Adipocytokines play an important role in adipose tissue homeostasis, especially in
obesity-associated disorders such as non-alcoholic fatty liver and their complications
including hepatocellular carcinoma (HCC). Although visfatin is an adipocytokine highly
expressed in visceral fat that has been demonstrated to play a critical role in the
progression of human malignancies, little is known about the role of visfatin in HCC
associated with chronic hepatitis C virus (HCV) and hepatitis B virus (HBV) infection.
In this study, we investigated whether plasma visfatin levels were altered in patients
with HCC and the association between plasma visfatin levels and pretreatment hematologic
profiles. Plasma visfatin levels were measured by enzyme-linked immunosorbent assays
in 193 patients with different stages of HBV or HCV infection, and 92 healthy control
subjects. The patients with HCC and chronic HCV or HBV infection had higher levels
of visfatin than patients with HBV, HCV, and cirrhosis. In multivariate logistic regression
analysis, levels of alpha-fetoprotein (AFP) (OR: 1.13, p=0.003), and plasma visfatin
(OR: 1.17, p=0.046) were independently associated with HCC. Multiple stepwise regression
analysis showed that plasma visfatin level was positively associated with age, aspartate
aminotransferase to platelet ratio index (APRI), and AFP. Trend analyses confirmed
that plasma visfatin concentration was associated with AFP>8ng/mL, cirrhosis, HCC,
tumor size>5cm, and Barcelona Clinic Liver Cancer-C stage. These results suggested
that the plasma visfatin level is associated with the presence of HCC, and that a
higher plasma visfatin level may be important in the pathogenesis of HCC. Visfatin
may act as both a protective and pro-inflammatory factor. Plasma visfatin concentration
may serve as an additional tool to identify patients with more advanced necroinflammation.