Association of plasma visfatin levels with inflammation, atherosclerosis and acute coronary syndromes (ACS) in humans

Inhibition of ethanol-induced eNAMPT secretion attenuates liver ferroptosis through BAT-Liver communication

BACKGROUND & AIMS

Extracellular nicotinamide phosphoribosyltransferase (eNAMPT) has long been recognized as an adipokine. However, the exact role of eNAMPT in alcoholic liver disease (ALD) and its relevance to brown adipose tissue (BAT) remain largely unknown. This study aimed to evaluate the impact of eNAMPT on liver function and the underlying mechanisms involved in BAT-Liver communication.

METHODS

Serum eNAMPT levels were detected in the serum of both ALD patients and mice. Chronic and binge ethanol feeding was used to induce alcoholic liver injury in mice. An eNAMPT antibody, a coculture model of brown adipocytes and hepatocytes, and BAT-specific Nampt knockdown mice were used to investigate the role of eNAMPT in ALD.

RESULTS

Serum eNAMPT levels are elevated in ALD patients and are significantly positively correlated with the liver injury index. In ALD mice, neutralizing eNAMPT reduced the elevated levels of circulating eNAMPT induced by ethanol and attenuated liver injury. In vitro experiments revealed that eNAMPT induced hepatocyte ferroptosis through the TLR4-dependent mitochondrial ROS-induced ferritinophagy pathway. Furthermore, ethanol stimulated eNAMPT secretion from brown adipocytes but not from other adipocytes. In the coculture model, ethanol-induced release of eNAMPT from brown adipocytes promoted hepatocyte ferroptosis. In BAT-specific Nampt-knockdown mice, ethanol-induced eNAMPT secretion was significantly reduced, and alcoholic liver injury were attenuated. These effects can be reversed by intraperitoneal injection of eNAMPT.

CONCLUSION

Inhibition of ethanol-induced eNAMPT secretion from BAT attenuates liver injury and ferroptosis. Our study reveals a previously uncharacterized critical role of eNAMPT-mediated BAT-Liver communication in ALD and highlights its potential as a therapeutic target.

Visfatin (NAMPT) affects global gene expression in porcine anterior pituitary cells during the mid-luteal phase of the oestrous cycle

BACKGROUND

The pituitary belongs to the most important endocrine glands involved in regulating reproductive functions. The proper functioning of this gland ensures the undisturbed course of the oestrous cycle and affects the female's reproductive potential. It is believed that visfatin, a hormone belonging to the adipokine family, may regulate reproductive functions in response to the female's metabolic state. Herein we verified the hypothesis that suggests a modulatory effect of visfatin on the anterior pituitary transcriptome during the mid-luteal phase of the oestrous cycle.

RESULTS

RNA-seq analysis of the porcine anterior pituitary cells revealed changes in the expression of 202 genes (95 up-regulated and 107 down-regulated in the presence of visfatin, when compared to the non-treated controls), assigned to 318 gene ontology terms. We revealed changes in the frequency of alternative splicing events (235 cases), as well as long noncoding RNA expression (79 cases) in the presence of the adipokine. The identified genes were associated, among others, with reproductive system development, epithelial cell proliferation, positive regulation of cell development, gland morphogenesis and cell chemotaxis.

CONCLUSIONS

The obtained results indicate a modulatory influence of visfatin on the regulation of the porcine transcriptome and, in consequence, pituitary physiology during the mid-luteal phase of the oestrous cycle.

Effect of non-surgical periodontal therapy on salivary and gingival crevicular fluid concentration of visfatin in periodontal health and disease

Background and objective

Visfatin, a pleotropic mediator mostly produced by visceral fat, is crucial in controlling the immunological and defensive systems. It serves the roles of a cytokine, an enzyme involved in energy metabolism, and a growth factor. The objective of the present study was to assess the impact of non-surgical periodontal therapy (scaling and root planing) on visfatin concentrations in saliva and gingival crevicular fluid in individuals with Periodontitis (stage-II grade-A).

Materials and methods

54 individuals were divided into Group A (Periodontally Healthy) and Group B1(Periodontitis baseline) based on periodontal parameters including plaque index (PI), gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL), and radiographic parameters. After NSPT (SRP), Group B1 patients were recalled after 4 weeks, constituting Group B2 (post NSPT group B1). At baseline and 4 weeks after non-surgical periodontal therapy (SRP), all clinical parameters, salivary and GCF samples were recorded. An ELISA kit was used to measure the levels of visfatin. Using the paired t-test, unpaired t-test, and Pearson's correlation coefficient, data were analysed using SPSS 15.

Results

After non-surgical periodontal treatment (SRP), the mean salivary and gingival crevicular fluid concentration of visfatin considerably decreased to a level comparable to periodontal health. In all groups, GCF visfatin concentration was higher than salivary concentration of visfatin. In periodontitis patients, visfatin concentration in GCF was 1.5 times higher than in saliva.

Conclusion

The results of this investigation suggest a direct correlation between salivary and gingival crevicular fluid visfatin concentration and periodontal tissue inflammation and disease activity.

Obesity and male fertility disorders

Often associated with obesity, male infertility represents a widespread condition that challenges the wellbeing of the couple. In this article, we provide a comprehensive and critical analysis of studies exploring the association between obesity and male reproductive function, to evaluate the frequency of this association, and establish the effects of increased body weight on conventional and biofunctional sperm parameters and infertility. In an attempt to find possible molecular markers of infertility in obese male patients, the numerous mechanisms responsible for infertility in overweight/obese patients are reviewed in depth. These include obesity-related functional hypogonadism, insulin resistance, hyperinsulinemia, chronic inflammation, adipokines, irisin, gut hormones, gut microbiome, and sperm transcriptome. According to meta-analytic evidence, excessive body weight negatively influences male reproductive health. This can occurr through a broad array of molecular mechanisms. Some of these are not yet fully understood and need to be further elucidated in the future. A better understanding of the effects of metabolic disorders on spermatogenesis and sperm fertilizing capacity is very useful for identifying new diagnostic markers and designing therapeutic strategies for better clinical management of male infertility.

Adipokines: Deciphering the cardiovascular signature of adipose tissue

Obesity and hypertension are intimately linked due to the various ways that the important cell types such as vascular smooth muscle cells (VSMC), endothelial cells (EC), immune cells, and adipocytes, communicate with one another to contribute to these two pathologies. Adipose tissue is a very dynamic organ comprised primarily of adipocytes, which are well known for their role in energy storage. More recently adipose tissue has been recognized as the largest endocrine organ because of its ability to produce a vast number of signaling molecules called adipokines. These signaling molecules stimulate specific types of cells or tissues with many adipokines acting as indicators of adipocyte healthy function, such as adiponectin, omentin, and FGF21, which show anti-inflammatory or cardioprotective effects, acting as regulators of healthy physiological function. Others, like visfatin, chemerin, resistin, and leptin are often altered during pathophysiological circumstances like obesity and lipodystrophy, demonstrating negative cardiovascular outcomes when produced in excess. This review aims to explore the role of adipocytes and their derived products as well as the impacts of these adipokines on blood pressure regulation and cardiovascular homeostasis.

The Functional Effects of Visfatin on Human Left Internal Mammary Artery

ABSTRACT

Visfatin may play a role in vascular dysfunction in metabolic disorders. Apart from its insulin-mimetic actions, it has divergent actions in the cardiovascular system with discordant results in the literature. Thus, we aimed to study the effects of visfatin on vascular responses of the human left internal mammary artery. Sections of redundant human left internal mammary artery were cut into 3-mm wide rings and hung in 20-mL organ baths containing physiologic salt solution and attached to an isometric force transducer connected to a computer-based data acquisition system. Removing endothelium caused an increase in pD2 values for visfatin-induced relaxation responses (10 -12 -10 -7 M) (9.06 ± 0.21 and 11.08 ± 0.92, respectively). Nicotinamide phosphoribosyltransferase inhibitor FK866 (10 µM) reversed the visfatin-induced relaxations (10 -12 -10 -7 M) ( P = 0.024). Incubations with nitric oxide synthase inhibitor nitro- l -arginine methylester and guanylate cyclase inhibitor 1H-[1,2,4] oxadiazolo [4,3-a] quinoxalin-1-one (ODQ) caused significant reductions in relaxation responses of visfatin ( P = 0.011 and 0.008, respectively). Visfatin incubations decreased relaxation responses to acetylcholine but not to sodium nitroprusside. Incubations with visfatin did not change contractile responses to angiotensin II, endothelin-1, noradrenalin, and phenylephrine. In this study, visfatin caused endothelium-dependent relaxations mediated by nitric oxide-cyclic guanosine monophosphate pathway and nicotinamide phosphoribosyltransferase activity. Furthermore, visfatin-induced decreases in relaxation responses were also related to endothelium-derived nitric oxide.

