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

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          Abstract

          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.

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          Most cited references25

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          The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease.

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            Visfatin: a protein secreted by visceral fat that mimics the effects of insulin.

            Fat tissue produces a variety of secreted proteins (adipocytokines) with important roles in metabolism. We isolated a newly identified adipocytokine, visfatin, that is highly enriched in the visceral fat of both humans and mice and whose expression level in plasma increases during the development of obesity. Visfatin corresponds to a protein identified previously as pre-B cell colony-enhancing factor (PBEF), a 52-kilodalton cytokine expressed in lymphocytes. Visfatin exerted insulin-mimetic effects in cultured cells and lowered plasma glucose levels in mice. Mice heterozygous for a targeted mutation in the visfatin gene had modestly higher levels of plasma glucose relative to wild-type littermates. Surprisingly, visfatin binds to and activates the insulin receptor. Further study of visfatin's physiological role may lead to new insights into glucose homeostasis and/or new therapies for metabolic disorders such as diabetes.
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              Visfatin, an adipocytokine with proinflammatory and immunomodulating properties.

              Adipocytokines are mainly adipocyte-derived cytokines regulating metabolism and as such are key regulators of insulin resistance. Some adipocytokines such as adiponectin and leptin affect immune and inflammatory functions. Visfatin (pre-B cell colony-enhancing factor) has recently been identified as a new adipocytokine affecting insulin resistance by binding to the insulin receptor. In this study, we show that recombinant visfatin activates human leukocytes and induces cytokine production. In CD14(+) monocytes, visfatin induces the production of IL-1beta, TNF-alpha, and especially IL-6. Moreover, it increases the surface expression of costimulatory molecules CD54, CD40, and CD80. Visfatin-stimulated monocytes show augmented FITC-dextran uptake and an enhanced capacity to induce alloproliferative responses in human lymphocytes. Visfatin-induced effects involve p38 as well as MEK1 pathways as determined by inhibition with MAPK inhibitors and we observed activation of NF-kappaB. In vivo, visfatin induces circulating IL-6 in BALB/c mice. In patients with inflammatory bowel disease, plasma levels of visfatin are elevated and its mRNA expression is significantly increased in colonic tissue of Crohn's and ulcerative colitis patients compared with healthy controls. Macrophages, dendritic cells, and colonic epithelial cells might be additional sources of visfatin as determined by confocal microscopy. Visfatin can be considered a new proinflammatory adipocytokine.
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                Author and article information

                Contributors
                Journal
                Ther Adv Cardiovasc Dis
                Ther Adv Cardiovasc Dis
                TAK
                sptak
                Therapeutic Advances in Cardiovascular Disease
                SAGE Publications (Sage UK: London, England )
                1753-9447
                1753-9455
                05 October 2019
                2019
                : 13
                : 1753944719880448
                Affiliations
                [1-1753944719880448]Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Islampaşa, Rize 53100, Turkey
                [2-1753944719880448]Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
                [3-1753944719880448]Department of Medical Microbiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
                [4-1753944719880448]Ministry of Health, Family Health Center, Rize, Ankara, Turkey
                [5-1753944719880448]Department of Cardiology, University of Health Sciences, Kartal Kosuyolu Training and Research Hospital, Istanbul, Turkey
                [6-1753944719880448]Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
                Author notes
                Author information
                https://orcid.org/0000-0002-1441-7320
                Article
                10.1177_1753944719880448
                10.1177/1753944719880448
                6778987
                31588856
                a818f0cc-8bcb-47bb-9b4f-bad96090d32f
                © The Author(s), 2019

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 6 February 2019
                : 12 August 2019
                Categories
                Original Research
                Custom metadata
                January-December 2019

                Cardiovascular Medicine
                visfatin,syntax score,inflammation,stable coronary artery disease
                Cardiovascular Medicine
                visfatin, syntax score, inflammation, stable coronary artery disease

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