Assessment of serum visfatin level in beta thalassemia patients

Abstract

Background Thalassemias are monogenetic hematologic disorders which are caused by faulty synthesis of one or more of the Hb chains which leads to imbalance in globin chains resulting in hemolysis and impaired erythropoiesis and chronic inflammatory condition. Visfatin is a pro-inflammatory adipocytokine which is mostly expressed in visceral adipose tissue and its testing may help in assessment of severity of the disease. Aim of the work This study aims at measuring serum visfatin level in Beta thalassemia patients and its possible correlation to disease severity (major andintermedia). Patients and methods Forty-one patients diagnosed as β-thalassemia (major, intermedia) and twenty age and sex-matched healthy individuals as the control group were tested for serum visfatin levels by enzyme-linked immunosorbent assay. Results Serum visfatin was higher in theß-thalassemia major(ß-TM) group than in the control group (P<0.001). Serum visfatinand serum ferritin were higher inß-TM group than in ß-thalassemia intermediagroup (ß-TI)(p < 0.001).Serum visfatin was found positively correlated with platelet count (P< 0.001) in the ß-TM group.As per ROC curve analysis, measured serum visfatin level was found to discriminate ß-TM group from β-TI group and control group. Conclusion There is an association between serum visfatin and the degree of severity of β thalassemia disease. Recommendations Testing of the relationship between serum visfatin level and other vascular inflammatory markers in β-thalassemia disease (asadiponectin, resistin, intracellular adhesion molecule (ICAM)) to clarify the exact mechanism of the inflammatory process in the disease and its complications to alter the course of the disease.Also to study serum visfatin in complicated β-thalassemia patients to establish its possible role in cardiac, vascular, endocrine or any other complications and comparing it with non-complicated patients.

Randomized Clinical and Biochemical Study Comparing the Effect of L-arginine and Sildenafil in Beta Thalassemia Major Children With High Tricuspid Regurgitant Jet Velocity

“…It also indicates the possible inflammatory role of visfatin in this condition, the possible association of this adipocytokine with endothelial and vascular dysfunction in patients with β-thalassemia, and its correlation with disease severity. 11,12 Both L-arginine and sildenafil reduced visfatin serum level after 2 months of treatment. This effect can be partly attributed to the direct anti-inflammatory effect or the ability of these drugs to prevent the progression of inflammation through vaso-modulatory mechanisms similar to that reported previously in other chronic inflammatory diseases.…”

“…10 Most of these inflammatory vascular injury markers have been reported to increase in β thalassemia patients. 11,12 Therefore, inflammatory markers such as IL-1β as well as vascular endothelial markers such as serum visfatin and E-selectin levels can be useful as indicators to fully understand this mechanism and to assess the efficacy of potential therapies.…”

Serum visfatin level in β-thalassemia and its correlation with disease severity

“…reported that sTfR levels in individuals with thalassemia were higher, but the difference was not significant [ 20 ]. Another study reported that serum ferritin levels were significantly higher in ThM but not in ThT and in the control group ( P < 0.001) [ 21 ].…”

“…The expression of visfatin is increased in response to infection, hypoxia, and inflammatory cytokines, and it has the potential to subsequently enhance the activation of the inflammatory cascade [ 20 , 21 ]. The current study provides evidence that individuals diagnosed with β-thalassemia major and β-thalassemia minor exhibit elevated levels of visfatin in their serum compared to healthy individuals.…”

“…compared serum visfatin levels between 41 patients with thalassemia and a control group of 21 healthy individuals. They found that patients with β-thalassemia major ( P < 0.001) and intermedia ( P < 0.001) had significantly higher concentrations of serum visfatin than the controls [ 21 ]. These findings lend even more credence to the concept that an upregulated inflammatory cascade and an elevated level of proinflammatory markers have a significant part in the pathogenesis of the disease.…”