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

Association between visfatin and periodontitis: a systematic review and meta-analysis

Background

Periodontitis is a chronic inflammatory disease caused by bacterial infection in the periodontal support tissue. Visfatin, a hormone secreted mainly by adipocytes and macrophages, plays an important role in immune regulation and defense. Although studies have indicated that patients with periodontitis have significantly high serum and gingival crevicular fluid levels of visfatin, the relationship between this adipocytokine and periodontal disease remains unclear.

Aim

The aim of this study was to systematically evaluate the association between visfatin levels and periodontitis.

Methods

The PubMed, Web of Science, ScienceDirect, EBSCO, and Wiley Online Library databases were searched for potential studies, using "periodontitis" and "visfatin" as the keywords in the title and abstract search fields. Standardized mean difference (SMD) values with corresponding 95% confidence intervals (CIs) were determined from the results of this meta-analysis.

Results

In total, 22 articles involving 456 patients with periodontitis and 394 healthy individuals (controls) were included in the meta-analysis. Visfatin levels were significantly higher in the patients with periodontitis than in the healthy individuals (SMD: 3.82, 95% CI [3.01-4.63]). Moreover, the visfatin levels were significantly lowered after periodontitis treatment (SMD: -2.29, 95% CI [-3.33 to -1.26]).

Conclusion

This first-ever meta-analysis comparing visfatin levels between patients with periodontitis and healthy individuals suggests that this adipocytokine can be a diagnostic and therapeutic biomarker for periodontal disease.

A synthesis of pathways linking diet, metabolic risk and cardiovascular disease: a framework to guide further research and approaches to evidence-based practice

Cardiovascular disease (CVD) is the most common non-communicable disease occurring globally. Although previous literature has provided useful insights into the important role that diet plays in CVD prevention and treatment, understanding the causal role of diets is a difficult task considering inherent and introduced weaknesses of observational (e.g. not properly addressing confounders and mediators) and experimental research designs (e.g. not appropriate or well designed). In this narrative review, we organised current evidence linking diet, as well as conventional and emerging physiological risk factors, with CVD risk, incidence and mortality in a series of diagrams. The diagrams presented can aid causal inference studies as they provide a visual representation of the types of studies underlying the associations between potential risk markers/factors for CVD. This may facilitate the selection of variables to be considered and the creation of analytical models. Evidence depicted in the diagrams was systematically collected from studies included in the British Nutrition Task Force report on diet and CVD and database searches, including Medline and Embase. Although several markers and disorders linked to conventional and emerging risk factors for CVD were identified, the causal link between many remains unknown. There is a need to address the multifactorial nature of CVD and the complex interplay between conventional and emerging risk factors with natural and built environments, while bringing the life course into the spotlight.

Visfatin is negatively associated with coronary artery lesions in subjects with impaired fasting glucose

It is not determined whether serum visfatin levels are related to the presence and severity of coronary artery disease (CAD) in non-diabetic subjects. In this study, a total of 65 consecutive non-diabetic participants who underwent coronary angiography were enrolled. Serum visfatin and fasting glucose, as well as the serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglyceride, were measured in all participants before the procedure. The extent of coronary artery lesions was determined by Gensini score. Serum visfatin levels were significantly lower in patients with CAD compared to participants with normal coronary arteries. Inversely, the circulating levels of fasting glucose were found to be elevated in patients with CAD compared with the control subjects. Multivariable logistic regression analysis demonstrated that visfatin and impaired fasting glucose (IFG) were independently associated with the presence of CAD in non-diabetics. No significant relationship was found between serum visfatin and fasting glucose levels in IFG subjects. However, there was a negative association between visfatin concentrations and Gensini score in participants with IFG. Both circulating visfatin concentrations and IFG are independently associated with CAD in non-diabetics. Serum visfatin levels are negatively related to the angiographic severity of CAD in subjects with IFG.

Prognostic role of inflammatory cytokines and novel adipokines in acute myocardial infarction: An updated and comprehensive review

Acute myocardial infarction (AMI) is one of the major causes of morbidity and mortality worldwide. The inflammation response during and after AMI is common and seems to play a key role in the peri-AMI period, related with ischaemia-reperfusion injury, adverse cardiac remodelling, infarct size and poor prognosis. In this article, we provide an updated and comprehensive overview of the most important cytokines and adipokines involved in the complex pathophysiology mechanisms in AMI, summarizing their prognostic role post-AMI. Data so far support that elevated levels of the major proinflammatory cytokines TNFα, IL-6 and IL-1 and the adipokines adiponectin, visfatin and resistin, are linked to high mortality and morbidity. In contrary, there is evidence that anti-inflammatory cytokines and adipokines as IL-10, omentin-1 and ghrelin can suppress the AMI-induced inflammatory response and are correlated with better prognosis. Mixed data make unclear the role of the novel adipokines leptin and apelin. After all, imbalance of pro-inflammatory and anti-inflammatory cytokines may result in worst AMI prognosis. The incorporation of these inflammation biomarkers in established prognostic models could further improve their prognostic power improving overall the management of AMI patients.

