Plasma fetuin-A is associated with endothelial dysfunction and subclinical atherosclerosis in subjects with nonalcoholic fatty liver disease.
OBJECTIVE
Nonalcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome (MetS) is closely associated with an increased risk of cardiovascular disease. Fetuin-A is associated with MetS and NAFLD. We investigated the relationship of circulating fetuin-A level with markers of endothelial dysfunction and presence of carotid atherosclerosis in subjects with NAFLD.


METHODS
The consecutive 115 patients with NAFLD and age-matched 74 healthy subjects were enrolled. Plasma levels of fetuin-A and markers of endothelial dysfunction [asymmetric dimethyl arginine (ADMA) and adiponectin] were measured by ELISA method. Insulin sensitivity was determined by homeostasis model assessment of insulin resistance (HOMA-IR) index. Carotid artery intima-media thickness (cIMT) was assessed by high-resolution ultrasonography.


RESULTS
Fetuin-A and ADMA were higher and, adiponectin was lower in NAFLD group than the control group (P = 0·004, P < 0·001 and P < 0·001, respectively). In addition, NAFLD group had greater cIMT measurements than the controls (P < 0·001). However, no difference was found for fetuin-A, ADMA, adiponectin and cIMT between two groups when the findings were adjusted according to the glucose, lipids and HOMA-IR index. In correlation analysis, fetuin-A was found to be positively correlated with triglyceride (r = 0·23, P = 0·001), HOMA-IR (r = 0·29, P < 0·001), ADMA (r = 0·24, P = 0·001), cIMT (r = 0·3, P = 0·003) and, negatively correlated with HDL-C (r = -0·17, P = 0·02) and adiponectin (r = -0·19, P = 0·01) levels. Multiple linear regression analysis showed that fetuin-A was independently associated with ADMA and cIMT levels.


CONCLUSIONS
This study demonstrated for the first time that circulating fetuin-A in NAFLD is independently associated with endothelial dysfunction and subclinical atherosclerosis.
Department of Gastroenterology, Gulhane School of Medicine.
Teoman
T
Dogru
Halil
H
Genc
Serkan
S
Tapan
Fatih
F
Aslan
Cemal Nuri
CN
Ercin
Fatih
F
Ors
Muammer
M
Kara
Erdim
E
Sertoglu
Yildirim
Y
Karslioglu
Sait
S
Bagci
Ismail
I
Kurt
Alper
A
Sonmez
D052242:Adiponectin / Q000097:blood; D000328:Adult; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D050197:Atherosclerosis / Q000097:blood* / Q000378:metabolism; D002340:Carotid Artery Diseases / Q000097:blood / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D005234:Fatty Liver / Q000097:blood* / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D055815:Young Adult; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
D052242:Adiponectin; D060749:alpha-2-HS-Glycoprotein; C018524:N,N-dimethylarginine; D001120:Arginine