Clinical significance of serum adipokine visfatin/eNampt in relation to prostate cancer detection and aggressiveness

Background Prostate cancer is a common malignancy ranked as the second most common cause of cancer and the fifth cause of cancer-related mortality worldwide. The association between obesity and prostate cancer remains poorly understood, but evidence suggests that obesity may adversely affect the risk of developing high-grade disease. Adipokines may contribute toward the molecular basis for a link between obesity and prostate cancer. Several studies have shown the role of visfatin in different cancers including astrocytomas, myeloma, and male oral squamous cell; gastric, endometrial, hepatocellular, and colorectal carcinomas; and invasive breast cancer. Objective In the present study, we attempted to investigate whether a high serum level of visfatin is a good biomarker associated with prostate cancer, especially high-grade cancer, and in obese patients; then, it could be used as a biomarker for the detection of prostate cancer and to determine its aggressiveness. Participants and method The present study included 89 individuals divided as follows: 15 age-matched volunteers, control group (group I), 36 patients diagnosed with benign prostatic hyperplasia (BPH group) (group II), and 38 patients diagnosed with prostate cancer (PC group) (group III). Results There was a statistically significant increase in serum visfatin level in PC patients (group III) compared with both the controls (group I) and patients with BPH (group II) (P < 0.001, P < 0.001, respectively). In PC patients, the median value of serum visfatin was 55.36 ng/ml (44.32-94.02), whereas it was 12.06 ng/ml (10.36-17.74) in the BPH group and 14.89 ng/ml (10.68-18.62) in the control group. BMI, visfatin, and prostatic-specific antigen were found to be the major significant determinants of the tumor grade (Gleason score) of PC (with a 95% confidence interval 0.096-0.233, P < 0.001; 0.083-0.016, P = 0.005; and 0.001-0.019, P = 0.033, respectively). Conclusion In this study, we found a significant positive association between serum visfatin and PC, especially in obese individuals, and we suggest that visfatin could be used as a new promising biomarker for PC; further investigations are warranted to confirm its role in the diagnosis of PC and to assess its aggressiveness.