Clinical Correlates of Circulating Visfatin Levels in a Community-Based Sample

Visfatin, a novel adipokine with insulin-mimetic characteristics, is highly expressed in visceral fat (1). Associations of circulating visfatin concentrations with diabetes and obesity have not been rigorously established, most likely due to small sample sizes of prior studies. Furthermore, relations of visfatin to other cardiovascular risk factors in the general population have not been examined systematically. Accordingly, we tested the hypothesis that plasma visfatin would be positively related to obesity, diabetes, and visceral adiposity in a community-based sample. The design and selection criteria of the Framingham Third Generation Cohort are detailed elsewhere (2). Briefly, 4,095 adults (53% women; mean age 40 years) having at least one parent in the Framingham Offspring Study cohort were recruited in 2001–2005. At their first examination, participants underwent anthropometry, medical history and physical examination, laboratory assessment of cardiovascular risk factors, and, in a subsample, imaging for coronary calcification and adiposity using multidetector computer tomography (MDCT). The present study was performed in a subsample of 374 participants (9% eligible; 53% women) in whom plasma visfatin was assayed. We randomly selected these participants using a weighted sampling scheme with oversampling of the lowest and highest sex-specific quintiles of BMI (ratio of 1.5:2:1.5 for the lowest, middle three, and upper quintiles, respectively) using the participants undergoing MDCT imaging as the sampling frame. We chose this sampling strategy for cost efficiency and optimizing the use of nonrenewable serological resources (given …