Department of Medicine III, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry, RWTH-University Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
Dis Markers. 2018 Aug 26;2018:7315356. doi: 10.1155/2018/7315356. eCollection 2018.
The adipokine visfatin, also termed pre-B-cell colony-enhancing factor (PBEF), is mainly derived from adipose tissue but has been implicated in the regulation of innate immune responses. We hypothesized that visfatin could be a potential circulating biomarker in critical illness and sepsis. We therefore measured serum levels of visfatin in a cohort of 229 critically ill medical patients upon admission to the intensive care unit (ICU). In comparison to 53 healthy controls, visfatin levels were significantly elevated in medical ICU patients, especially in patients with sepsis. Visfatin serum concentrations were strongly associated with disease severity and organ failure but did not differ between patients with or without obesity or type 2 diabetes. Visfatin levels correlated with biomarkers of renal failure, liver dysfunction, and other adipokines (e.g., resistin, leptin, and adiponectin) in critically ill patients. High visfatin levels at ICU admission indicated an increased mortality, both at the ICU and during long-term follow-up of approximately two years. Our data therefore demonstrate that circulating visfatin is a valuable biomarker for risk and prognosis assessment in critically ill patients. Furthermore, visfatin seems to be involved in the pathogenesis of excessive systemic inflammation, supporting further research on visfatin as a therapeutic target.
脂联素（也称为前 B 细胞集落增强因子，PBEF）是一种主要来源于脂肪组织的细胞因子，参与调节固有免疫反应。我们假设脂联素可能是危重病和脓毒症的潜在循环生物标志物。因此，我们在入住重症监护病房（ICU）的 229 名危重病患者队列中测量了血清脂联素水平。与 53 名健康对照者相比，重症监护病房的患者血清脂联素水平明显升高，尤其是脓毒症患者。脂联素血清浓度与疾病严重程度和器官衰竭密切相关，但在肥胖或 2 型糖尿病患者之间无差异。脂联素水平与危重病患者的肾功能衰竭、肝功能障碍和其他脂肪因子（如抵抗素、瘦素和脂联素）的生物标志物相关。入住 ICU 时的高脂联素水平预示着 ICU 死亡率和大约两年的长期随访死亡率均升高。因此，我们的数据表明，循环脂联素是评估危重病患者风险和预后的有价值的生物标志物。此外，脂联素似乎参与了过度全身炎症的发病机制，支持进一步研究脂联素作为治疗靶点。
