Szeberin Z, Fehérvári M, Krepuska M, Apor A, Rimely E, Sarkadi H, Széplaki G, Prohászka Z, Kalabay L, Acsády G
Department of Vascular Surgery, Semmelweis University, Budapest, Hungary.
Int Angiol. 2011 Oct;30(5):474-50.
Fetuin-A is a hepatic glycoprotein that inhibits extraosseous calcification. Lower serum fetuin-A concentration was associated with severe arterial calcification in patients with end stage renal disease. We evaluated the association of serum fetuin-A levels and the severity of atherosclerosis in patients with peripheral vascular disease having normal renal function.
In this cross-sectional study among 93 chronic atherosclerotic patients with lower extremity vascular disease, systemic atherosclerosis and calcification was assessed by ultrasound (carotid intima-media thickness/IMT/, calcification at the abdominal aorta, carotid and femoral bifurcations, aortic and mitral valves) and angiography (Bollinger score). Standard serum markers of inflammation, diabetes, renal function, ankle-brachial indexes and traditional risk factors for atherosclerosis were noted and Fontaine classification was applied for the severity of symptoms.
The patients mean (SD) age was 59.95 (7.61) years, 78% were men, 35% had diabetes. Serum fetuin-A level showed significant negative correlation with ultrasound calcification score (P=0.018, r=-0.257) and Bollinger angiographic score (P=0.035, r=-0.347). Fetuin-A did not correlate with IMT or Fontaine classification. Fetuin-A also showed significant correlation with albumin, transferrin and hemoglobin A1c (r=0.287, 0.305 and 0.219, respectively at P<0.05). Logistic regression analysis confirmed the association between fetuin-A and calcification score (OR: 3.03, CI: 1.05-8.7), P=0.039) independent of traditional risk factors.
Our data show that serum fetuin-A levels inversely correlate with the severity of atherosclerosis in nonuremic patients with symptomatic chronic lower limb ischemia. These data support a putative protective role for fetuin-A in the development of arterial calcification.
胎球蛋白-A是一种抑制骨外钙化的肝脏糖蛋白。终末期肾病患者血清胎球蛋白-A浓度降低与严重动脉钙化相关。我们评估了肾功能正常的外周血管疾病患者血清胎球蛋白-A水平与动脉粥样硬化严重程度之间的关联。
在这项针对93例慢性下肢血管疾病动脉粥样硬化患者的横断面研究中，通过超声（颈动脉内膜中层厚度/IMT/、腹主动脉、颈动脉和股动脉分叉处、主动脉和二尖瓣的钙化情况）和血管造影（博林格评分）评估全身动脉粥样硬化和钙化情况。记录炎症、糖尿病、肾功能的标准血清标志物、踝臂指数以及动脉粥样硬化的传统危险因素，并应用Fontaine分类法评估症状的严重程度。
患者的平均（标准差）年龄为59.95（7.61）岁，78%为男性，35%患有糖尿病。血清胎球蛋白-A水平与超声钙化评分（P = 0.018，r = -0.257）和博林格血管造影评分（P = 0.035，r = -0.347）呈显著负相关。胎球蛋白-A与IMT或Fontaine分类无关。胎球蛋白-A还与白蛋白、转铁蛋白和糖化血红蛋白A1c显著相关（r分别为0.287、0.305和0.219，P < 0.05）。逻辑回归分析证实了胎球蛋白-A与钙化评分之间的关联（比值比：3.03，可信区间：1.05 - 8.7），P = 0.039），且独立于传统危险因素。
我们的数据表明，在有症状的慢性下肢缺血的非尿毒症患者中，血清胎球蛋白-A水平与动脉粥样硬化的严重程度呈负相关。这些数据支持胎球蛋白-A在动脉钙化发展中具有假定的保护作用。
