SERUM VISFATIN CONCENTRATION IS ASSOCIATED WITH AN

ATHEROGENIC METABOLIC PROFILE

T.D. Filippatos1, A. Liontos1, F. Barkas1, E. Klouras1, V. Tsimihodimos1, M. Georgoula1, Z.

Mitrogianni1, AD Tselepis2, MS Elisaf1

1Department of Internal Medicine, School of Medici1ne, University of Ioannina, Ioannina, Greece

2Laboratory of Biochemistry, Department of Chemistry, University of Ioannina, Ioannina, Greece

Background

Human visfatin has been implicated in the pathogenesis of type 2 diabetes mellitus, obesity, dyslipidaemia, and hypertension and generally of atherosclerosis-related diseases.Controversial results exist regarding the expression, circulating levels and the role of visfatin in the atherosclerosis-related diseases.

Aim of the study

Aim of the present study was to assess in non-diabetic individuals the association of plasma visfatin levels with cardiovascular disease (CVD) risk and the atherosclerosis - related metabolic variables.

Methods (1)Non-diabetic subjects (n = 179) attending the Outpatient Lipid Clinic of the University Hospital of Ioannina participated in the present study.No participant had symptomatic ischemic heart disease or any other clinically evident vascular disease (assessed by history, physical examination, electrocardiogram and routine biochemical check).

Exclusion criteriaSymptomatic ischemic heart disease or any other clinically evident vascular diseaseAbnormal hepatic function (aminotransferase activity > 3 times the upper limit of normal, and/or history of chronic liver disease, such as cirrhosis or alcoholic liver disease)Impaired renal function (serum creatinine levels > 159 μmol/L, 1.8 mg/dL)Raised thyroid-stimulating hormone (TSH) levels (> 5.0 μU/L) Drugs that may interfere with glucose or lipid metabolism.

Results (1)Baseline demographic characteristics of study patients

N (females/males) 179 (107/72)

Age, years 49 ± 11 (range 27 – 78)

Current smokers, % 22.3

Body weight, kg 82 ± 18

BMI, kg/m2 31.6 ± 7.7

Waist circumference, cm 101 ± 15

Diastolic BP, mm Hg 84 ± 10

Systolic BP, mm Hg 132 ± 18

Visfatin, ng/ml  

Tertile 1 12.2 (7.0 – 16.0)

Tertile 2 19.0 (16.2 – 23.0)

Tertile 3 31.0 (23.6 – 57.0)BMI = body mass index; BP = blood pressureValues are expressed as mean ± SD, except visfatin which is expressed as median (range).

Results (2)Ten-year Framingham risk scores for coronary heart disease (CHD), myocardial infarction (MI), stroke and cardiovascular disease (CVD) according to visfatin tertiles

Parameter Tertile 1N = 61

Tertile 2N = 59

Tertile 3N = 59

p (ANOVA)

CHD (%) 5.6 8.0 8.8a 0.02

MI (%) 2.5 4.1 4.2a 0.04

STROKE (%) 1.2 2.0 2.0 NS

CVD (%) 8.1 12.1a 13.0a 0.007

Results (3)Anthropometric variables according to visfatin tertiles

BMI = body mass indexa = p < 0.05 vs tertile 1 (post-hoc analysis)b = p < 0.05 vs tertile 2 (post-hoc analysis)

Vis

fatin

ter

tiles

Results (4)Blood pressure according to visfatin tertiles

SBP = systolic blood pressure; DBP = diastolic blood pressure a = p < 0.05 vs tertile 1 (post-hoc analysis)

Vis

fatin

te

rtile

s

Results (5)Metabolic variables according to visfatin tertiles

Vis

fatin

ter

tiles

Results (6)Anthropometric and biochemical variables according to visfatin tertiles

ParameterTertiles p

(ANOVA or χ2)

Age (years) 47 ± 11 (29 -73)

50 ± 11 (27 -78) 51 ± 12 (29 -74) NS

Gender (females/males)

34/27 40/19 33/26 NS

HOMA index 1.9 (0.4 – 12.0) 2.8 (0.9 – 18.2)a 2.6 (0.9 – 19.8)a 0.01

Uric acid (mg/dl) 4.8 ± 1.6 4.9 ± 1.5 5.5 ± 1.5a 0.03

apoE (mg/L) 33 ± 15 38 ± 14 45 ± 27a 0.01

Lp(a) (mg/L) 8.9 (0 -73) 10.5 (0 – 113)a 10.5 (0 – 102)a 0.04

Results (7)LDL subclasses according to visfatin tertiles

Results (8)HDL subclasses according to visfatin tertiles

Conclusions

Our results support a role for visfatin in the detection of subjects with

many metabolic abnormalities, which result in an increased CVD risk.