LAUSR

Our recently published paper showed that intimal thickening may be the first event occurring in coronary preatherosclerosis and other studies. In a Letter to the Editor, Gavrili suggests that specific risk marker identification in infants and fetuses is crucial to predict the development of cardiovascular (CV) disease. In this context, the author emphasizes that the increased concentrations of peripheral blood visfatin, an adipocytokine produced by visceral adipose tissue, may be a risk marker of coronary artery disease. In fact, serum levels of visfatin and interleukin-6 have been found in obese men with coronary artery disease. In addition, a study in 105 patients aged 45 to 75 years showed an association of serum microRNA-21 levels with visfatin, inflammation, and acute coronary syndromes. Accordingly, Briana and Malamitsi-Puchner proposed visfatin as a risk marker for a plethora of diseases in adults and infants, including insulin resistance/type 2 diabetes mellitus and CV disease. Visfatin plays a role in plaque destabilization, as well as in glucose and lipid metabolism, and its pro-inflammatory effect is mediated by the upregulation of monocyte chemoattractant protein-1. So far, no relationship between intimal thickening/hyperplasia and visfatin has been demonstrated in fetuses and neonates. However, given that vascular smooth muscle cells are the “prima donnas” of migration and proliferation involved in intimal layer thickening and that these cells interact with monocytes and macrophages within the intima, visfatin may play a role. Visfatin still seems far from being considered as a specific marker of arterial intimal preatherosclerotic lesions. ORCID iD