Elevated peripheral visfatin levels in narcoleptic patients.
OBJECTIVE
Narcolepsy is a severe sleep disorder that is characterized by excessive daytime sleepiness, cataplexies and a tendency towards obesity. Recent discoveries indicate that the major pathophysiology is a loss of hypocretin (orexin) producing neurons due to immunologically mediated degeneration. Visfatin is a recently described proinflammatory adipokine. It is identical to the immune modulating pre-B-cell colony enhancing factor (PBEF). Our study examines the hypothesis that visfatin levels are altered in narcoleptic patients.


METHODS
For the analysis, a total of n = 54 patients (n = 18 males and n = 36 females) with the diagnosis of narcolepsy according to DSM-IV and the International Classification of Sleep Disorders were examined (BMI mean 30.3+/-5.5, age mean 52.5+/-16.1 years). As a control group 39 unrelated (n = 12 males and n = 27 females) healthy volunteers with no sleep disorder according to DSM-IV were included (BMI mean 28.5+/-4.6, age mean 51.1+/-13.6 years). Peripheral visfatin levels were measured using a commercial enzyme immunoassay kit with a measurement range from 0.1-1000 ng/ml. Narcolepsy symptoms, severity and frequency of symptoms as well as the total duration of various aspects of the symptomatology were assessed by unstructured and structured clinical interviews in including the Stanford Center for Narcolepsy Sleep Inventory.


RESULTS
Circulating visfatin was found to be significantly increased in HLA DR2 positive narcoleptic patients compared to controls.


CONCLUSIONS
Taken together, our results add to the evidence of disturbed immunological regulation in patients with narcolepsy.
Dahmen
Norbert
N
Department of Psychiatry, University of Mainz, Mainz, Germany.
Manderscheid
Nina
N
Helfrich
Jana
J
Musholt
Petra B
PB
Forst
Thomas
T
Pfützner
Andreas
A
Engel
Alice
A
D000328:Adult; D017668:Age of Onset; D000368:Aged; D015992:Body Mass Index; D016207:Cytokines / Q000097:blood*; D005260:Female; D015802:HLA-DR2 Antigen / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000097:blood / Q000201:enzymology*; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood*; D017286:Polysomnography; D012016:Reference Values
D016207:Cytokines; D015802:HLA-DR2 Antigen; D054409:Nicotinamide Phosphoribosyltransferase; C085455:nicotinamide phosphoribosyltransferase, human