Early changes in serum visfatin after abdominal surgery: a new pro-inflammatory marker in diagnosis?

Background. Visfatin is an adipocytokine produced primarily by visceral adipose tissue. In addition to its effect on the insulin receptor, it is a proinflammmatory cytokine with accumulating evidence for its rise in circulation, accompanying systemic inflammation. The aim of this study was to evaluate changes in serum visfatin levels in the early post-abdominal surgery period with serum levels of other proinflammatory cytokines, to determine whether it could be used as a marker of inflammation. Methods and Results. This was a prospective cross-sectional study of 42 patients undergoing elective laparotomic right hemicolectomy for adenocarcinoma colon. The parameters determined were visfatin, leptin, adiponectin, TNF alpha, interleukin-6 and C-reactive protein levels. The dynamics of change in these markers were assessed at + 12, + 24, + 48, and + 72 h after surgery. Serum levels of visfatin peaked as early as 24 h post-surgery, returning to normal after 72 h. TNF alpha and IL-6 levels reached their maximum 12 to 24 h later while CRP levels peaked after 72 h. Conclusions. Significantly increased serum levels of visfatin detected in the early period after abdominal surgery preceded increase in the levels of other proinflammatory markers including TNF alpha, IL-6, and CRP. Given its dynamics, visfatin could serve as an early predictor of the development of inflammatory changes in patients undergoing surgery, particularly those with obesity (BMI > 30 kg/m(2)).