title: Fetuin-A is associated with disease severity and exacerbation frequency in patients with COPD.
abstract: Fetuin-A is a liver protein that may serve as an inhibitor of systemic inflammation in humans. In the present study we assessed the levels of fetuin-A in COPD patients in stable condition and on exacerbation in an attempt to evaluate it as a clinically relevant biomarker that may serve as predictor of exacerbations of COPD (ECOPD). One hundred COPD outpatients (GOLD stage I to IV) were enrolled in a tertiary University hospital and were submitted to a detailed evaluation, including pulmonary function testing, exercise capacity, quality of life and evaluation of the presence of metabolic syndrome and serum CRP. All patients were followed-up for 1 year, and 36 were re-evaluated at the onset of an ECOPD. Forty otherwise healthy smokers served as controls. Serum fetuin-A levels were reproducible at baseline, 6 and 12 months. COPD patients presented lower levels of fetuin compared to controls [394.5 (321.8-419.6) vs. 487.3 (441.0-548.0) mg/L, p < 0.001]. COPD patients with GOLD stage IV had lower fetuin-A levels compared to stages I-II and III (p < 0.05). Fetuin-A was significantly reduced at the onset of an ECOPD compared to baseline (p < 0.001) and the time to the first ECOPD significantly different between patients with high and low levels of fetuin-A [HR 2.163 (95%CI 1.104-4.238), p = 0.024). The results of the present study suggest that fetuin-A is a reproducible and clinically relevant biomarker in patients with COPD that may be useful in the identification of exacerbation-prone patients.
authors.affiliation: Respiratory Medicine Department, University of Thessaly Medical School, Larissa, Greece.
authors.forename: Markos
authors.initials: M
authors.lastname: Minas
authors.forename: Parthena
authors.initials: P
authors.lastname: Mystridou
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Georgoulias
authors.forename: Spyros
authors.initials: S
authors.lastname: Pournaras
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kostikas
authors.forename: Konstantinos I
authors.initials: KI
authors.lastname: Gourgoulianis
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D018450:Disease Progression; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D008875:Middle Aged; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D060749:alpha-2-HS-Glycoprotein; D002097:C-Reactive Protein