Role of visfatin in obesity-induced insulin resistance

The growing worldwide burden of insulin resistance (IR) emphasizes the importance of early identification for improved management. Obesity, particularly visceral obesity, has been a key contributing factor in the development of IR. The obesity-associated chronic inflammatory state contributes to the development of obesity-related comorbidities, including IR. Adipocytokines, which are released by adipose tissue, have been investigated as possible indicators of IR. Visfatin was one of the adipocytokines that attracted attention due to its insulin-mimetic activity. It is released from a variety of sources, including visceral fat and macrophages, and it influences glucose metabolism and increases inflammation. The relationship between visfatin and IR in obesity is debatable. As a result, the purpose of this review was to better understand the role of visfatin in glucose homeostasis and to review the literature on the association between visfatin levels and IR, cardiovascular diseases, and renal diseases in obesity.

Serum visfatin concentrations are positively associated with ventricular arrhythmias: a single-center preliminary study

BACKGROUND

Visfatin has been reported to be closely related to cardiovascular diseases associated with inflammation, but the correlation between visfatin and ventricular arrhythmia (VA) has not been discussed yet. The study aims to explore the association between serum visfatin concentrations and VA in patients.

METHODS

Sixty-seven hospitalized patients diagnosed with VA and 131 control subjects were enrolled in this crosssectional study between May 20, 2017 and November 8, 2019. Classification of VA types was based on the presence of structural heart disease (SHD). The patients' blood samples were collected to examine their serum levels of visfatin. Results were analyzed using analysis of variance and t-test. Furthermore, binary logistic regression analysis was used to validate whether elevated visfatin was independently associated with VA.

RESULTS

Compared with the controls (mean age, 64.2 ± 13.2 years; 71% of men), the patients with VA (68.2 ± 11.6 years, 58%) had higher serum levels of visfatin (1.80 ± 0.47 ng/mL versus 1.48 ± 0.41 ng/mL; p <0.001). After further grouping patients according to the presence of SHD, the serum levels of VA patients with SHD were the highest. Moreover, binary logistic regression analysis identified age (OR = 1.043; 95% CI, 1.015-1.072, p = 0.003), history of stroke (OR = 2.065; 95% CI, 1.450-5.696, p = 0.005), hsCRP (>10 mg/L) (OR = 4.123; 95% CI, 1.888-9.001, p < 0.001), and elevated visfatin level (>1.40 ng/L) (OR = 3.126; 95% CI, 1.544-6.328, p = 0.002) as independent risk factors with VA.

DISCUSSION

Serum visfatin levels were significantly elevated in the patients with VA, and increased with the risk rating of VA.

Functional effects of visfatin in isolated rat mesenteric small resistance arteries

A new adipocytokine, visfatin is expressed in perivascular adipose tissue (PVAT) and exerts effects on vascular system in addition to its relationship with various pathological conditions. The present study aimed to investigate the functional effects of visfatin and the possible underlying mechanism(s) of the effects of visfatin in isolated rat mesenteric small resistance arteries. The study was conducted in small resistance arterial rings isolated from rat mesenteric vascular beds. While visfatin incubation did not produce significant alterations in contractile responses of mesenteric arterial rings to noradrenaline, relaxation responses to acetylcholine but not to sodium nitroprusside (SNP) were significantly reduced in endothelium-intact rings. The inhibitory effect of visfatin on responses to acetylcholine was not observed in endothelium-denuded preparations. Incubation of tissues with nicotinamide phosphoribosyl transferase (NAMPT) inhibitor FK866 or superoxide dismutase (SOD) reversed the inhibitory effects of visfatin on relaxation responses to acetylcholine. Co-incubation of visfatin with Nω-nitro-L-arginine methylester (L-NAME) did not produce a significant alteration in vascular responses to acetylcholine compared to L-NAME incubation alone. Mesenteric PVAT visfatin levels were significantly higher than and correlated positively with plasma visfatin levels. The results of our study indicated that visfatin-induced reductions in endothelium-dependent relaxations of rat isolated small resistance arteries are mediated by oxygen free radicals and a reduction in nitric oxide (NO) bioavailability. It was suggested that increment in systemic and/or local visfatin levels due to various pathologies including obesity and excessive weight gain may play a substantial role in initiation and/or propagation of vascular dysfunctions.

Visfatin as a Promising Marker of Cardiometabolic Risk

Adipose tissue is an endocrine organ that produces molecules with important functions in the human body called adipokines. Visfatin can be secreted from various sources, such as macrophages, chondrocytes and amniotic epithelial cells other than adipose tissue. The main effect of visfatin is to promote inflammatory processes. In addition, visfatin has pivotal effects on the entire cardiovascular system, such as endothelial dysfunction, atherosclerosis, plaque rupture and mobilization, myocardial damage, fibrosis and new vessel formation. Vascular pathologies in other tissues also mediate its effects. Visfatin changes in a similar manner to cardiac markers in acute myocardial infarction, and the most cited feature in research studies is that it may be a cardiovascular risk marker. Visfatin is therefore expected to be widely used in cardiovascular pathology in the near future. Visfatin has many target tissues and various effects that occur in relatively complex biological pathways, making it difficult to understand visfatin adequately. In this review, we provide comprehensive information about this promising molecule.

Role of hypothalamic-pituitary adrenal-axis, toll-like receptors, and macrophage polarization in pre-atherosclerotic changes induced by social isolation stress in mice

It has been well documented that chronic stress can induce atherosclerotic changes, however, the underlying mechanisms is yet to be established. In this regard, this study aimed to elucidate the relation between hypothalamic-pituitary adrenal-axis (HPA-axis), toll-like receptors (TLRs), as well as M1/M2 macrophage ratio and pre-atherosclerotic changes in social isolation stress (SIS) in mice. We used small interfering RNA against the glucocorticoid receptor (GR) to evaluate the relation between HPA-axis and TLRs. C57BL/6J mice were subjected to SIS and RT-PCR, ELISA, flow cytometry, and immunohistochemistry were used to assess the relations between pre-atherosclerotic changes and TLRs, macrophage polarization, pro-inflammatory cytokines, and cell adhesion molecules in aortic tissue. We used TAK-242 (0.3 mg/kg, intraperitoneally), a selective antagonist of TLR4, as a possible prophylactic treatment for atherosclerotic changes induced by SIS. We observed that isolated animals had higher serum concentration of corticosterone and higher body weight in comparison to normal animals. In isolated animals, results of in vitro study showed that knocking-down of the GR in bone marrow-derived monocytes significantly decreased the expression of TLR4. In vivo study suggested higher expression of TLR4 on circulating monocytes and higher M1/M2 ratio in aortic samples. Pathological study showed a mild pre-atherosclerotic change in isolated animals. Finally, we observed that treating animals with TAK-242 could significantly inhibit the pre-atherosclerotic changes. SIS can possibly increase the risk of atherosclerosis through inducing abnormal HPA-axis activity and subsequently lead to TLR4 up-regulation, vascular inflammation, high M1/M2 ratio in intima. Thus, TLR4 inhibitors might be a novel treatment to decrease the risk of atherosclerosis induced by chronic stress.

The Role of Visfatin (Adipocytokine) Biomarker in Oral Health and Diseases among Nonobese Indian Population: A Proteomic Assay

Visfatin is an adipocytokine and a potential biomarker encoded by the nicotinamide phosphoribosyltransferase gene. It belongs to the nicotinic acid phosphoribosyltransferase family and involved in various metabolic processes and aging. The aim of this study was to evaluate the role of visfatin biomarker in oral diseases like periodontitis. A total of 60 patients (20–50 years) were included in this study, and they were divided into three groups. Group I consisted of 20 subjects with healthy periodontium, group II consisted of 20 subjects with generalized moderate gingivitis, and group III consisted of 20 subjects with generalized periodontitis. The clinical periodontal parameters, including plaque index, gingival index, probing pocket depth, and clinical attachment levels, were recorded, and saliva samples were collected. Salivary visfatin concentrations were assessed using standard enzyme-linked immunosorbent assay. The results of the study showed that the visfatin concentrations were higher in patients with gingivitis and periodontitis compared with those of healthy individuals. Visfatin was found highest in group III (38.22 ± 3.38 ng/mL) followed by group II (26.66 ± 2.24 ng/mL) and the group I (25.60 ± 2.19 ng/mL). Thus, salivary visfatin is a potential inflammatory biomarker and acts as a mediator in the pathogenesis of periodontal disease and, might serve as a diagnostic and therapeutic biomarker in oral diseases like periodontitis.

