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Association of serum visfatin and its mRNA expression levels with cognitive function and idiopathic intracranial hypertension in obese Egyptian women

The Egyptian Journal of Internal Medicine volume 31, pages 763–773 (2019)Cite this article

Abstract

Background

An epidemic of obesity has spread across the globe. Obesity has numerous comorbidities, including airway disease, insulin resistance, type 2 diabetes, cardiovascular disease, atherosclerosis, degenerative neurological disease, cognitive dysfunction, and cancer. Inflammatory cytokine is suggested to play a role in obesity and its complications. The current study aimed to estimate the expression and serum visfatin concentrations in obese Egyptian women. Moreover, we aimed to evaluate the possible association of visfatin gene expression and its serum levels with idiopathic intracranial hypertension (IIH) and cognitive dysfunction

Participants and methods

This cross-sectional study enrolled 60 obese women and 40 lean healthy women as controls. Obese women were classified according to grades of obesity into three groups. All participants underwent full clinical, neurological, and psychiatric examination. IIH group included patients with intracranial pressure greater than 25 cm H2O (opening pressure measured during lumber puncture in lateral decubitus position). Cognitive function was evaluated by using Montreal Cognitive Assessment scale (MoCA), Arabic version. Estimation of visfatin expression levels was determined by real-time PCR, and serum visfatin concentrations were measured using enzyme-linked immunosorbent assay.

Results

Our results revealed that obese women had higher values of visfatin expression (1.44±0.29) and serum levels (124.1±) compared with lean women (1.01±0.3 and 46.1±33.8, respectively). The visfatin expression and serum levels were significantly positively correlated with obesity indices, metabolic risks, MoCA, cerebrospinal fluid opening pressure, and cognitive dysfunction. Linear regression test showed that BMI, cerebrospinal fluid opening pressure, and MoCA were the main predictors of both serum and expression levels of visfatin in obese women. The receiver operating characteristic curve analysis revealed that the power of serum visfatin levels was higher than visfatin expression in differentiating obese women from lean ones.

Conclusion

There was a strong independent association between both higher visfatin expression and serum levels and obesity indices, metabolic risks, IIH, and cognitive dysfunction in obese Egyptian women.

References

  1. World Health Organization. Obesity and overweight. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/www.who.int/topics/obesity/en(Accessed 5 October 2017)

  2. Badran M, Laher I. Obesity in Arabic-speaking countries. J Obes 2011; 24:1–9.

    Article  Google Scholar 

  3. Fru¨hbeck G. Obesity: screening for the evident in obesity. Nat Rev Endocrinol 2012; 8:570–572.

    Article  Google Scholar 

  4. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384:766–781.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Mokdad AH, Ford ES, Barbara A, Bowman Ali, Dietz WH, Frank Vinico F, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289:76–79.

    Article  PubMed  Google Scholar 

  6. Giuseppe V, Wall M, Siegel PZ, Rojas PB. Symptoms and disease associations in idiopathic intracranial hypertension (pseudotumor cerebri): a case-control study. Neurology 1991; 4(Pt 1):239–244.

    Google Scholar 

  7. Wall M. Idiopathic intracranial hypertension (pseudotumor cerebri). Curr Neurol Neurosci Rep 2008; 8:87–93.

    Article  PubMed  Google Scholar 

  8. Wall M, George D. Idiopathic intracranial hypertension. A prospective study of 50 patients. Brain 1991; 114(Pt 1A):155–180.

    PubMed  Google Scholar 

  9. Friedman DI. Pseudotumor cerebri. Neurol Clin 2004; 22:99–131.

    Article  PubMed  Google Scholar 

  10. Henouda AS, Metti F, Nouri M. Blindness in idiopathic intracranial hypertension. J D Ophtalmol 2007; 30:588.

    Google Scholar 

  11. Hess LM, Insel KC. Chemotherapy-related change in cognitive function: a conceptual model. Oncol Nurs Forum 2007; 34:981–994.

    Article  PubMed  Google Scholar 

  12. Shefer G, Marcus Y, Stern N. Is obesity a brain disease?. Neurosci Biobehav Rev 2013; 37:2489–2503.

    Article  PubMed  Google Scholar 

  13. Yaffe K. Metabolic syndrome and cognitive decline. Curr Alzheimer Res 2007; 4:123–126.

    Article  CAS  PubMed  Google Scholar 

  14. Suemoto CK, Gilsanz P, Mayeda ER, Glymour MM. Body mass index and cognitive function: the potential for reverse causation. Int J Obes 2015; 39:1383–1389.

