Abdel-Wahab Ali F I, Fathy Osama, Al-Harizy Randa
Department of Pharmacology, Cairo University, Cairo, Egypt.
Arab J Nephrol Transplant. 2013 Jan;6(1):11-20.
Fetuin-A, a systemic calcification inhibitor, has been negatively related to vascular calcification (VC) and cardiovascular mortality. In this study we investigated the association between fetuin-A levels and atherosclerotic vascular complications in systemic lupus erythematosus (SLE) patients with and without lupus nephritis (LN).
We recruited 20 SLE patients without LN, 20 SLE patients with LN and 20 healthy controls. We determined serum creatinine, lipid profile, high sensitivity C-reactive protein (hsCRP), calcium, phosphate and fetuin-A levels, and calculated the calcification risk index (CRI) and SLE disease activity index (SLEDAI) for all subjects. Vascular disease burden was assessed by quantification of carotid artery intima-media-thickness (IMT) and the ankle-brachial index (ABI).
Fetuin-A levels were significantly lower in LN patients (0.47 ± 0.1 g/L) compared to SLE patients without LN (0.54 ± 0.1 g/L) and both were significantly lower than controls (0.78 ± 0.2 g/L). CRI was significantly higher in LN patients (89.1 ± 12.1 mg/L) compared to SLE patients without LN (67.2 ± 9.3 mg/L) and both were significantly higher than controls (34.2 ± 6.2 mg/L). Peripheral arterial disease (ABI > 0.9) was significantly more common in LN patients (55%) compared to SLE patients without LN (30%) as well as controls (0%). Fetuin-A levels showed significant negative correlations with serum creatinine, hsCRP, CRI, IMT and ABI in SLE patients with and without LN.
Fetuin-A levels were decreased in SLE patients with and without LN and negatively correlated with vascular complications. This suggests a potentially important role for fetuin-A deficiency as marker of vascular disease in SLE patients with and without LN.
胎球蛋白-A是一种全身性钙化抑制剂，与血管钙化（VC）和心血管死亡率呈负相关。在本研究中，我们调查了有或无狼疮性肾炎（LN）的系统性红斑狼疮（SLE）患者胎球蛋白-A水平与动脉粥样硬化血管并发症之间的关联。
我们招募了20例无LN的SLE患者、20例有LN的SLE患者和20名健康对照者。我们测定了所有受试者的血清肌酐、血脂谱、高敏C反应蛋白（hsCRP）、钙、磷和胎球蛋白-A水平，并计算了钙化风险指数（CRI）和SLE疾病活动指数（SLEDAI）。通过定量颈动脉内膜中层厚度（IMT）和踝臂指数（ABI）评估血管疾病负担。
与无LN的SLE患者（0.54±0.1 g/L）相比，LN患者的胎球蛋白-A水平（0.47±0.1 g/L）显著降低，且两者均显著低于对照组（0.78±0.2 g/L）。与无LN的SLE患者（67.2±9.3 mg/L）相比，LN患者的CRI显著更高（89.1±12.1 mg/L），且两者均显著高于对照组（34.2±6.2 mg/L）。与无LN的SLE患者（30%）以及对照组（0%）相比，外周动脉疾病（ABI>0.9）在LN患者中（55%）更为常见。有或无LN的SLE患者中，胎球蛋白-A水平与血清肌酐、hsCRP、CRI、IMT和ABI均呈显著负相关。
有或无LN的SLE患者胎球蛋白-A水平均降低，且与血管并发症呈负相关。这表明胎球蛋白-A缺乏在有或无LN的SLE患者中作为血管疾病标志物可能具有重要作用。