Nicotinamide adenine dinucleotide: Biosynthesis, consumption and therapeutic role in cardiac diseases

Nicotinamide adenine dinucleotide (NAD) is an abundant cofactor that plays crucial roles in several cellular processes. NAD can be synthesized de novo starting with tryptophan, or from salvage pathways starting with NAD precursors like nicotinic acid (NA), nicotinamide (NAM) or nicotinamide riboside (NR), referred to as niacin/B₃ vitamins, arising from dietary supply or from cellular NAD catabolism. Given the interconversion between its oxidized (NAD⁺ ) and reduced form (NADH), NAD participates in a wide range of reactions: regulation of cellular redox status, energy metabolism and mitochondrial biogenesis. Plus, NAD acts as a signalling molecule, being a cosubstrate for several enzymes such as sirtuins, poly-ADP-ribose-polymerases (PARPs) and some ectoenzymes like CD38, regulating critical biological processes like gene expression, DNA repair, calcium signalling and circadian rhythms. Given the large number of mitochondria present in cardiac tissue, the heart has the highest NAD levels and is one of the most metabolically demanding organs. In several models of heart failure, myocardial NAD levels are depressed and this depression is caused by mitochondrial dysfunction, metabolic remodelling and inflammation. Emerging evidence suggests that regulating NAD homeostasis by NAD precursor supplementation has therapeutic efficiency in improving myocardial bioenergetics and function. This review provides an overview of the latest understanding of the different NAD biosynthesis pathways, as well as its role as a signalling molecule particularly in cardiac tissue. We highlight the significance of preserving NAD equilibrium in various models of heart diseases and shed light on the potential pharmacological interventions aiming to use NAD boosters as therapeutic agents.

Correlation of Serum Adipolin with Epicardial Fat Thickness and Severity of Coronary Artery Diseases in Acute Myocardial Infarction and Stable Angina Pectoris Patients

OBJECTIVE

Adipolin/C1q/TNF-related protein-12 is a family of CTRPs highly expressed in adipose tissue with glucose-lowering and anti-inflammatory effects. Various risk factors have been suggested in the incidence of cardiovascular diseases, such as a decrease in anti-inflammatory or an increase in inflammatory factors. The purpose of the present study was to investigate the correlation of adipolin with anthropometric, angiographic, echocardiographic, and biochemical parameters.

SUBJECT AND METHODS

A total of 90 patients who were candidates for angiography were included in the study and divided into 3 groups: 30 patients with acute myocardial infarction (AMI), 30 patients with stable angina pectoris (SAP), and 30 subjects as a control group with a history of chest pain but normal angiography. Anthropometric, angiographic, echocardiographic, and biochemical parameters were measured in all subjects.

RESULTS

Serum adipolin levels were significantly decreased in patients with AMI compared with the SAP and control groups (p < 0.001 for both). In addition, there was a negative association between serum levels of adipolin and epicardial fat thickness (EFT) and Gensini score in CAD patients. The results of multivariate linear regression analysis revealed that EFT values were independently associated with serum adipolin levels.

CONCLUSION

The current study showed an independent association of adipolin with EFT for the first time in patients with AMI. Decreased adipolin levels in patients with AMI may be involved in the process of atherosclerosis, which requires further study.

Visfatin serum concentration is associated with cardiac allograft vasculopathy in heart transplant recipients

Cardiac allograft vasculopathy (CAV) still is one of the most important limiting factors of long-term survival following heart transplant (HT). This study aimed to investigate the association between proinflammatory adipokine-visfatin and the incidence of CAV in HT recipients. After HT, 182 patients who had a follow-up visit at the Transplantation Clinic between 2016 and 2017 were analyzed. The median age was 60.5 years, and 76.4% were men. The incidence of CAV was 54.9%. According to the multivariable proportional hazard regression analysis, visfatin level (1.795 [1.539-2.094]; P < .001) was significantly associated with CAV, and statin use was protective against CAV (0.504 [0.32-0.793]; P = .003). The area under the receiver operating characteristic curve indicated an excellent discriminatory power of visfatin (0.9548 [0.9281-0.9816]) for CAV detection. The cutoff value of 5.42 ng/mL for visfatin yielded a sensitivity of 89% and specificity of 91%. This is the first study to demonstrate that visfatin serum concentrations are independently associated with the incidence of CAV in HT recipients. Visfatin allows for simple and cheap detection of CAV given its excellent discriminatory ability and high sensitivity and specificity. In addition, we have found an independent association between the statin use and a lower risk of CAV.

Visfatin/eNampt induces endothelial dysfunction in vivo: a role for Toll-Like Receptor 4 and NLRP3 inflammasome

Visfatin/extracellular-nicotinamide-phosphoribosyltranferase-(eNampt) is a multifaceted adipokine enhanced in type-2-diabetes and obesity. Visfatin/eNampt cause in vitro endothelial dysfunction and vascular inflammation, although whether the same effects are achieved in vivo is unknown. Toll-like receptor-4 (TLR4), a main surface pattern recognition receptor of innate immune system is a potential target for visfatin/eNampt. We studied its capacity to generate vascular dysfunction in vivo, focusing on TLR4 role and downstream activation of nod-like-receptor-protein-3 (NLRP3)-inflammasome. 4 month-old C57BL/6 mice were exposed to 7 days infusion of visfatin/eNampt, alone or together with FK 866 (Nampt enzymatic inhibitor), CLI 095 (TLR4 blocker), MCC 950 (NLRP3-inflammasome inhibitor), or anakinra (interleukin(IL)-1-receptor antagonist). Endothelial dysfunction was tested in isolated microvessels. In human umbilical endothelial cells (HUVEC), proteins related to the NLRP3-inflammasome phosphorylated p-65, NLRP3, caspase-1, pro-IL-1β, and mature IL-1β were determined by Western blot, while the inflammasome related apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC-specks) was studied by immunofluorescence. Impaired endothelium-dependent relaxations were observed in isolated mesenteric microvessels from visfatin/eNampt-infused mice. This effect was attenuated by co-treatment with FK 866 or CLI 095, supporting a role for Nampt enzymatic activity and TLR4 activation. Moreover, cultured HUVEC exposed to visfatin/eNampt showed higher expression and activation of NLRP3-inflammasome. Again, this effect relied on Nampt enzymatic activity and TLR4 activation, and it was abrogated by the inflammasome assembly blockade with MCC 950. The endothelial dysfunction evoked by visfatin/eNampt infusion in vivo was also sensitive to both MCC 950 and anakinra treatments, suggesting that the NLRP3-inflammasome-driven tissular release of IL-1β is the final mediator of endothelial damage. We conclude that Visfatin/eNampt produces in vivo vascular dysfunction in mice by a Nampt-dependent TLR4-mediated pathway, involving NLRP3-inflammasome and paracrine IL-1β. Thus, those targets may become therapeutic strategies for attenuating the adipokine-mediated vascular dysfunction associated to obesity and/or type-2-diabetes.

Serum visfatin level is associated with complexity of coronary artery disease in patients with stable angina pectoris

BACKGROUND

Visfatin is an adipokine that plays a role in the inflammatory process of atherosclerosis. This study aimed to investigate whether adipokine is associated with the extent of stable coronary artery disease (CAD).

METHODS

The study population included 110 patients who underwent elective coronary angiography (CAG) due to stable angina pectoris. The severity of CAD was assessed by the 'Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX)' score. We evaluated patients in two groups: group 1 with a SYNTAX score <22 (low) and group 2 with a SYNTAX score ⩾22 (intermediate to high).

RESULTS

Serum visfatin (8.6 ± 4.2 ng/ml versus 13.4 ± 5.2 ng/ml, p < 0.001) and serum C-reactive protein (CRP) levels [0.46 (0.25-0.77) mg/dl versus 0.71 (0.32-1.10) mg/dl, p < 0.001] were lower in group 1. A positive significant correlation was found between serum visfatin level and SYNTAX score (r = 0.559, p < 0.001). In a multivariate logistic regression analysis, visfatin [odds ratio (OR) 1.22, 95% confidence interval (CI) 1.10-1.36; p < 0.001], CRP (OR 6.22, 95% CI 1.70-22.7; p = 0.006), and diabetes mellitus (OR 3.83, 95% CI 1.10-13.2; p = 0.034) were found to be independent predictors of SYNTAX score.

