胎球蛋白A是术前非酒精性脂肪性肝病患者肝脏脂肪含量的预测指标。
Fetuin A is a Predictor of Liver Fat in Preoperative Patients with Nonalcoholic Fatty Liver Disease.
作者信息
von Loeffelholz C, Horn P, Birkenfeld A L, Claus R A, Metzing B U, Döcke S, Jahreis G, Heller R, Hoppe S, Stockmann M, Lock J F, Rieger A, Weickert M O, Settmacher U, Rauchfuß F, Pfeiffer A F H, Bauer M, Sponholz C
机构信息
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.
出版信息
J Invest Surg. 2016 Oct;29(5):266-74. doi: 10.3109/08941939.2016.1149640. Epub 2016 Mar 16.
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.
CONCLUSION
Fetuin A is suggested as noninvasive biomarker of hepatic steatosis in preoperative settings.
背景
非酒精性脂肪性肝病（NAFLD）和脂肪性肝炎（NASH）是围手术期患者常见的合并症。然而，尚未在这一群体中评估肝源蛋白胎球蛋白A的预测作用。
目的
研究胎球蛋白A作为术前患者NAFLD/NASH预测指标的作用。
方法
纳入58名受试者。对接受开腹手术的患者以及急性肝衰竭亚组患者进行胎球蛋白A研究。采集血液和肝脏标本。对NAFLD进行组织学评估。另外通过酶法分析肝脏脂肪，采用酶联免疫吸附测定法检测循环胎球蛋白A，通过逆转录聚合酶链反应检测胎球蛋白A信使核糖核酸。
结果
单变量相关性研究表明胎球蛋白A与肝脏脂肪变性（r = 0.40，p = 0.029）和肝细胞气球样变性（r = 0.34，p = 0.026）相关。与非NAFLD受试者相比，NAFLD患者（p = 0.009）和NASH患者（p = 0.029）的胎球蛋白A升高。然而，通过线性模型校正主要混杂因素后，胎球蛋白A仍与肝脏脂肪变性相关，但与气球样变性或其他NAFLD特征无关。支持这一点的是，生化分析的肝脏脂质与血浆中的胎球蛋白A相关（r = 0.34，p = 0.033），与肝脏胎球蛋白A信使核糖核酸相关（r = 0.54，p < 0.001）。此外，血浆胎球蛋白A与肝脏信使核糖核酸相关（r = 0.32，p = 0.036），而急性肝衰竭时循环水平降低64%（p < 0.001），证实肝脏是胎球蛋白A的主要来源。
结论
胎球蛋白A被认为是术前肝脏脂肪变性的无创生物标志物。
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