title: Visfatin levels in patients with severe pneumonia.
abstract: BACKGROUND
  As a cytokine highly expressed in internal organs, visfatin could be used as a biomarker of systemic inflammation response for chronic obstructive pulmonary diseases, but few studies have reported the use of visfatin in severe pneumonia. The present study was undertaken to determine the plasma levels of visfatin in patients with severe pneumonia.
  
  
  METHODS
  A total of 70 patients, including 40 patients with severe pneumonia (group A) and 30 patients with non severe pneumonia (group B) who had been admitted to the ICU from June 2009 to June 2010, were enrolled in this prospective study. And another 30 healthy physical examinees served as healthy controls (group C). Patients were excluded if they suffered from severe diseases of the heart, brain and kidney, cancers, autoimmune diseases, or received special treatment in the latest month. The plasma levels of visfatin, IL-6, IL-8 and TNF-α were measured by ELISA, while the level of CRP was determined by immuneturbidimetry, and the routine blood test was performed. Blood gas analysis and Acute Physiology and Chronic Health Evaluation II (APACHE II) were performed in patients with pneumonia. Comparisons between the groups were conducted by Student's t test, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson's correlation test or Spearman's rank-order correlation test.
  
  
  RESULTS
  The plasma level of visfatin in group A was significantly higher than that in groups B and C (P<0.001), and the level of visfatin in group B was significantly higher than that in group C (P<0.001). The plasma level of visfatin was positively correlated with CRP, TNF-α, APACHE II and PMN% in patients with severe pneumonia (rho =0.653, r=0.554, r=0.558, r=0.484, respectively, P<0.05 for all), while it was negatively correlated with PaO2 and PaO2/FiO2 (rho =-0.422, r=-0.543, respectively, P<0.05 for all).
  
  
  CONCLUSIONS
  Visfatin may be involved in the systematic inflammation response in patients with severe pneumonia as a pro-inflammatory cytokine, and it is valuable in assessing the severity of pneumonia..
authors.affiliation: Department ofRespiration(Xie J, Long W), Department of Emergency (Shi JD), Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240, China; Emergency Department, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China (Lu YM); Emergency Department, Central Hospital, Minhang District, Ruijin Hospital, Shanghai, China (Deng XQ).
authors.forename: Xie
authors.initials: X
authors.lastname: Juan
authors.affiliation: Department ofRespiration(Xie J, Long W), Department of Emergency (Shi JD), Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240, China; Emergency Department, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China (Lu YM); Emergency Department, Central Hospital, Minhang District, Ruijin Hospital, Shanghai, China (Deng XQ).
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Lu
authors.affiliation: Department ofRespiration(Xie J, Long W), Department of Emergency (Shi JD), Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240, China; Emergency Department, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China (Lu YM); Emergency Department, Central Hospital, Minhang District, Ruijin Hospital, Shanghai, China (Deng XQ).
authors.forename: Jin-Dong
authors.initials: JD
authors.lastname: Shi
authors.affiliation: Department ofRespiration(Xie J, Long W), Department of Emergency (Shi JD), Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240, China; Emergency Department, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China (Lu YM); Emergency Department, Central Hospital, Minhang District, Ruijin Hospital, Shanghai, China (Deng XQ).
authors.forename: Xing-Qi
authors.initials: XQ
authors.lastname: Deng
authors.affiliation: Department ofRespiration(Xie J, Long W), Department of Emergency (Shi JD), Fifth People's Hospital Affiliated to Fudan University, Shanghai 200240, China; Emergency Department, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China (Lu YM); Emergency Department, Central Hospital, Minhang District, Ruijin Hospital, Shanghai, China (Deng XQ).
authors.forename: Wei
authors.initials: W
authors.lastname: Long
keywords: Acute Physiology and Chronic Health Evaluation II (APACHE II); C-reactive protein; Granulocyte percent (PMN%); Interleukin-6; Interleukin-8; Severe pneumonia; Tumor necrosis factor-a; Visfatin