Visfatin correlates with
inflammation and its levels in peripheral blood are associated with some inflammatory diseases. This study aimed to assess the relationship between plasma
visfatin levels and conversion of
laparoscopic cholecystectomy to open surgery in
acute cholecystitis. One hundred and forty-six
acute cholecystitis patients and 146 sex- and age-matched healthy controls were recruited and their plasma
visfatin levels were determined using an
enzyme immunoassay. 17 patients (11.6%) underwent conversion. Plasma
visfatin levels were statistically significantly elevated in all patients (97.2±41.8ng/mL), those with (161.4±71.3ng/mL) or without conversion (88.7±26.9ng/mL), compared to controls (40.3±13.3ng/mL, all P<0.001). A linear regression analysis showed that plasma
visfatin levels were positively associated with plasma
C-reactive protein levels (t=0.510, P<0.001). A logistic-regression analysis showed that age [odds ratio (OR) 1.160, 95% confidence interval (CI) 1.011-1.332, P=0.035] and plasma
visfatin levels (OR 1.035, 95% CI 1.005-1.066, P=0.022) appeared to be the independent predictors of conversion. A receiver operating characteristic curve analysis found that plasma
visfatin levels predicted conversion with high area under curve (AUC) (AUC, 850; 95% CI, 0.781-0.903). The AUC of the
visfatin concentration was similar to that of age (AUC, 0.738; 95% CI, 0.659-0.807) (P=0.188).
Visfatin improved the AUC of age to 0.914 (95% CI, 0.856-0.954) (P=0.011) using a combined logistic-regression model. Thus, high plasma levels of
visfatin are associated with systemic
inflammation, and may independently predict conversion of
laparoscopic cholecystectomy to open surgery in
acute cholecystitis.