity?

Overweight and obesity have become a dangerous disease requiring multiple interventions, treatment and preventions. In women of reproductive age, obesity is one of the most common medical conditions. Among others, obese state is characterized by low‐grade systemic inflammation and enhanced oxidative stress. Increased maternal body mass index might amplify inflammation and reactive oxygen species production, which is associated with unfavourable clinical outcomes that affect both mother and child. Intrauterine growth retardation, preeclampsia, or gestational diabetes mellitus are examples of the hampered maternal and foetoplacental unit interactions. Visfatin is the obesity‐related adipokine produced mainly by the visceral adipose tissue. Visfatin affects glucose homeostasis, as well as the regulation of genes related to oxidative stress and inflammatory response. Here, we review visfatin interactions in pregnancy‐related disorders linked to obesity. We highlight the possible predictive and prognostic value of visfatin in diagnostic strategies on gravidas with obesity.     

血清visfatin水平与2型糖尿病、冠心病的关系

目的 探讨血清visfatin水平与2型糖尿病、冠心病的关系.方法 收集陕西西安地区汉族人群286例受试对象,其中包括106例单纯2糖尿病(T2DM)患者、40例2型糖尿病合并冠心病(T2DM+CHD)患者、54例冠心病(CHD)患者和86例健康对照者(Control),采用ELISA法检测上述人群血清visfatin水平.结果 ①空腹血清visfatin水平在病例组均较对照组显著增高(P＜0.01),T2DM+CHD组增高最为明显;②visfatin水平与腰臀比(WHR),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-c),空腹血糖(FPG),空腹胰岛素(FINS),糖化血红蛋白(HbA1C),Lg稳态模型胰岛素抵抗指数(LgHOMA-IR)呈显著正相关(P＜0.01),与高密度脂蛋白胆固醇(HDL-c)呈显著负相关(P＜0.01);③以visfatin为应变量进行多重线性回归分析,结果HbA1c(β=0.634,P=0.000),LgHOMA-IR(β =0.247,P =0.000)进入方程.结论 visfatin可能是2型糖尿病、冠心病发病的危险因子之一,可能促进2型糖尿病合并冠心病的发生.     

2型糖尿病患者血清内脂素浓度与血脂的相关性研究

目的探讨2型糖尿病患者血清内脂素浓度与血脂的关系。方法选取2型糖尿病患者182例,另选健康对照组100例,常规测量身高、体重,所有实验对象空腹采血离心取血清测定内脂素、甘油三酯（TG）、胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）。结果 2型糖尿病组血清内脂素浓度均高于对照组（P〈0.05）;2型糖尿病患者内脂素量与TG、HDL-C、VLDL-C呈正相关（P〈0.05）。结论 2型糖尿病患者血清内脂素的量可能与2型糖尿病发生及血脂代谢相关。     

妊娠期糖尿病母血和脐血血清内脂素的变化及其意义

目的 观察妊娠期糖尿病(GDM)妇女母血和脐血血清内脂素水平,分析其与新生儿体重、性别比、Ponderal指数(PI)的相关性.方法 选择2005年1月至2010年12月于牡丹江市妇女儿童医院诊治的36例GDM患者(GDM组,n=36)为研究对象(单胎妊娠).采用酶联免疫吸附法(ELISA)测定36例GDM孕妇和40例...     

Association between serum visfatin levels and psoriasis and their correlation with disease severity: a meta-analysis

ObjectiveTo determine the association between serum visfatin levels and psoriasis and to evaluate the correlation between serum visfatin levels and the severity of psoriasis.MethodsThe electronic databases PubMed®, Embase® and the Cochrane Library were searched for articles published from inception to 1 May 2020. Data were extracted and then standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pooled estimates.ResultsA total of 11 studies met the inclusion criteria and were included (448 patients diagnosed with psoriasis and 377 controls). This meta-analysis demonstrated that patients with psoriasis had significantly higher levels of visfatin than the controls (SMD = 0.90, 95% CI 0.52, 1.28). Subgroup analyses showed that differences in serum visfatin levels between the patient group and the control group were associated with ethnicity, Psoriasis Area and Severity Index (PASI) and body mass index. Additionally, a meta-analysis of correlations showed that visfatin levels in patients with psoriasis were positively correlated with PASI (r = 0.51, 95% CI 0.14, 0.75).ConclusionsThis meta-analysis showed that serum visfatin levels in patients with psoriasis were significantly higher than those in the controls and a positive correlation between serum visfatin levels and psoriasis severity was observed.