Correlation analysis between heart rate variability, epicardial fat thickness, visfatin and AF recurrence post radiofrequency ablation

Background

The aim of the present study is to investigate the possible correlation between heart rate variability (HRV), epicardial fat thickness (EFT), visfatin and AF recurrence post radiofrequency ablation.

Methods

Data of 337 AF patients to whom radiofrequency ablation therapy had been initiated at our hospital over the past three years were evaluated. The patients enrolled were divided into the non-recurrence group (102 patients) and the recurrence group (235 patients) according to AF recurrence in the preceding 12 months. General data in the two groups were collected and HRV, EFT, and visfatin levels were comprehensively compared for each patients of the two groups.

Results

The recurrence group showed significantly higher results in rMSSD, PNN50, HF, total EFT, and visfatin but with evidently lower results in LF/HF when comparing the non-recurrence group (P < 0.05). The significantly different general variables in the general data and laboratory parameters, rMSSD, PNN50, HF, total EFT, visfatin, LF/HF were used as independent variables, and AF recurrence post radiofrequency ablation was used as dependent variables. Logistic regression analysis revealed that the risk factors of AF recurrence post radiofrequency ablation were rMSSD, PNN50, HF, total EFT, visfatin, and LF/HF, and the difference was statistically significant (P < 0.05).

Conclusion

HRV, EFT, visfatin appear to show high association with AF recurrence post radiofrequency ablation.

The Role of Adipokines in Cardiovascular Pathology

The recent decades saw a steady growth of obesity incidence worldwide. Obesity is an independent risk factor for cardiovascular diseases (CVDs) and type 2 diabetes mellitus and is also associated with a shorter life expectancy. Not only hemodynamic but also hormone metabolic processes, arising from excessive accumulation of adipose tissue in human body, underlie the development of CVDs. Adipose tissue has now been proved to be a hormone-active substrate. Studies of the influence of adipokines will bring us closer to understanding cardiovascular pathogenesis and help personalize prophylactic strategies.

Blood Adipokins in Young People with Early Ischemic Heart Disease on the Background of Abdominal Obesity

Aim      To study blood adipokines spectrum in people aged 25-44 years with early ischemic heart disease (IHD), including that associated with abdominal obesity (AO).Material and methods  A cross-sectional study was performed on a random sample of the population aged 25-44 years in Novosibirsk. 1457 subjects (653 men, 804 women) were evaluated. This study included 123 people divided into four study subgroups: subgroup 1, with IHD associated with AO (n=24); subgroup 2, with IHD and without AO (n=25); subgroup 3, without IHD and with AO (n=44); and subgroup 4, without either IHD or AO (n=30). Concentrations of serum adipokines were measured simultaneously by multiplex assay with a Luminex MAGPIX flow fluorometer and by immune enzyme assay with a MULTISCAN analyzer.Results Subjects with early IHD had lower blood concentrations of adipsin and visfatin than subjects without IHD. Subjects with early IHD associated with AO had higher blood concentrations of adipsin, plasminogen activator inhibitor-1, and leptin and lower concentrations of monocyte chemoattractant protein-1 (MCP-1) and visfatin compared to subjects with early IHD and without AO. The multivariate logistic regression analysis showed that lower blood concentrations of MCP-1 were associated with a likelihood of early IHD.Conclusion      In young people aged 25-44 years, lower blood concentrations of MCP-1 were associated with a likelihood of early IHD, including that associated with AO.

Visfatin associated with major adverse cardiovascular events in patients with acute myocardial infarction

BACKGROUND

Visfatin is an adipokine that related with the inflammation in atherosclerosis and the destabilization of atherosclerotic plaque. The aim of this study was to observe the relationship between visfatin and major adverse cardiovascular events (MACEs) in acute myocardial infarction (AMI) patients.

METHODS

We enrolled a total of 238 patients (183 AMI and 55 control) who underwent coronary angiography. Patients with AMI were followed for an average of 19.3 months and 159 patients were finally included in the study.

RESULTS

It was observed patients with AMI had higher serum visfatin levels than controls. The total incidence of MACEs was 11.32% (18/159) in AMI patients. After calculation of the Youden index, the best cut-off value of visfatin on the curve of receiver-operating characteristic was 8.799 ng/mL for predicting the occurrence of MACEs. The occurrence of MACEs was elevated in high-visfatin group (≥8.799 ng/mL) compared with low-visfatin group (≤8.799 ng/mL). The time to MACEs was correlated with visfatin (HR = 1.235, 95%CI 1.051-1.451, P = 0.01) and high-visfatin group had an earlier time to MACEs and a shorter time of cumulative survival.

CONCLUSIONS

Increased serum visfatin levels were observed in AMI patients, and correlated with an earlier onset and higher incidence of MACEs.