CONCLUSIONS

Serum visfatin level was positively correlated with CAD severity in patients with high SYNTAX score. Serum visfatin level can be a useful biomarker for predicting high SYNTAX scores in patients with angina pectoris undergoing CAG.

Clinical Significance of Platelet Volume and Other Platelet Parameters in Acute Myocardial Infarction and Stable Coronary Artery Disease

BACKGROUND

Platelets are important in the initiation of thrombosis, and their morphological and functional changes are closely related with the occurrence and development of coronary artery thrombosis. Platelet parameters might be valuable in distinguishing between acute myocardial infarction (AMI) and stable coronary artery disease (SCAD).

OBJECTIVE

This study was designed to detect and compare changes in platelet parameters, such as mean platelet volume (MPV) in patients with acute myocardial infarction (AMI) and stable coronary artery disease (SCAD) and to investigate their roles in these diseases.

METHODS

Specimen collection: Between January 2011 and December 2013, 2 mL of elbow vein blood was drawn from each of 31 patients primarily diagnosed with AMI, 34 SCAD patients and 50 healthy subjects; and placed in EDTA-K2 anticoagulant tubes. Platelet count (PLT), MPV, plateletcrit (PCT), platelet distribution width (PDW), white blood cell (WBC) and neutrophil (NEU) counts were determined using an STKS automated hematology analyzer (Beckman Courter).

RESULTS

Compared with the control group, MPV levels were significantly higher in the AMI and SCAD groups (p < 0.05), while PLT was significantly lower (p < 0.05).

CONCLUSION

These results suggest that MPV and other related parameters have a certain value in the diagnosis of SCAD and AMI.

Visfatin, PON-1 Levels in Iraqi Hyperthyroidism Patient's with Dyslipidemia

In the study, it is aimed to research the likely role of visfatin in hyperthyroid and subclinical hyperthyroid status related to dislipidemia, after determining the visfatin and PON-1 levels thirty healthy individuals were enrolled in this study as control group and thirty hyperthyroidism patient's with dyslipidemia they were treated with. The subjects aged ranged (30-50) years and with BMI (25-29) kg/m². Serum was used in determination of lipid profile total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), thyroid threonine (T3) and thyroxin (T4), thyroid stimulating hormone (TSH), visfatin and paraoxonase-1 (PON-1). The results showed significant increase in T3, T4, TC, TG, LDL and VLDL in patient group when comparing to control group. While significant decrease was found in TSH and HDL in patient group when comparing to control group. The results also represented significant increase in visfatin levels in patient group comparing to control group. While there are significant reducation in PON-1 levels in patient group comparing to control group. The conclusion could be drown from this study that visfatin and PON-1 effected hyperthyroidism patient's with dyslipidemia All the patients in hyperthyroid group were heterozygotes for Familial Hypercholesterolemia is a disorder that is passed down through families. It causes LDL (bad) cholesterol level to be very high. The condition begins at birth and can cause heart attacks at an early age.

Serum Adipokine Levels in Patients Considered for Lung Transplantation

The aim of the study was to investigate serum concentration of visfatin, irisin, and omentin in patients diagnosed as having end-stage lung diseases who qualified for lung transplantation (LTx) and to find the relationship between adipokine levels and clinical status.

MATERIAL AND METHODS

The study population consisted of 23 consecutive patients (10 patients diagnosed as having cystic fibrosis, 6 patients diagnosed as having chronic obstructive pulmonary disease, and 7 patients diagnosed as having idiopathic pulmonary fibrosis) who qualified for LTx. Patients performed pulmonary function tests; visfatin, irisin, and omentin serum levels were assessed using commercially available enzyme-linked immunosorbent assay kits.

RESULTS

Mean visfatin serum level was 4.99 ± 3.83 pg/mL; mean irisin serum level was 2.82 ± 0.24 ng/mL; mean omentin serum level was 389.99 ± 320.85 ng/mL. Mean distance in 6-minute walk test (6MWT) was 310.62 ± 147.09 m. Average partial pressure of oxygen (pO₂) was 55.79 ± 10.33 mm Hg, forced expiratory volume (FEV1) was 26.25 ± 22.38%, and forced vital capacity (FVC) was 56.95 ± 21.91% of a due value. There was no statistically significant correlation between adipokine levels and 6MWT, pO₂, FEV1, and FVC in patients waiting for LTx, regardless of underlying lung disease. Significant difference between patients was noted only in 6MWT, FEV1, and pO₂ in connection to lung disease.

CONCLUSION

Our findings indicate that adipokines may not have a statistically significant effect on parameters of pulmonary function. Results require further investigation on a larger study group, especially comparison of adipokine serum levels between groups of overweight patients, obese patients, and patients with normal weight who qualify for LTx.

Increased Peripheral Blood Visfatin Concentrations May Be a Risk Marker of Coronary Artery Disease: A Meta-Analysis of Observational Studies

A comprehensive quantitative evaluation of the relationship between peripheral blood visfatin concentrations and coronary artery disease (CAD) is lacking. This study is the first attempt to quantify this relationship via a meta-analysis of published observational studies in terms of weighted mean difference (WMD). Literature retrieval, article selection, and data extraction were conducted. Heterogeneity was inspected using both subgroup and meta-regression analyses. In total, 15 articles involving 1053 CAD cases and 714 controls were included. Overall, peripheral blood visfatin concentrations were significantly higher in CAD cases than in controls (WMD: 4.72 ng/mL; 95% confidence interval [CI]: 2.97-6.47; P < .001), with significant heterogeneity and publication bias. Six studies were theoretically missing based on filled funnel plot, and considering the impact of these missing studies still detected a significant overall mean difference in visfatin (WMD: 2.82 ng/mL; 95% CI: 2.22-3.58; P < .001; number of studies: 21). Subgroup and meta-regression analyses indicated age, body mass index, race, diabetes, systolic blood pressure, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were identified as possible causes of heterogeneity. In conclusion, our findings suggest that increased peripheral blood visfatin concentrations may be a risk marker of CAD.

Vascular dysfunction elicited by a cross talk between periaortic adipose tissue and the vascular wall is reversed by pioglitazone

AIM

Perivascular adipose tissue (PVAT) is in intimate contact with the vessel wall and extravascular PVAT-derived inflammatory mediators may adversely influence atherosclerotic plaque formation and stability through outside-to-inside signaling. We sought to investigate the role of PVAT on the atheroma development in an experimental animal model of metabolic syndrome (MS) associated with oxidative stress and low-grade inflammatory state. We also studied the effect of pioglitazone an insulin sensitizer, on the aortic wall and its surrounding PVAT, considering a bi-directional communication between both layers.

METHODS

Apolipoprotein E-deficient mice (ApoE^-/- ) were fed with standard diet (CD, control diet) or fructose overload (10% w/v) (FD, fructose diet) for 8 weeks and treated with or without pioglitazone the latest 4 weeks.

RESULTS

Biochemical variables show that glycemia and lipid peroxidation determined by thiobarbituric acid reactive species (TBARS) significantly increased in FD-fed ApoE^-/- mice. FD significantly increased aortic PVAT expression of oxidative stress associated genes: p22^phox , Nox1, Nox2, Nox4 and p47^phox , and proinflammatory genes: Visfatin, MCP-1, and MMP-9. Pioglitazone diminished PVAT-oxidative damage elicited by fructose treatment and markedly down-regulated proinflammatory markers. Even pioglitazone did not prevent the development of the aortic atheroma plaques stimulated by FD, significantly diminished VCAM-1 expression, MMP-9 expression and activity in aortic media wall and significantly reduced the accumulation of lipids and macrophages in atheroma plaques.

CONCLUSION

Our results support the fact that PVAT contributes to the development and progression of cardiovascular disease by underlying mechanisms elicited by "outside-in" signaling. Treatment with pioglitazone may offer a new effect on the whole vessel wall, promoting the stability of advanced atherosclerotic plaques.

Serum Levels of Visfatin, Omentin and Irisin in Patients with End-Stage Lung Disease Before and After Lung Transplantation

Background

The aim of this study was to investigate serum concentrations of visfatin, irisin, and omentin in patients with end-stage lung diseases (ESLD) before and after lung transplantation (LTx) and to find relationship between adipokines levels and clinical outcomes.