    Article  CAS  Google Scholar 

  15. Fitzpatrick AL, Kuller LH, Lopez OL, Diehr P, O’Meara ES, Longstreth Jr, et al. Midlife and late-life obesity and the risk of dementia: cardiovascular health study. Arch Neurol 2009; 66:336–342.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Moschen AR, Kaser A, Enrich B, Mosheime BA, Theurl M, Niederegger H, et al. Visfatin, an adipocytokine with proinflammatory and immunomodulating properties. J Immunol 2007; 178:1748–1758.

    Article  CAS  PubMed  Google Scholar 

  17. Gligor R, Zdremtan D, Pilat L, Tîrgovi CI, Gold VI, Davila C, et al. Correlation of visfatin with the lipidic metabolism in diabetic and obese patients. Proc Rom Acad 2012; 1:37–43.

    Google Scholar 

  18. Fukuhara A, Matsuda M, Nishizawa M, Katsumori Segawa K, Tanaka M, Kishimoto K, et al. Visfatin a protein secreted by visceral fat that mimics the effects of insulin. Science 2005; 307:426–430.

    Article  CAS  PubMed  Google Scholar 

  19. Sommer G, Garten A, Petzold S, Beck-Sickinger AG Blüher M, Stumvoll M, et al. Visfatin/PBEF/Nampt: structure, regulation and potential function of a novel adipokine. Clin Sci (Lond) 2008; 115:13–23.

    Article  CAS  Google Scholar 

  20. Friedman DI, Jacobson DM. Diagnostic criteria for idiopathic intracranial hypertension. Neurology 2002; 59:1492–1495.

    Article  PubMed  Google Scholar 

  21. Rahman TT, El Gaafary MM. Montreal Cognitive Assessment Arabic version: reliability and validity prevalence of mild cognitive impairment among elderly attending geriatric clubs in Cairo. Geriatr Gerontol Int 2009; 9:54–61.

    Article  PubMed  Google Scholar 

  22. Smith T, Gildeh N, Holmes C. The Montreal Cognitive Assessment: validity and utility in a memory clinic setting. Can J Psychiatry 2007; 52:329–332.

    Article  PubMed  Google Scholar 

  23. Frieldewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge. Clin Chem 1972; 18:499–502.

    Article  Google Scholar 

  24. Friedman DI, Rausch EA. Headache diagnoses in patients with treated idiopathic intracranial hypertension. Neurology 2002; 58:1551–1553.

    Article  PubMed  Google Scholar 

  25. Sørensen PS, Thomsen AM, Gjerris F. Persistent disturbances of cognitive functions in patients with pseudotumor cerebri. Acta Neurol Scand 1986; 73:264–268.

    Article  PubMed  Google Scholar 

  26. Kaplan CP, Miner ME, Mcgregor JM. Pseudotumour cerebri: risk for cognitive impairment. Brain Inj 1997; 11:293–303.

    Article  CAS  PubMed  Google Scholar 

  27. Yri HM, Fagerlund B, Hysse Birgitte F, Jensen RH. Cognitive function in idiopathic intracranial hypertension: a prospective case–control study. BMJ Open 2014; 4:e004376.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Elbanhawy IA, Ramzy GM, Basheer MA, Khedr DM. Neurophysiological tests screening cognitive impairment in idiopathic intracranial hypertension patients. Egypt J Neurol Psychiat Neurosurg 2018; 54:7.

    Article  Google Scholar 

  29. Almarzouqi SJ, Morgan ML, Lee AG. Idiopathic intracranial hypertension in the Middle East: a growing concern. Saudi J Ophthalmol 2015; 29:26–31.

    Article  PubMed  Google Scholar 

  30. Kim TW, Choung HK, Khwarg SI, Hwang JM, Yang HJ. Obesity may not be a risk factor for idiopathic intracranial hypertension in Asians. Eur J Neurol 2008; 15:876–879.

    Article  PubMed  Google Scholar 

  31. Liu IH, Wang AG, Yen MY. Idiopathic intracranial hypertension: clinical features in Chinese patients. Jpn J Ophthalmol 2011; 55:138–142.

