['Pre-eclampsia (PE) is a serious cardiovascular complication in pregnancy which shares risk factors with the metabolic syndrome including insulin resistance and obesity. Recently, visfatin was introduced as a novel insulin-mimetic adipokine which is up-regulated when weight is gained. In the current study, we investigated visfatin serum levels in pre-eclamptic patients as compared to healthy gestational age-matched controls.', 'Visfatin was quantified by ELISA in control (n = 20) and PE (n = 15) patients. Furthermore, visfatin was correlated to clinical and biochemical measures of renal function, glucose and lipid metabolism, as well as inflammation.', 'Mean maternal visfatin serum levels adjusted for maternal age were about twofold up-regulated in PE (31.1 +/- 23.4 microg/l) as compared to controls (15.7 +/- 23.1 microg/l). Furthermore, visfatin concentrations correlated positively with age, blood pressure, creatinine, free fatty acids (FFA), IL-6 and C reactive protein (CRP), whereas a negative correlation was found with fasting insulin and the HOMA-insulin resistance index (HOMA-IR). In multivariate analyses, HOMA-IR and CRP remained independently associated with visfatin serum levels and explained 58% of the variation in visfatin concentrations.'] Are serum levels of the adipokine visfatin increased in pre-eclampsia?