Material/Methods

Fourteen consecutive lung transplant recipients (six males and seven females; age 32.0±14.2 years; body mass index (BMI) 21.8±5.3 kg/m²) who underwent lung transplantation with initial diagnosis of respiratory failure due to cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) were included. Visfatin, irisin, and omentin serum levels were assayed using commercially available ELISA kits at four time points: the day of LTx (day 0), 72 hours (day 3), one month (day 30) and three months (day 90) after LTx.

Results

Omentin serum concentration decreased significantly within three days after LTx (350.5±302.0 to 200.0±0.90 ng/mL; p<0.05), while visfatin serum levels decreased later, 30 days after Ltx (4.81±3.78 to 0.78±0.35 [0.4–1.1] pg/mL; p<0.05). Downregulated serum levels of both adipokines remained stable for the next two months (256.0 [201.7–642.9] ng/mL and 0.77±0.76 pg/mL, respectively; p<0.05). Serum levels of irisin were unchanged before and after Ltx. Immunosuppressive regimen did not affect serum levels of the analyzed adipokines.

Conclusions

The study showed for the first time serum omentin and visfatin levels to be decreased after LTx in ESLD patients. Successful LTx contributes to the improvement of impaired lung function parameters and attenuation of ongoing inflammatory process, resulting in altered visfatin and omentin serum levels. Additional influence of immunosuppressive treatment on omentin and visfatin serum concentration cannot be excluded.

Subcutaneous injection of dendritic cells aggravates atherosclerosis in ApoE‑knockout mice by activation of TLR4

Dendritic cells (DCs) are specialized antigen‑presenting cells which are important in immune diseases, in particular atherosclerosis, a chronic inflammatory disease, however their role in atherosclerosis‑associated immunity is unclear. To evaluate the role of DCs in atherosclerosis, exogenous bone marrow‑derived DCs were transferred into ApoE‑/‑ mice in the present study. The extent of disease was measured in the aorta and was compared with mice treated with phosphate‑buffered saline (PBS) or left untreated and fed a western diet. Mice receiving exogenous DCs demonstrated significantly larger atherosclerotic lesions compared with the mice treated with PBS, with increasing numbers of mature DCs in circulation and enhanced DC infiltration into plaque lesions, in addition to activation of circulating inflammatory components and atherosclerotic lesions. Furthermore, it was demonstrated that exogenous DCs upregulated the expression of Toll‑like receptor 4 (TLR4) on DCs, which may be an important mechanism to activate DCs and aggravate atherosclerosis. Therefore the present study concluded that exogenous DCs may induce maturation of endogenous DCs via upregulation of TLR4, further increasing the inflammatory response and accelerating atherosclerosis.

Regulation and Function of Extracellular Nicotinamide Phosphoribosyltransferase/Visfatin

Nicotinamide phosphoribosyltransferase (NAMPT) is an adipokine-enzyme, which was described as to play bioactivities both in the intracellular and in the extracellular environment. However, while the functions of intracellular NAMPT (iNAMPT) are well known, much less is known on extracellular NAMPT (eNAMPT), also called visfatin or pre-B cell colony-enhancing factor. iNAMPT catalyzes the rate-limiting step in the NAD+ biosynthesis pathway from nicotinamide. Its inhibition severely reduces intracellular NAD+ levels, achieving anti-inflammatory and anti-cancer effects. eNAMPT can be detected in the human circulation and in many extracellular environments. Studies show that eNAMPT can act as a growth factor, as an enzyme, and as a cytokine, but its true mechanism of secretion and its physiological functions are still debated. Increased levels of eNAMPT have been associated with different metabolic disorders and cancers. eNAMPT was demonstrated to modulate the pathways involved in the pathophysiology of obesity, diabetes, atherosclerosis, and cardiovascular events by regulating the oxidative stress response, apoptosis, and inflammation. In cancer, eNAMPT was shown to play a pivotal role in modulating cancer cell metabolism, in promoting epithelial-to-mesenchymal transition and in shaping the tumor microenvironment. In line with these functions, circulating eNAMPT levels are frequently increased in cancer patients. Given these pleiotropic roles of eNAMPT in human disease, this protein has attracted attention as a therapeutic target. In this narrative review, we will discuss recent evidence on eNAMPT-driven signalling, highlighting the emerging pathophysiological roles of this protein in different disorders and the potential therapeutic opportunities linked to its targeting. © 2017 American Physiological Society. Compr Physiol 7:603-621, 2017.

Nicotinamide Phosphoribosyltransferase Promotes Pulmonary Vascular Remodeling and Is a Therapeutic Target in Pulmonary Arterial Hypertension

BACKGROUND

Pulmonary arterial hypertension is a severe and progressive disease, a hallmark of which is pulmonary vascular remodeling. Nicotinamide phosphoribosyltransferase (NAMPT) is a cytozyme that regulates intracellular nicotinamide adenine dinucleotide levels and cellular redox state, regulates histone deacetylases, promotes cell proliferation, and inhibits apoptosis. We hypothesized that NAMPT promotes pulmonary vascular remodeling and that inhibition of NAMPT could attenuate pulmonary hypertension.

METHODS

Plasma, mRNA, and protein levels of NAMPT were measured in the lungs and isolated pulmonary artery endothelial cells from patients with pulmonary arterial hypertension and in the lungs of rodent models of pulmonary hypertension. Nampt^+/- mice were exposed to 10% hypoxia and room air for 4 weeks, and the preventive and therapeutic effects of NAMPT inhibition were tested in the monocrotaline and Sugen hypoxia models of pulmonary hypertension. The effects of NAMPT activity on proliferation, migration, apoptosis, and calcium signaling were tested in human pulmonary artery smooth muscle cells.

RESULTS

Plasma and mRNA and protein levels of NAMPT were increased in the lungs and isolated pulmonary artery endothelial cells from patients with pulmonary arterial hypertension, as well as in lungs of rodent models of pulmonary hypertension. Nampt^+/- mice were protected from hypoxia-mediated pulmonary hypertension. NAMPT activity promoted human pulmonary artery smooth muscle cell proliferation via a paracrine effect. In addition, recombinant NAMPT stimulated human pulmonary artery smooth muscle cell proliferation via enhancement of store-operated calcium entry by enhancing expression of Orai2 and STIM2. Last, inhibition of NAMPT activity attenuated monocrotaline and Sugen hypoxia-induced pulmonary hypertension in rats.

CONCLUSIONS

Our data provide evidence that NAMPT plays a role in pulmonary vascular remodeling and that its inhibition could be a potential therapeutic target for pulmonary arterial hypertension.

The Role of Adipocytokines in Coronary Atherosclerosis

PURPOSE OF REVIEW

The aim of this review is to overview the pathophysiological role of adipocytokines in atherogenesis, focusing on their potential role as biomarkers of coronary disease.

RECENT FINDINGS

Several lines of evidence indicated adipose tissue not only as depot but rather as an endocrine organ. In this context, the balance between pro- and anti-inflammatory adipocytokines has been shown to critically regulate vascular homeostasis in both physiological and pathophysiological conditions. Overweight and obesity are characterized by dysfunctional adipose tissue and then the prevalence of pro-inflammatory mediators, with a detrimental effect on vascular health. As opposite to adiponectin, pro-inflammatory adipocytokines, such as leptin and resistin, promote endothelial dysfunction and inflammatory processes involved in atherosclerotic plaque progression and vulnerability. Therefore, many adipocytokines have been investigated as potential biomarkers of cardiovascular (CV) risk, but their role has not yet been clearly established. Furthermore, the perivascular adipose tissue recently emerged as a critical modulator of atherosclerotic processes, due to the close interaction with the underlying vascular tissue. The ongoing discovery of new adipocytokines and the complex pathophysiological role of the different adipose tissue depots strongly contribute to define the complexity of adipocytokines network. Understanding those complex interactions may allow determining new potential biomarkers of CV risk and potential therapeutic targets.

