title: Serum Fetuin A Levels: Are They a Reliable Marker for Hepatic Steatosis and Regional Adiposity in Renal Transplant Recipients?
abstract: BACKGROUND
  Fetuin A is a protein expressed in the liver and it is an important inhibitor of ectopic calcification. High levels of fetuin A correlate with insulin resistance, hepatic steatosis, and regional adiposity in the general population. The association between hepatic steatosis and fetuin A level in renal transplant recipients (RTRs) remains unclear.
  
  
  OBJECTIVE
  The aim of this study was to explore the relationships between fetuin A, hepatic steatosis, and regional adiposity in RTRs.
  
  
  METHODS
  Data from 44 patients with normal renal functions were included, all subjected to history taking for clinical data, assessment of central obesity and regional adiposity, assessment of hepatic steatosis using abdominal ultrasound (US), and measurements of serum fetuin A concentration using enzyme-linked immunosorbent assay (ELISA) kits.
  
  
  RESULTS
  Our study included 20 females (45.4%) and 24 males (54.6%) with mean age of 41.26 ± 11.2 years. Twenty-four subjects had hepatic steatosis. Fetuin A level in RTRs with hepatic steatosis with a mean of 1642.92 ± 358.91 is significantly higher (P < .001) than those without hepatic steatosis with a mean of 711.74 ± 57.85. Serum fetuin A level was positively correlated with regional adiposity (P = .021) and hepatic steatosis grade (P = .017). Fetuin A level increased with increased duration after renal transplantation (P < .001). The best cutoff value for detecting entrance into phase 3 or 4 steatosis is fetuin of 1862 with sensitivity of 88.9% and specificity of 87.7%.
  
  
  CONCLUSIONS
  Fetuin A is positively correlated with hepatic steatosis and regional adiposity in RTRs. Fetuin increases with increased duration after renal transplantation. Accordingly it may be used as a marker for hepatic steatosis and regional adiposity in these patients.
authors.affiliation: Internal Medicine and Nephrology Department, Cairo University, Cairo, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Roshdy
authors.affiliation: Internal Medicine and Nephrology Department, Cairo University, Cairo, Egypt.
authors.forename: H
authors.initials: H
authors.lastname: Okash
authors.affiliation: Internal Medicine and Nephrology Department, Cairo University, Cairo, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Soliman
authors.affiliation: Internal Medicine and Nephrology Department, Cairo University, Cairo, Egypt. Electronic address: hodamamoun@yahoo.com.
authors.forename: H
authors.initials: H
authors.lastname: Maamoun
authors.affiliation: Chemical Pathology Department, Cairo University, Cairo, Egypt.
authors.forename: O
authors.initials: O
authors.lastname: Shaker
authors.affiliation: Internal Medicine and Nephrology Department, Cairo University, Cairo, Egypt.
authors.forename: M A
authors.initials: MA
authors.lastname: Soliman
authors.affiliation: Internal Medicine Department, Cairo University, Cairo, Egypt.
authors.forename: A
authors.initials: A
authors.lastname: Hamdy
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005234:Fatty Liver / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007668:Kidney / Q000378:metabolism; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
chemical_list: D015415:Biomarkers; D060749:alpha-2-HS-Glycoprotein