Serum visfatin in sickle cell disease: association with frequency of vaso-occlusive crises

Background Hypercoagulability in sickle cell disease (SCD) is multifactorial, involving abnormalities in platelet function, thrombin generation, fibrinolysis, and other multiple mechanisms. Visfatin, an adipocytokine with proinflammatory potential, can have a negative impact on the vascular endothelium in SCD. Objective We aimed to evaluate the association between serum visfatin level in SCD patients and the frequency of vaso-occlusive crises (VOC)/year in those patients. Patients and methods Sixteen sickle cell anemia (SCA) and 14 sickle β-plus thalassemia pediatric patients were studied in steady state. Twenty age-matched and sex-matched healthy individuals, who served as the control group, were evaluated with respect to serum visfatin levels by means of enzymelinked immunosorbent assay. Results Hemoglobin (Hb) level was higher in the control group than in the SCA group (P 0.001), whereas total leukocyte count and serum visfatin were higher in the SCA group than in the control group (P=0.02 and 0.001, respectively). Hb level and platelet count were higher in the control group than in the sickle β thalassemia group (P 0.001 and 0.04, respectively). Serum visfatin was higher in the sickle β thalassemia group than in the control group (P 0.001). HbS%, serum visfatin, and frequency of VOC/ year were higher in the SCA group than in the sickle β thalassemia group (P=0.002, 0.001, and 0.002, respectively). Serum visfatin was positively correlated with total leukocyte count, serum ferritin level, and frequency of VOC/year (P=0.005, 0.01 and 0.03, respectively) in the SCA group. Conclusion Serum visfatin is increased in SCD patients compared with that in healthy children and is associated with the frequency of VOC; it can be used as a predictive index for VOC occurrence and follow-up in those patients.