    Article  PubMed  Google Scholar 

  32. Mungreiphy NK, Dhall M, Tyagi R, Saluja K, Kumar A, Tungdim MG, et al. Ethnicity, obesity and health pattern among Indian population. J Nat Sci Biol Med 2012; 3:52–59.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Kerwin DR, Zhang Y, Kotchen JM, Espeland MA, Linda Van Horn LV, Mctigue KM, et al. The cross-sectional relationship between body mass index, waist-hip ratio, and cognitive performance in postmenopausal women enrolled in the Women’s Health Initiative. J Am Geriatrics Soc 2010; 58:1427–1432.

    Article  Google Scholar 

  34. Elias MF, Elias PK, Sullivan LM, Wolf PA, D’Agostino RB. Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study. Int J Obes Relat Metab Disord 2003; 27:260–268.

    Article  CAS  PubMed  Google Scholar 

  35. Cekmez F, Cekmez Y, Pirgon O, Canpolat FE, Aydinöz S, Metin Ipcioglu O, Karademir F. Evaluation of new adipocytokines and insulin resistance in adolescents with polycystic ovary syndrome. Eur Cytokine Netw 2011; 22:32–37.

    Article  CAS  PubMed  Google Scholar 

  36. Kowalska I, Straczkowski M, Nikolajuk A, Adamska A, Karczewska-Kupczewska M, Otziomek E, et al. Serum visfatin in relation to insulin resistance and markers of hyperandrogenism in lean and obese women with polycystic ovary syndrome. Hum Reprod 2007; 22:1824–1829.

    Article  CAS  PubMed  Google Scholar 

  37. Zhang J, Zhou L, Tang L, Xu L. Plasma visfatin levels and mRNA expression of visfatin in peripheral blood mononuclear cells and peripheral blood monocyte-derived macrophages from normal-weight females with polycystic ovary syndrome. Exp Ther Med 2014; 7:1215–1220.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  38. Curat CA, Wegner V, Sengenes C, Miranville A, Tonus C, Busse R, Bouloumie A. Macrophages in human visceral adipose tissue: increased accumulation in obesity and a source of resistin and visfatin. Diabetologia 2006; 49:744–747.

    Article  CAS  PubMed  Google Scholar 

  39. Dahl TB, Yndestad A, Skjelland M, Øie E, Dahl A, Michelsen A, et al. Increased expression of visfatin in macrophages of human unstable carotid and coronary atherosclerosis: possible role in inflammation and plaque destabilization. Circulation 2007; 115:972–980.

    Article  CAS  PubMed  Google Scholar 

  40. El-Taweel HMA, Salah NA, Selem AK, El-Refaeey AA, Abdel-Aziz AF. visfatin gene expression and oxidative stress in pregnancy-induced hypertension. Egypt J Basic Appl Sci 2018; 5:69–74.

    Google Scholar 

  41. Adya R, Tanb K, Chen J, Randeva HS. Nuclear factor-kappa B induction by visfatin in human vascular endothelial cells: Its role in MMP-2/9 production and activation. Diabetes Care 2008; 31:758–760.

    Article  CAS  PubMed  Google Scholar 

  42. Adya R, Tanb K, Chen J, Randeva HS. Pre-B cell colony enhancing factor (PBEF)/visfatin induces secretion of MCP-1 in human endothelial cells: role in visfatin-induced angiogenesis. Atherosclerosis 2009; 205:113–119.

    Article  CAS  PubMed  Google Scholar 

  43. Li C, Zhu Q, He Q, Wang J, Wang F, Zhang H. Plasma levels of cyclooxygenase-2 (COX-2) and visfatin during different stages and different subtypes of migraine headaches. Med Sci Monit 2017; 23:24–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Sarchielli P, Floridi A, Mancini ML, Rossi C, Coppola F, Baldi A, et al. NF-kappaB activity and iNOS expression in monocytes from internal jugular blood of migraine without aura patients during attacks. Cephalalgia 2006; 26:1071–1079.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Zagazig University, 44519, Zagazig, Egypt

    Nearmeen M. Rashad MD & Samir A. Afifi

  2. Department of Neurology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Hanan M. Sabry

  3. Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Amira A. Fouad

  4. Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Maha A. Fathy

  5. Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Amira M. El-Helaly

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  1. Nearmeen M. Rashad MD
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  2. Hanan M. Sabry
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  3. Amira A. Fouad
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  4. Samir A. Afifi
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Correspondence to Nearmeen M. Rashad MD.

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Rashad, N.M., Sabry, H.M., Fouad, A.A. et al. Association of serum visfatin and its mRNA expression levels with cognitive function and idiopathic intracranial hypertension in obese Egyptian women. Egypt J Intern Med 31, 763–773 (2019). https://doi.org/10.4103/ejim.ejim_133_19

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