Roshdy A, Okash H, Soliman A, Maamoun H, Shaker O, Soliman M A, Hamdy A
Internal Medicine and Nephrology Department, Cairo University, Cairo, Egypt.
Internal Medicine and Nephrology Department, Cairo University, Cairo, Egypt.
Transplant Proc. 2015 Nov;47(9):2703-6. doi: 10.1016/j.transproceed.2015.07.033.
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.
The aim of this study was to explore the relationships between fetuin A, hepatic steatosis, and regional adiposity in RTRs.
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.
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%.
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.
胎球蛋白A是一种在肝脏中表达的蛋白质，是异位钙化的重要抑制剂。在普通人群中，高水平的胎球蛋白A与胰岛素抵抗、肝脂肪变性和局部肥胖相关。肾移植受者（RTRs）中肝脂肪变性与胎球蛋白A水平之间的关联仍不清楚。
本研究旨在探讨RTRs中胎球蛋白A、肝脂肪变性和局部肥胖之间的关系。
纳入44例肾功能正常患者的数据，所有患者均进行临床资料病史采集、中心性肥胖和局部肥胖评估、使用腹部超声（US）评估肝脂肪变性以及使用酶联免疫吸附测定（ELISA）试剂盒测量血清胎球蛋白A浓度。
我们的研究包括20名女性（45.4%）和24名男性（54.6%），平均年龄为41.26±11.2岁。24名受试者有肝脂肪变性。有肝脂肪变性的RTRs的胎球蛋白A水平平均为1642.92±358.91，显著高于无肝脂肪变性者，后者平均为711.74±57.85（P<.001）。血清胎球蛋白A水平与局部肥胖（P=.021）和肝脂肪变性分级（P=.017）呈正相关。胎球蛋白A水平随肾移植后时间延长而升高（P<.001）。检测进入3期或4期脂肪变性的最佳临界值是胎球蛋白1862，敏感性为88.9%，特异性为87.7%。
在RTRs中，胎球蛋白A与肝脂肪变性和局部肥胖呈正相关。胎球蛋白随肾移植后时间延长而升高。因此，它可作为这些患者肝脂肪变性和局部肥胖的标志物。