Potential beneficial effect of some adipokines positively correlated with the adipose tissue content on the cardiovascular system

Obesity is a risk factor of cardiovascular diseases. However, in the case of heart failure, obese and overweight patients have a more favourable prognosis compared to patients who have a normal body weight. This phenomenon is referred to as the "obesity paradox," and it is explained by, among others, a positive effect of adipokines produced by adipose tissue, particularly by the tissue located in the direct vicinity of the heart and blood vessels. The favourable effect on the cardiovascular system is mostly associated with adiponectin and omentin, but the levels of these substances are reduced in obese patients. Among the adipokines which levels are positively correlated with the adipose tissue content, favourable activity is demonstrated by apelin, progranulin, chemerin, TNF-α (tumour necrosis factor-)α, CTRP-3 (C1q/tumour necrosis factor (TNF) related protein), leptin, visfatin and vaspin. This activity is associated with the promotion of regeneration processes in the damaged myocardium, formation of new blood vessels, reduction of the afterload, improvement of metabolic processes in cardiomyocytes and myocardial contractile function, inhibition of apoptosis and fibrosis of the myocardium, as well as anti-inflammatory and anti-atheromatous effects. The potential use of these properties in the treatment of heart failure and ischaemic heart disease, as well as in pulmonary hypertension, arterial hypertension and the limitation of the loss of cardiomyocytes during cardioplegia-requiring cardiosurgical procedures, is studied. The most advanced studies focus on analogues of apelin and progranulin.

Association of serum microRNA-21 levels with Visfatin, inflammation, and acute coronary syndromes

MicroRNAs (miRNAs) are short non-coding RNAs that regulate gene expression. It seems that microRNA-21 (miR-21) and Visfatin, a novel adipocytokine, play roles in inflammation and atherosclerosis. The aim of this study was to investigate the association of miR-21 with Visfatin, inflammation, atherosclerosis and acute coronary syndrome (ACS). Based on coronary angiography and electrocardiogram (ECG), 53 patients with ACS and 52 patients with stable CAD were enrolled in this study. We assayed serum miR-21, Visfatin, and routine chemistries using quantitative reverse transcriptase polymerase chain reaction (QRT-PCR), enzyme-linked immunosorbent assay (ELISA) and automated analyzer, respectively. We used a regression analysis to describe the relationship between the variables. Serum miR-21 level in 2^-ΔCt value was significantly higher in ACS patients (10.52 ± 1.01-fold) than the stable CAD patients (4.4 ± 0.79-fold) (F = 4.59, p < 0.001). In addition, serum Visfatin was significantly higher in ACS patients (17.5 ± 0.61 ng/ml) than the stable CAD patients (12.7 ± 0.49 ng/ml) (F = 2.62, p < 0.001). Furthermore, the serum miR-21 level correlated positively with serum Visfatin level (r = 0.26, p = 0.008), hs-CRP (r = 0.29, p = 0.003), age (r = 0.21, p = 0.034) and negatively with HDL-cholesterol (r = -0.28, p = 0.004). We concluded that the increased serum miR-21 and Visfatin may be involved in the pathogenesis of ACS through promoting inflammation or may result from inflammatory responses to ACS. Furthermore, the potential role of miR-21 and Visfatin in plaque instability and inflammation warrants further investigations.

Adipo/cytokines in atherosclerotic secretomes: increased visfatin levels in unstable carotid plaque

Background

Novel pro-inflammatory and anti-inflammatory derivatives from adipose tissue, known as adipokines, act as metabolic factors. The aim of this study was to analyse the secreted expression of different adipo/cytokines in secretomes of unstable carotid atherosclerotic plaque versus non-atherosclerotic mammary artery.

Methods

We evaluated the secretion levels of adiponectin, visfatin, lipocalin-2, resistin, IL-6 and TNFR2 by ELISA in human secretomes from cultured unstable carotid atherosclerotic plaque (n = 18) and non-atherosclerotic mammary artery (n = 13). We also measured visfatin serum levels in patients suffering from atherosclerosis and in a serum cohort of healthy subjects (n = 16).

Results

We found that visfatin levels were significantly increased in unstable carotid atherosclerotic plaque secretome than in non-atherosclerotic mammary artery secretome. No differences were found with regard the other adipo/cytokines studied. Regarding visfatin circulating levels, there were no differences between unstable carotid atherosclerotic plaque and non-atherosclerotic mammary artery group. However, these visfatin levels were increased in comparison to serum cohort of healthy subjects.

Conclusions

Of all the adipo/cytokines analysed, only visfatin showed increased levels in secretomes of unstable carotid atherosclerotic plaque. Additional human studies are needed to clarify the possible role of visfatin as prognostic factor of unstable carotid atherosclerotic plaque.

Obesity and Cardiovascular Risk: Variations in Visfatin Gene Can Modify the Obesity Associated Cardiovascular Risk. Results from the Segovia Population Based-Study. Spain

Objectives

Our aim was to investigate if genetic variations in the visfatin gene (SNPs rs7789066/ rs11977021/rs4730153) could modify the cardiovascular-risk (CV-risk) despite the metabolic phenotype (obesity and glucose tolerance). In addition, we investigated the relationship between insulin sensitivity and variations in visfatin gene.

Material and Methods

A population-based study in rural and urban areas of the Province of Segovia, Spain, was carried out in the period of 2001–2003 years. A total of 587 individuals were included, 25.4% subjects were defined as obese (BMI ≥30 Kg/m²).

Results

Plasma visfatin levels were significantly higher in obese subjects with DM2 than in other categories of glucose tolerance. The genotype AA of the rs4730153 SNP was significantly associated with fasting glucose, fasting insulin and HOMA-IR (Homeostasis model assessment-insulin resistance) after adjustment for gender, age, BMI and waist circumference.

The obese individuals carrying the CC genotype of the rs11977021 SNP showed higher circulating levels of fasting proinsulin after adjustment for the same variables.

The genotype AA of the rs4730153 SNP seems to be protective from CV-risk either estimated by Framingham or SCORE charts in general population; and in obese and non-obese individuals. No associations with CV-risk were observed for other studied SNPs (rs11977021/rs7789066).

Conclusions

In summary, this is the first study which concludes that the genotype AA of the rs4730153 SNP appear to protect against CV-risk in obese and non–obese individuals, estimated by Framingham and SCORE charts. Our results confirm that the different polymorphisms in the visfatin gene might be influencing the glucose homeostasis in obese individuals.

Apelin and Visfatin Plasma Levels in Healthy Individuals With High Normal Blood Pressure

BACKGROUND

High normal blood pressure (BP; 130-139/85-89 mm Hg) is related with increased cardiovascular (CV) risk compared to normal BP (120-129/80-84 mm Hg) or/and optimal BP (<120/80 mm Hg). Low apelin plasma levels have been associated with arterial hypertension and atherosclerosis, while high visfatin plasma levels may promote vascular inflammation and atherosclerotic plaque destabilization and have been evaluated as a marker for identifying stages of essential hypertension. We sought to compare the apelin and visfatin plasma levels between subjects with high normal BP and subjects with normal or optimal BP matched for age, gender, smoking, and body mass index (BMI).

METHODS

Twenty-five subjects with high normal BP (office BP 136±3/88±2 mm Hg, age 57±4 years, 76% males, 32% smokers, BMI 24.0±1.7 kg/m2) and 35 subjects with normal or optimal BP (office BP 118±2/78±2 mm Hg, age 55±7 years, 63% males, 29% smokers, BMI 23.2±1.4 kg/m2) were studied. The apelin and visfatin plasma levels were determined with the enzyme-linked immunosorbent assay.

RESULTS

Compared to normal or optimal BP subjects, apelin levels were significantly lower (205±108 vs. 325±152 pg/ml, P < 0.001) and visfatin levels significantly higher (11.0±2.0 vs. 7.2±0.9 ng/ml, P = 0.002) in high normal BP subjects. No significant differences were found between the 2 groups (P = NS) regarding the basic clinical characteristics, the glycemic/lipid profile, and the renal function parameters.

CONCLUSIONS

The emerging, from the present study, data raise the hypothesis that lower apelin and higher visfatin plasma levels in high normal BP subjects compared to normal or optimal BP individuals could partially explain the higher CV risk of the high normal BP group.

Association between serum visfatin and carotid atherosclerosis in diabetic and non-diabetic patients on maintenance hemodialysis

Introduction

Adipose tissue releases bioactive factors termed adipokines. Visfatin is an adipokine that plays an active role promoting vascular inflammation and atherosclerosis. The purpose of this study was to determine the association between serum visfatin levels and carotid atherosclerosis in diabetic and non-diabetic patients on maintenance hemodialysis (HD) in order to clarify the role of serum visfatinas, a risk factor for cardiovascular complications in HD patients.

