Fiore Carmelo E, Celotta Gabriella, Politi Grazia G, Di Pino Luigi, Castelli Zaira, Mangiafico Roberto A, Signorelli Salvatore S, Pennisi Pietra
Department of Internal Medicine, University of Catania O.V.E., Catania, Italy.
Atherosclerosis. 2007 Nov;195(1):110-5. doi: 10.1016/j.atherosclerosis.2006.08.052. Epub 2006 Sep 29.
Alpha2-Heremans-Schmid glycoprotein (AHSG; fetuin), a member of the cystatin superfamily of cysteine protease inhibitors involved in vascular pathology and bone metabolism, has been reported to be reduced in patients with atherosclerosis and medial calcification related to end stage renal disease or dialysis. No data on fetuin in patients with peripheral artery disease associated with low bone mass and normal renal function are available in the literature. In the present study we evaluated serum fetuin concentrations, bone mass, and markers of bone turnover in patients with atherosclerosis of peripheral vessels and normal kidney function.
Ninety consecutive patients with evidence of atherosclerotic plaques at the common carotid or femoral artery were studied. Severity grade of disease was documented by ultrasound measurement of intima-media thickness (IMT). Fasting serum levels of fetuin were measured by sandwich enzyme immunoassay.
The mean patient serum concentration of fetuin was 57.68+/-13.6 ng/ml, significantly higher than that of control subjects (41.6+/-7.6 ng/ml; p<0.001). The mean serum concentration of bone-specific alkaline phosphatase (BAP) were 8.4+/-2.3 microg/l, significantly lower than controls (13.6+/-1.6 microg/l; p<0.001). Fetuin was correlated with IMT (r=0.8530; p<0.0001) and inversely correlated with BAP (r=-0.5503; p<0.0001). Patients had a vertebral and femoral bone mass significantly lower than controls.
This study documented for the first time that, in patients with atherosclerosis of peripheral vessels, serum fetuin levels were higher than in healthy subjects, and correlated with the severity of disease; further studies are required to analyse the role of AHSG as an independent predictor of atherosclerotic disease and low bone mass in patients with normal renal function.
α2-赫里曼斯-施密德糖蛋白（AHSG；胎球蛋白）是半胱氨酸蛋白酶抑制剂胱抑素超家族的成员，参与血管病理和骨代谢，据报道，在患有动脉粥样硬化以及与终末期肾病或透析相关的血管中层钙化的患者中其水平降低。文献中尚无关于外周动脉疾病合并低骨量且肾功能正常患者胎球蛋白的相关数据。在本研究中，我们评估了外周血管动脉粥样硬化且肾功能正常患者的血清胎球蛋白浓度、骨量和骨转换标志物。
对90例在颈总动脉或股动脉有动脉粥样硬化斑块证据的连续患者进行研究。通过超声测量内膜中层厚度（IMT）记录疾病严重程度分级。采用夹心酶免疫测定法测量空腹血清胎球蛋白水平。
患者血清胎球蛋白平均浓度为57.68±13.6 ng/ml，显著高于对照组（41.6±7.6 ng/ml；p<0.001）。骨特异性碱性磷酸酶（BAP）的平均血清浓度为8.4±2.3 μg/l，显著低于对照组（13.6±1.6 μg/l；p<0.001）。胎球蛋白与IMT相关（r=0.8530；p<0.0001），与BAP呈负相关（r=-0.5503；p<0.0001）。患者的椎体和股骨骨量显著低于对照组。
本研究首次证明，在外周血管动脉粥样硬化患者中，血清胎球蛋白水平高于健康受试者，并与疾病严重程度相关；需要进一步研究来分析AHSG作为肾功能正常患者动脉粥样硬化疾病和低骨量独立预测指标的作用。
