Circulating visfatin in obese non-diabetic patients in relation to cardiovascular risk factors, insulin resistance, and adipocytokines: A contradictory piece of the puzzle

Objective: Obesity and insulin resistance are associated with cardiovascular risk factors. The aim of the present study was to explore the relation of circulating visfatin to insulin resistance, cardiovascular risk factors, anthropometry, and adipocytokines in obese patients without diabetes mellitus. Methods: A population of 228 obese non-diabetic outpatients was analyzed in a prospective way. All patients with a 2-wk weight-stabilization period before recruitment were enrolled. Biochemical analysis and nutritional evaluation were performed. Results: Subjects were 62 men (27.2%) and 166 women (62.8%) with a mean age of 41.1 +/- 16.4 y and a mean body mass index of 35.8 +/- 3.6 kg/m(2). Patients were divided in two groups by median visfatin value (22.8 ng/mL), i.e., those with low values (group I) and those with high values (group II). Patients in group I had greater weight, body mass index, fat mass, fat-free mass, insulin, homeostasis model of assessment, triacylglycerol, leptin, and adiponectin than patients in group II. Patients in group II had higher total cholesterol, low-density lipoprotein cholesterol, resistin, and tumor necrosis factor-a levels than patients in group I. In a multivariate analysis with age- and sex-adjusted basal visfatin concentration as a dependent variable, only weight and leptin remained as an independent predictor in the model (F = 6.5, P < 0.05), with an inverse correlation. Conclusion: Total cholesterol, low-density lipoprotein cholesterol, tumor necrosis factor-a, and resistin levels are elevated in patients with visfatin levels above the median value. Homeostasis model of assessment, insulin, weight, fat mass, fat-free mass, triacylglycerols, leptin, and adiponectin are decreased in these patients. (C) 2010 Elsevier Inc. All rights reserved.