Methods

Forty patients on maintenance hemodialysis were enrolled in this case-control study in 2015. They were subdivided into two groups, i.e., a diabetic group (n = 20) and a non-diabetic group (n = 20). Twenty healthy subjects who were age and gender matched were included as a control group. Carotid Duplex studies were performed on all patients, and serum visfatin was determined by a competitive enzyme immunoassay.

Results

HD patients showed a highly significant increase in serum visfatin, urea, creatinine, Ca×Ph, K, fasting glucose, triglycerides, LDL levels, and a significant decrease in eGFR, Na, HDL, and Hb compared to the control group. Also, serum visfatin levels showed a highly significant increase in the diabetic HD group compared to both the non-diabetic HD and control groups. Serum visfatin showed a highly significant increase in non-diabetic HD patients compared to the control group. Carotid intima-media thickness (IMT) showed a highly significant increase in HD group compared to the control group. Serum visfatin correlated positively with serum urea, creatinine, glucose, and IMT, but it was negatively correlated with eGFR, Na, and HDL

Conclusion

We concluded that serum visfatin is increased in HD patients with and without diabetes. Moreover, its association with IMT may be involved in the pathogenesis of atherosclerosis in CRF patients.

Increased serum visfatin as a risk factor for atherosclerosis in patients with ischaemic cerebrovascular disease

INTRODUCTION

The present study aimed to investigate the possible associations between serum levels of visfatin, an adipokine, and atherosclerosis in patients with ischaemic cerebrovascular disease.

METHODS

A total of 95 participants were recruited for this study. Group A comprised 35 individuals with no history of cerebrovascular disease (control group) and Group B comprised 60 patients with ischaemic cerebrovascular disease. Group B was further categorised into two subgroups based on the ultrasonographic findings of the common carotid artery intima‑media thickness (CCA‑IMT) - Group B1 consisted of 21 patients with no atherosclerosis (i.e. CCA‑IMT ≤ 0.9 mm) and Group B2 consisted of 39 patients with atherosclerosis (i.e. CCA‑IMT > 0.9 mm). The body mass index, fasting blood total cholesterol, triglycerides, high‑density lipoprotein cholesterol, low‑density lipoprotein cholesterol and glucose levels of each patient were measured. Serum visfatin levels were determined using enzyme‑linked immunosorbent assays. Visfatin levels were compared between groups, and stepwise logistic regression analysis was used to identify risk factors for atherosclerosis, including visfatin levels.

RESULTS

The mean serum visfatin level of the patients in Group B was higher than that in Group A (75.5 ± 77.80 ng/mL vs. 8.6 ± 4.69 ng/mL; p < 0.05) and the level was higher in patients from Group B2 than those from Group B1 (89.0 ± 80.68 ng/mL vs. 50.4 ± 72.44 ng/mL; p < 0.05). Multivariate regression analysis showed that CCA‑IMT values were not significantly associated with visfatin levels. However, logistic regression analysis showed that serum visfatin was an independent risk factor for atherosclerosis (odds ratio 37.80; p = 0.004).

CONCLUSION

Serum visfatin may be an independent risk factor for cerebral infarction, as high serum visfatin levels are positively associated with the underlying pathogenic mechanisms of ischaemic cerebrovascular disease.

Serum levels of adipocytokines in psoriasis patients receiving tumor necrosis factor-α inhibitors: results of a retrospective analysis

BACKGROUND

Adipocytokines are bioactive molecules that are deeply involved in the occurrence of atherosclerosis, obesity, and autoimmune inflammatory diseases.

OBJECTIVES

This study was conducted to evaluate the effects of tumor necrosis factor-α (TNF-α) inhibitors on serum levels of adipocytokines in patients with chronic plaque psoriasis.

METHODS

Serum levels of adiponectin, resistin, visfatin, leptin, TNF-α, and interleukin-6 (IL-6) were evaluated in sera obtained from 47 patients with psoriasis, both at baseline and after they had received TNF-α inhibitors for 24 weeks. Equivalent data were obtained for 39 control subjects matched by age, sex, body mass index, waist : hip ratio, geographical origin, Mediterranean dietary habits, and smoking habits.

RESULTS

At baseline, mean serum levels of TNF-α, IL-6, leptin, resistin, and visfatin were higher in the psoriasis group than in healthy controls; these differences were statistically significant (P < 0.05). Conversely, mean serum levels of adiponectin were significantly lower in patients with psoriasis than in controls (P < 0.0001). Serum levels of adipocytokines did not linearly correlate with anthropometric indices in psoriasis patients (P > 0.05), except in the case of leptin, for which serum levels were related to waist : hip ratio in both men and women (P < 0.05). After 24 weeks of treatment, although serum levels of proinflammatory adipocytokines were decreased, only that of leptin showed a statistically significant reduction (P = 0.0003). Serum levels of adiponectin, an anti-inflammatory adipocytokine, were only mildly increased and persisted at a significantly lower level than in healthy controls (P > 0.005).

CONCLUSIONS

Patients with psoriasis show an imbalance between pro- and anti-inflammatory adipocytokines, which is reduced but not normalized after administration of TNF-α inhibitors for 24 weeks. This partial rebalancing seems to be mainly related to a reduction in proinflammatory adipocytokines, rather than an increase in anti-inflammatory adipocytokines.

Effect of Non-surgical Periodontal Therapy on Serum and Salivary Concentrations of Visfatin in Patients with Chronic Periodontitis

Background and aims. Visfatin, mainly secreted by visceral adipose tissue, especially by macrophages, plays an important role in regulating the defense and immune functions, and functions as a growth factor, a cytokine, an enzyme and more importantly as a proinflammatory mediator. The aim of the present study was to evaluate the effect of non-surgical periodontal treatment on serum and salivary levels of visfatin in patients with generalized moderate-to-severe chronic periodontitis. Materials and methods. Eighteen patients with generalized moderate-to-severe chronic periodontitis were selected based on periodontal parameters of gingival index (GI), probing pocket depth (PPD), clinical attachment level (CAL) and radiographic parameters. Serum and salivary samples were collected at baseline and one month following non-surgical periodontal therapy (scaling and root planing ([SRP]). Visfatin levels were measured using an ELISA kit. Data were analyzed by SPSS 15, using paired t-test and Pearson's correlation coefficient. Results. Mean salivary and serum levels of visfatin significantly decreased after non-surgical periodontal treatment (P<0.05). Changes in salivary visfatin levels were more prominent. Conclusion. According to the findings of this study it seems that there is a direct relationship between periodontal tissue inflammation and disease activity with salivary and serum visfatin levels.

Mechanisms of enhanced insulin secretion and sensitivity with n-3 unsaturated fatty acids

The widespread acceptance that increased dietary n-3 polyunsaturated fatty acids (PUFAs), especially α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), improve health is based on extensive studies in animals, isolated cells and humans. Visceral adiposity is part of the metabolic syndrome, together with insulin resistance, dyslipidemia, hypertension and inflammation. Alleviation of metabolic syndrome requires normalization of insulin release and responses. This review assesses our current knowledge of the mechanisms that allow n-3 PUFAs to improve insulin secretion and sensitivity. EPA has been more extensively studied than either ALA or DHA. The complex actions of EPA include increased G-protein-receptor-mediated release of glucagon-like peptide 1 (GLP-1) from enteroendocrine L-cells in the intestine, up-regulation of the apelin pathway and down-regulation of other control pathways to promote insulin secretion by the pancreatic β-cells, together with suppression of inflammatory responses to adipokines, inhibition of peroxisome proliferator-activated receptor α actions and prevention of decreased insulin-like growth factor-1 secretion to improve peripheral insulin responses. The receptors involved and the mechanisms of action probably differ for ALA and DHA, with antiobesity effects predominating for ALA and anti-inflammatory effects for DHA. Modifying both GLP-1 release and the actions of adipokines by n-3 PUFAs could lead to additive improvements in both insulin secretion and sensitivity.

