Visfatin Between Fact and Fiction; A Marker of Obesity or a New Player in the Pathogenesis of Type 2 Diabetes Mellitus

An adipose-tissue-derived protein termed visfatin was described recently with putative key role in pathogenesis of type 2 diabetes mellitus. It turns out, though, that the molecule was previously identified as a growth factor for early B-lymphocytes termed pre-B cell colony enhancing factor (PBEF). Visfatin was reported to be expressed almost exclusively in visceral adipose tissue and has insulin-like metabolic effects. These findings are very attractive and could provide a hot point of medical research to answer if visfatin provide a novel mechanism by which visceral fat accumulation can promote the development of type 2 diabetes mellitus (T2DM). However, its patho-physiological role in humans remains largely unknown. The Aim of this study is to investigate the role of plasma visfatin as a missing link between obesity and type 2 DM patients. Methods: Plasma visfatin concentrations were measured through ELISA in forty obese patients and compared to forty age and sex matched healthy non-obese subjects. Obese patients further subdivided into two subgroups according to presence of diabetes mellitus. Results: Plasma visfatin was found to be elevated in obese (38.7±13.3 ng/ml) compared to lean subjects (20.8±3.8 ng/ml), (P < 0.01).In obese patients no significant difference was found in diabetic obese patients (39.1± 7.3 ng/ml) in comparison to non diabetic patients (36.9±7.4 ng/ml) .In the other hand; no significant differences between diabetic patients according to diabetic control and line of treatments. Only waist to hip ratio was correlated with plasma visfatin level. Conclusion: Our results indicate that visfatin is elevated in obese patients apart from the presence of diabetes, diabetes control and line of treatments. Visfatin more reasonably to be a marker of obesity as a product of visceral fat cells rather than a new key in pathogenesis of type 2 diabetes mellitus . It seems that visfatin could not be one of the missing links between type 2 diabetes mellitus and its relation to visceral obesity. Further large scale studies are needed to determine its relation to immune status of obese patients and other adipo-cytokines and the effect of weight loss on its level.