The Role of Secretory Activity Molecules of Visceral Adipocytes in Abdominal Obesity in the Development of Cardiovascular Disease: A Review

Adipose tissue is considered one of the endocrine organs in the body because of its ability to synthesize and release a large number of hormones, cytokines, and growth and vasoactive factors that influence a variety of physiological and pathophysiological processes, such as vascular tone, inflammation, vascular smooth muscle cell migration, endothelial function, and vascular redox state. Moreover, genetic factors substantially contribute to the risk of obesity. Research into the biochemical effects of molecules secreted by visceral adipocytes as well as their molecular genetic characteristics is actively conducted around the world mostly in relation to pathologies of the cardiovascular system, metabolic syndrome, and diabetes mellitus. Adipokines could be developed into biomarkers for diagnosis, prognosis, and therapeutic targets in different diseases. This review describes the relevance of secretory activity molecules of visceral adipocytes in cardiovascular disease associated abdominal obesity.

Diagnostic Significance of Plasma Levels of Novel Adipokines in Patients With Symptomatic Intra- and Extracranial Atherosclerotic Stenosis

Background: Adipokines have been proven to be associated with atherosclerotic diseases such as ischemic stroke and coronary heart disease. The role of novel adipokines in the development of symptomatic intracranial atherosclerotic stenosis (sICAS) and extracranial atherosclerotic stenosis (sECAS) has not yet been investigated. This study aimed to evaluate the plasma levels of novel adipokines in patients with sICAS and sECAS and their associations with the prognosis of sICAS groups.

Methods: A total of 134 patients with acute ischemic stroke attribute to large-artery atherosclerosis (LAA) and 66 age- and sex-matched controls without atherosclerotic stenosis (NCAS) were included in this study. The LAA group was further sub-classified as sICAS (n = 102) and sECAS (n = 32) according to the location of atherosclerosis. Demographics, clinical parameters, angiographical features and plasma levels of novel adipokines (apelin, visfatin, omentin, RBP-4) were assayed and compared among groups.

Results: LAA patients had significantly lower levels of omentin [39.92 (30.74–52.61) ng/ml vs. 54.42 (34.73–79.91) ng/ml, P < 0.001] and visfatin [11.32 (7.62–16.44) ng/ml vs. 13.01 (9.46–27.54) ng/ml, P < 0.001] than those in the NCAS group. Multiple logistic regression analysis identified that the lowest tertile of omentin was independently associated with LAA (OR, 3.423; 95% CI, 1.267–9.244, when referenced to the third tertile). Levels of omentin, visfatin and RBP-4 showed no significant difference between sICAS and sECAS groups. However, median concentrations of apelin were lower in sECAS [84.94 (46.88–130.41) ng/mL) than in sICAS [118.64 (93.22–145.08) ng/mL, P = 0.002] and NCAS [114.38 (80.56–162.93) ng/mL, P = 0.004]. Logistic regression analysis showed that the lowermost tertile of apelin was independently associated with sECAS (OR, 5.121; 95% CI, 1.597–16.426) when adjusted for risk factors. As for sICAS patients, spearman coefficient analysis showed no significant correlation between these four adipokines and the severity of sICAS or the number of vessels with intracranial stenoses. Patients with severe stroke had lower levels of apelin (P = 0.005), while the other three adipokines showed no such difference. During follow up, no difference was found between these four novel adipokines and short- and long-term outcome of sICAS.

Conclusions: Lower levels of omentin are independent biomarkers of LAA while low apelin plasma levels seem to be risk factors of sECAS.

Circulating visfatin levels in the second and third trimester of pregnancies with gestational diabetes: a systematic review

INTRODUCTION

There are multiple published conflicting associations of the adipocytokine visfatin with gestational diabetes. In this study, we attempted to investigate this relationship via a systematic review of the published literature.

EVIDENCE ACQUISITION

Literature retrieval using PubMed, Google Scholar, Scopus and Hydi databases followed by article selection and data extraction were conducted. Relevant studies published up to June 2018 were included. In total, 29 cohorts that were published in 27 articles were analyzed. Three studies carried out in early pregnancy were excluded. A total of 2365 individuals, with 1069 gestational diabetes (GDM) cases and 1296 controls from studies describing visfatin in the second or third trimester of gestation were included.

EVIDENCE SYNTHESIS

The difference in visfatin levels between women with GDM and the controls in the second and third trimester was measured by weighted mean difference (WMD) and 95% confidence intervals (CI). Heterogeneity was inspected by using both subgroup and meta-regression analysis. Analysis was restricted to studies describing singleton pregnancies. The quality of included studies was assessed by the Newcastle-Ottawa Scale.

CONCLUSIONS

No significant difference in circulating visfatin levels in GDM during the second trimester of pregnancy (WMD -0.30 ng/mL, 95% CI: -2.06, 1.45, SE=0.895, P=0.733) was detected. Meta-analysis of the studies in the third trimester revealed a significant negative effect, that was however driven by only one study. This finding limits the meaningful interpretation of the pooled analysis. Significant heterogeneity was identified between studies, and meta-regression analysis showed that homeostatic model assessment for insulin resistance contributes significantly to heterogeneity. In conclusion, our findings suggest that peripheral blood visfatin concentration cannot be robustly associated with gestational diabetes status in the second and third trimesters of pregnancy.