title: Fetuin A is a Predictor of Liver Fat in Preoperative Patients with Nonalcoholic Fatty Liver Disease.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) and steatohepatitis (NASH) are frequent comorbidities in perioperative patients. However, the predictive role of the hepatokine fetuin A was not evaluated in this collective.
  
  
  OBJECTIVE
  To study fetuin A as predictor of NAFLD/NASH in preoperative patients.
  
  
  METHODS
  58 subjects were included. Fetuin A was studied in patients undergoing open abdominal surgery and in a subset with acute liver failure. Blood and liver specimens were sampled. NAFLD was histologically evaluated. Liver fat was additionally analyzed by an enzymatic approach, circulating fetuin A by enzyme linked-immunosorbent assay, fetuin A mRNA by reverse-transcription PCR.
  
  
  RESULTS
  Univariate correlation studies linked fetuin A to liver steatosis (r = 0.40, p = .029) and hepatocellular ballooning degeneration (r = 0.34, p = .026). Compared to non-NAFLD subjects fetuin A was increased in NAFLD (p = .009) and in NASH (p = .029). However, when corrected for main confounders by linear modeling, fetuin A remained related to hepatic steatosis, but not to ballooning degeneration or other NAFLD features. In support of this, biochemically analyzed liver lipids correlated with fetuin A in plasma (r = 0.34, p = .033) and with hepatic fetuin A mRNA (r = 0.54, p < .001). In addition, plasma fetuin A was related to hepatic mRNA (r = 0.32, p = .036), while circulating levels were reduced by 64% with acute liver failure (p < .001), confirming the liver as main fetuin A source.
  
  
  CONCLUSIONS
  Fetuin A is suggested as noninvasive biomarker of hepatic steatosis in preoperative settings.
authors.affiliation: a Department of Clinical Nutrition , German Institute of Human Nutrition Potsdam-Rehbruecke , Nuthetal , Germany ;|b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.|c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany ;
authors.forename: C
authors.initials: C
authors.lastname: von Loeffelholz
authors.affiliation: b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.|c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany ;
authors.forename: P
authors.initials: P
authors.lastname: Horn
authors.affiliation: d Section of Metabolic and Vascular Medicine, Medical Clinic III , University Hospital Carl Gustav Carus , Dresden , Germany ;
authors.forename: A L
authors.initials: AL
authors.lastname: Birkenfeld
authors.affiliation: b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.|c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany ;
authors.forename: R A
authors.initials: RA
authors.lastname: Claus
authors.affiliation: b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.|c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany ;
authors.forename: B U
authors.initials: BU
authors.lastname: Metzing
authors.affiliation: a Department of Clinical Nutrition , German Institute of Human Nutrition Potsdam-Rehbruecke , Nuthetal , Germany ;
authors.forename: S
authors.initials: S
authors.lastname: Döcke
authors.affiliation: e Institute of Nutrition , Friedrich Schiller University , Jena , Germany.
authors.forename: G
authors.initials: G
authors.lastname: Jahreis
authors.affiliation: b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.|f Institute for Molecular Cell Biology , Germany Center for Molecular Biomedicine, Jena University Hospital , Jena , Germany ;
authors.forename: R
authors.initials: R
authors.lastname: Heller
authors.affiliation: g Department of General, Visceral and Transplantation Surgery , Charité-Universitätsmedizin , Berlin , Germany ;
authors.forename: S
authors.initials: S
authors.lastname: Hoppe
authors.affiliation: g Department of General, Visceral and Transplantation Surgery , Charité-Universitätsmedizin , Berlin , Germany ;
authors.forename: M
authors.initials: M
authors.lastname: Stockmann
authors.affiliation: h Department of General-, Visceral-, Vascular- and Paediatric Surgery , University Hospital of Wuerzburg , Wuerzburg , Germany ;
authors.forename: J F
authors.initials: JF
authors.lastname: Lock
authors.affiliation: i Institute of Pathology , Charité-Universitätsmedizin , Berlin , Germany ;
authors.forename: A
authors.initials: A
authors.lastname: Rieger
authors.affiliation: j Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism , University Hospitals Coventry and Warwickshire , CV2 2DX , Coventry , UK , Division of Metabolic & Vascular Health , University of Warwick , CV4 7AL , Coventry , UK ;
authors.forename: M O
authors.initials: MO
authors.lastname: Weickert
authors.affiliation: k Department of General, Visceral and Transplantation Surgery , Friedrich Schiller University of Jena , Jena , Germany ;
authors.forename: U
authors.initials: U
authors.lastname: Settmacher
authors.affiliation: k Department of General, Visceral and Transplantation Surgery , Friedrich Schiller University of Jena , Jena , Germany ;
authors.forename: F
authors.initials: F
authors.lastname: Rauchfuß
authors.affiliation: a Department of Clinical Nutrition , German Institute of Human Nutrition Potsdam-Rehbruecke , Nuthetal , Germany ;|l Department of Endocrinology, Diabetes, and Nutrition , Charité-Universitätsmedizin , Berlin , Germany.
authors.forename: A F H
authors.initials: AF
authors.lastname: Pfeiffer
authors.affiliation: b Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC) , Friedrich Schiller University , Jena , Germany.|c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany ;
authors.forename: M
authors.initials: M
authors.lastname: Bauer
authors.affiliation: c Department of Anaesthesiology and Intensive Care , Jena University Hospital , Jena , Germany ;
authors.forename: C
authors.initials: C
authors.lastname: Sponholz
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D050356:Lipid Metabolism; D008099:Liver / Q000378:metabolism* / Q000473:pathology; D008113:Liver Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D057234:Preoperative Period; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D060749:alpha-2-HS-Glycoprotein / Q000235:genetics / Q000378:metabolism*
chemical_list: C556354:AHSG protein, human; D015415:Biomarkers; D012333:RNA, Messenger; D060749:alpha-2-HS-Glycoprotein
keywords: Fetuin A; NAFLD; NAFLD screening; hepatokine; insulin resistance; liver failure