title: Serum fetuin-A levels inversely correlate with the severity of arterial calcification in patients with chronic lower extremity atherosclerosis without renal disease.
abstract: OBJECTIVE
  Fetuin-A is a hepatic glycoprotein that inhibits extraosseous calcification. Lower serum fetuin-A concentration was associated with severe arterial calcification in patients with end stage renal disease. We evaluated the association of serum fetuin-A levels and the severity of atherosclerosis in patients with peripheral vascular disease having normal renal function.
  
  
  METHODS
  In this cross-sectional study among 93 chronic atherosclerotic patients with lower extremity vascular disease, systemic atherosclerosis and calcification was assessed by ultrasound (carotid intima-media thickness/IMT/, calcification at the abdominal aorta, carotid and femoral bifurcations, aortic and mitral valves) and angiography (Bollinger score). Standard serum markers of inflammation, diabetes, renal function, ankle-brachial indexes and traditional risk factors for atherosclerosis were noted and Fontaine classification was applied for the severity of symptoms.
  
  
  RESULTS
  The patients mean (SD) age was 59.95 (7.61) years, 78% were men, 35% had diabetes. Serum fetuin-A level showed significant negative correlation with ultrasound calcification score (P=0.018, r=-0.257) and Bollinger angiographic score (P=0.035, r=-0.347). Fetuin-A did not correlate with IMT or Fontaine classification. Fetuin-A also showed significant correlation with albumin, transferrin and hemoglobin A1c (r=0.287, 0.305 and 0.219, respectively at P<0.05). Logistic regression analysis confirmed the association between fetuin-A and calcification score (OR: 3.03, CI: 1.05-8.7), P=0.039) independent of traditional risk factors.
  
  
  CONCLUSIONS
  Our data show that serum fetuin-A levels inversely correlate with the severity of atherosclerosis in nonuremic patients with symptomatic chronic lower limb ischemia. These data support a putative protective role for fetuin-A in the development of arterial calcification.
authors.affiliation: Department of Vascular Surgery, Semmelweis University, Budapest, Hungary. zszeberin@yahoo.com
authors.forename: Z
authors.initials: Z
authors.lastname: Szeberin
authors.forename: M
authors.initials: M
authors.lastname: Fehérvári
authors.forename: M
authors.initials: M
authors.lastname: Krepuska
authors.forename: A
authors.initials: A
authors.lastname: Apor
authors.forename: E
authors.initials: E
authors.lastname: Rimely
authors.forename: H
authors.initials: H
authors.lastname: Sarkadi
authors.forename: G
authors.initials: G
authors.lastname: Széplaki
authors.forename: Z
authors.initials: Z
authors.lastname: Prohászka
authors.forename: L
authors.initials: L
authors.lastname: Kalabay
authors.forename: G
authors.initials: G
authors.lastname: Acsády
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000097:blood* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D015536:Down-Regulation; D005260:Female; D006801:Humans; D006814:Hungary; D016015:Logistic Models; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D018608:Ultrasonography, Doppler; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
chemical_list: C556354:AHSG protein, human; D015415:Biomarkers; D060749:alpha-2-HS-Glycoprotein