Bo S, Ciccone G, Baldi I, Gambino R, Mandrile C, Durazzo M, Gentile L, Cassader M, Cavallo-Perin P, Pagano G
Department of Internal Medicine, University of Turin, Corso Dogliotti 14, Turin 10126, Italy.
Nutr Metab Cardiovasc Dis. 2009 Jul;19(6):423-30. doi: 10.1016/j.numecd.2008.09.001. Epub 2008 Dec 13.
The biological activity and regulation of the novel adipokine visfatin are still largely unknown. Our aim was to evaluate if visfatin plasma concentrations may be influenced by a lifestyle intervention.
Out of 335 dysmetabolic patients from a population-based cohort, randomized to receive a lifestyle intervention program (intervention group) or family physician usual care (controls), 20 patients per group were randomly selected for plasma visfatin determination. The before-after variation (Delta) in visfatin concentration at 1-year from randomization, and the correlations between (Delta)visfatin and intervention-induced changes in waist circumference, fasting glucose, markers of inflammation, and oxidative stress were evaluated. The intervention group showed a significant improvement in waist circumference, and many metabolic/inflammatory variables, while the controls worsened. Visfatin concentrations slightly decreased in the former and significantly increased in the controls ((Delta)visfatin=-2.4 vs 66.0 ng/ml, p<0.001). In robust regression models, the following variables resulted associated with (Delta)visfatin: (Delta)waist circumference, (Delta)fasting glucose, (Delta)hs-CRP (high-sensitivity C-reactive protein) and (Delta)TNFalpha (tumor necrosis factor-alpha). Significant effects on (Delta)visfatin of (Delta)TNFalpha (beta=16.8; 6.1-25.6; p=0.003) and, modified by group, of (Delta)hs-CRP (beta=29.8; 95% CI 15.4-44.2; p<0.001 and beta=4.2; 2.9-5.5; p<0.001 in the control and intervention group, respectively) were detected. By controlling for (Delta)waist, the effects of (Delta)TNFalpha and of (Delta)hs-CRP on (Delta)visfatin by group did not change, while (Delta)waist was no longer associated. The association between (Delta)visfatin and (Delta)glucose was no longer significant, after adjusting for (Delta)hs-CRP.
Visfatin values increased with waist circumference and were associated with variations of inflammatory markers, suggesting participation in inflammatory mechanisms.
新型脂肪因子内脂素的生物活性及调控机制仍大多未知。我们的目的是评估内脂素血浆浓度是否会受到生活方式干预的影响。
在一个基于人群队列的335例代谢异常患者中,随机分为接受生活方式干预项目组(干预组)或家庭医生常规护理组(对照组),每组随机选取20例患者测定血浆内脂素。评估随机分组后1年时内脂素浓度的前后变化(Delta),以及(Delta)内脂素与干预引起的腰围、空腹血糖、炎症标志物和氧化应激变化之间的相关性。干预组腰围及许多代谢/炎症变量有显著改善,而对照组则恶化。干预组内脂素浓度略有下降,对照组显著升高((Delta)内脂素=-2.4 vs 66.0 ng/ml,p<0.001)。在稳健回归模型中,以下变量与(Delta)内脂素相关:(Delta)腰围、(Delta)空腹血糖、(Delta)高敏C反应蛋白(hs-CRP)和(Delta)肿瘤坏死因子-α(TNFalpha)。检测到(Delta)TNFalpha对(Delta)内脂素的显著影响(β=16.8;6.1-25.6;p=0.003),以及按组修正的(Delta)hs-CRP对(Delta)内脂素的影响(对照组β=29.8;95%CI 15.4-44.2;p<0.001,干预组β=4.2;2.9-5.5;p<0.001)。通过控制(Delta)腰围,(Delta)TNFalpha和(Delta)hs-CRP按组对(Delta)内脂素的影响不变,而(Delta)腰围不再相关。调整(Delta)hs-CRP后,(Delta)内脂素与(Delta)血糖之间的关联不再显著。
内脂素值随腰围增加而升高,并与炎症标志物的变化相关,提示其参与炎症机制。