Assessment of adipokines, adenine nucleotides and uric acid in the dynamics of coronary intervention

Introduction: The association of vaspin and visfatin, with a myocardial infarction is still not fully understood. Reduced levels of adenine nucleotides are hallmarks of chronic heart failure. There is little data concerning the relationship between these markers and their changes over time. Material/Methods: The concentration of adenine nucleotides, vaspin and visfatinwere assessed in 41 consecutive patients with acute myocardial infarction one before (day I) and four days after (day IV) percutaneous coronary intervention (PCI) and a control group. Results: Visfatin concentrations were higher before and after PCI vs. control (visfatin I: median 25.55, 20.12 - 30.69 ng/ml; visfatin IV: median 20.79, 16.89 - 25.61 ng/ml vs. control: median 14.94, 10.66 - 25.25 ng/ml; p < 0.0001). Vaspin concentrations were lower before and after PCI vs. control (vaspin I: median 0.18, 0.11 - 0.44 ng/ml; vaspin IV: median 0.24, 0.15 - 0.58 ng/ml vs. control: median 1.303, 1.13 - 2.26 ng/ml, p < 0.00001). Concentrations of visfatin, day I, correlated well to vaspin concentrations (r

Adipokines, vascular wall, and cardiovascular disease: a focused overview of the role of adipokines in the pathophysiology of cardiovascular disease

Epidemiological evidence has shown that abdominal obesity is closely associated with the development of cardiovascular (CV) disease, suggesting that it might be considered as an independent CV risk factor. However, the pathophysiological mechanisms responsible for the association between these 2 clinical entities remain largely unknown. Adipocytes are considered able to produce and secrete chemical mediators known as "adipokines" that may exert several biological actions, including those on heart and vessels. Of interest, a different adipokine profile can be observed in the plasma of patients with obesity or metabolic syndrome compared with healthy controls. We consider the main adipokines, focusing on their effects on the vascular wall and analyzing their role in CV pathophysiology.

Chemerin is a novel biomarker of acute coronary syndrome but not of stable angina pectoris

BACKGROUND

Recent evidence demonstrated that the circulating adipokines were associated with the onset of acute coronary syndrome (ACS) including unstable angina pectoris (UAP) and acute myocardial infarction (AMI). As a novel adipokine, chemerin has been related to atherosclerosis and the presence of coronary artery disease. However, the plasma levels of chemerin in patients with ACS have yet to be investigated.

METHODS

Plasma levels of chemerin and adiponectin were measured by an enzyme-linked immunosorbent assay (ELISA) in 60 patients with stable angina pectoris (SAP), 60 patients with UAP, 60 patients with AMI and 40 control patients. Left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured using a GE ViVid E7 ultrasonography machine, and the severity of coronary stenosis in patients was estimated with a Gensini coronary score following coronary angiography.

RESULTS

Plasma chemerin levels were significantly higher in ACS patients than in the control and SAP groups, while plasma adiponectin levels were significantly lower in ACS patients than the control group. A correlation analysis revealed that plasma chemerin levels were positively correlated with the levels of C-reactive protein (CRP) (r = 0.29, P < 0.01) and LVEDD (r = 0.27, P < 0.01) but negatively correlated with LVEF (r = -0.45, P < 0.01) and that plasma adiponectin levels were positively correlated with LVEF (r = 0.53, P < 0.01) but negatively correlated with CRP (r = -0.33, P < 0.01) and LVEDD (r = -0.30, P < 0.01). Although significant correlations between chemerin, adiponectin and BMI or the Gensini coronary score were found in patients with SAP, neither chemerin nor adiponectin was correlated with BMI and the Gensini coronary score in patients with ACS. Furthermore, both chemerin (OR 1.103, 95% CI 1.065 to 1.142; P = 0.001) and adiponectin (OR 0.871, 95% CI 0.776 to 0.970; P = 0.018) were independently associated with the presence of ACS.

CONCLUSIONS

Chemerin is a novel biomarker of acute coronary syndrome but not of stable angina pectoris.

Beijing ambient particle exposure accelerates atherosclerosis in ApoE knockout mice by upregulating visfatin expression

Ambient particulate matter (PM) exposure has been associated with atherosclerosis. However, research on the effect of real-world exposure to ambient PM in regulating visfatin expression in an animal model is very limited. The objective is to investigate whether Beijing ambient PM exposure could accelerate atherosclerosis in ApoE knockout (ApoE(-/-)) mice by upregulating visfatin expression. Forty male ApoE(-/-) mice were exposed to untreated ambient air (PM group, n = 20) or filtered air (FA group, n = 20), 24 h/day, 7 days/week, for 2 months. During the exposure, the mass concentrations of PM2.5 and PM10 in the two groups were continuously monitored. Moreover, a receptor source apportionment model was applied to apportion sources of PM2.5. At the end of the exposure, visfatin in plasma and aorta, biomarkers of inflammation, oxidative stress and lipid metabolism in blood samples, and bronchoalveolar lavage fluid (BALF) were determined, and the plaque area of the atherosclerosis lesions was quantified. PM-exposed mice were significantly higher than FA-exposed mice in terms of plasma visfatin, OxLDL, MDA, serum TC, LDL, TNF-α as well as IL-6, TNF-α, OxLDL, and MDA in BALF, while SOD and GSH-Px activities in plasma and BALF were reduced in PM-exposed mice. Pathological analysis of the aorta demonstrated that the plaque area and visfatin protein in the PM group increased significantly compared to the FA group. Our findings indicate that ambient PM exposure could accelerate atherosclerosis, which is related to visfatin upregulation, as well as the activation of inflammation and oxidative stress.

Aryl hydrocarbon receptor mediates indoxyl sulfate-induced cellular senescence in human umbilical vein endothelial cells

AIM

Vascular senescence, which is accelerated in individuals with chronic kidney disease (CKD), contributes to the development of cardio-renal syndrome, and various uremic toxins may play important roles in the mechanisms underlying this phenomenon. We recently reported that indoxyl sulfate (IS), a uremic toxin, directly activates aryl hydrocarbon receptor (AhR) and generates oxidative stress through NADPH oxidase-4 in human umbilical vein endothelial cells (HUVECs). In the current study, we sought to examine whether IS regulates sirtuin 1 (Sirt1) and affects endothelial senescence via AhR activation.

METHODS

HUVECs were incubated with 500 μmol/L of IS for the indicated time periods. In order to evaluate changes in the senescence of the HUVECs, the number of senescence-associated β-galactosidase (SA β-gal)-positive cells was determined using an image analysis software program. The intracellular nicotinamide phosphoribosyltransferase (iNampt) activity, cellular NAD(＋)/NADPH ratio and Sirt1 activity were analyzed according to a colorimetric assay to determine the mechanism of cellular senescence. Furthermore, we evaluated the involvement of AhR in the senescence-related changes induced by IS using AhR antagonists.

RESULTS

IS decreased the iNampt activity, NAD(＋)/NADPH ratio and Sirt1 activity, resulting in an increase in the percentage of SA β-gal-positive cells. On the other hand, the AhR antagonists restored the IS-induced decrease in the NAD(＋) content in association with an improvement in the iNampt activity and ameliorated the senescence-related changes. Taken together, these results indicate that IS impairs the iNampt-NAD(＋)-Sirt1 system via AhR activation, which in turn promotes endothelial senescence.

CONCLUSIONS

The IS-AhR pathway induces endothelial senescence. Therefore, blocking the effects of AhR in the endothelium may provide a new therapeutic tool for treating cardio-renal syndrome.

The effect of ezetimibe on adipose tissue hormones in patients with isolated hypercholesterolemia

BACKGROUND

Extra-lipid effects of ezetimibe, a new lipid-lowering agent, are so far poorly understood.

METHODS

Twenty-two patients with elevated total and LDL cholesterol levels, statin-intolerant or having contraindications to statin therapy, were treated with ezetimibe (10mg daily) for 90 days. Plasma levels of lipids, apolipoproteins, glucose homeostasis markers, leptin, adiponectin, visfatin, tumor necrosis factor-α (TNF-α), free fatty acids (FFA) and high sensitivity C-reactive protein (hsCRP) were examined at the beginning of the study and after 30 and 90 days of treatment.

RESULTS

Compared with the control age-, sex-, and weight-matched healthy subjects, isolated hypercholesterolemic patients exhibited higher plasma levels of leptin, visfatin and TNF-α and lower plasma levels of adiponectin. Their baseline FFA and hsCRP levels were also increased. Ezetimibe decreased circulating levels of total cholesterol, LDL cholesterol and apolipoprotein B-100. The drug significantly reduced plasma levels of visfatin and only tended to reduce plasma levels of leptin, TNF-α, visfatin, FFA and CRP. The effect of ezetimibe on these markers was lipid-independent but stronger in insulin-sensitive than in insulin-resistant patients.

CONCLUSIONS

The obtained results indicate that the presence of isolated hypercholesterolemia is associated with abnormal hormonal function of the adipose tissue. They also show that ezetimibe induces relatively small changes in adipose tissue hormonal function and systemic inflammation in patients with elevated cholesterol levels.