非酒精性脂肪性肝病和胎球蛋白-A在有症状的冠状动脉疾病和外周动脉疾病中发挥不同作用吗？
Do Nonalcoholic Fatty Liver Disease and Fetuin-A Play Different Roles in Symptomatic Coronary Artery Disease and Peripheral Arterial Disease?
作者信息
Nascimbeni Fabio, Romagnoli Dante, Ballestri Stefano, Baldelli Enrica, Lugari Simonetta, Sirotti Valentina, Giampaoli Valentina, Lonardo Amedeo
机构信息
Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena 41126, Italy.
Division of Internal Medicine, Hospital of Pavullo-Department of Internal Medicine, Azienda USL, Pavullo, Modena 41126, Italy.
出版信息
Diseases. 2018 Feb 16;6(1):17. doi: 10.3390/diseases6010017.
BACKGROUND AND AIMS
Nonalcoholic fatty liver disease (NAFLD) is strongly associated with both atherosclerotic cardiovascular disease (CVD) and Fetuin-A. However, the association of Fetuin-A with atherosclerosis is more controversial. We hypothesized that the pathogenic interplay of NAFLD, Fetuin-A and atherosclerosis varies based on arterial site. Accordingly, we aimed to assess NAFLD prevalence, Fetuin-A values and their relationship with symptomatic atherosclerosis occurring in different localizations: coronary artery disease (CAD) vs. peripheral arterial disease (PAD).
METHODS
One hundred and forty-nine consecutive patients with symptomatic atherosclerotic CVD were recruited: 45 with CAD diagnosed by coronary angiography and 104 with PAD detected by doppler-ultrasound and/or computed tomography angiography and/or angiography. NAFLD was diagnosed based on both ultrasonography and exclusion of competing etiologies. Serum Fetuin-A was measured with ELISA.
RESULTS
NAFLD was detected in 54% of the overall group, with higher rates in PAD (59%) than CAD (42%) patients. Median Fetuin-A values were 256 (111-662) μg/mL, higher in patients with CAD (378 (124-662) μg/mL) than those with PAD (236 (111-461) μg/mL). The main findings were: (1) CAD patients had higher Fetuin-A values and less frequently NAFLD than PAD patients; (2) NAFLD was positively associated with Fetuin-A values; however, this association was limited to CAD patients only; (3) Fetuin-A values were positively associated with both CAD and NAFLD.
CONCLUSION
The pathogenic interplay of NAFLD, Fetuin-A and atherosclerosis probably varies according to the arterial site.
背景与目的
非酒精性脂肪性肝病（NAFLD）与动脉粥样硬化性心血管疾病（CVD）及胎球蛋白-A均密切相关。然而，胎球蛋白-A与动脉粥样硬化的关联更具争议性。我们推测，NAFLD、胎球蛋白-A与动脉粥样硬化之间的致病相互作用因动脉部位而异。因此，我们旨在评估NAFLD患病率、胎球蛋白-A值及其与不同部位发生的有症状动脉粥样硬化的关系：冠状动脉疾病（CAD）与外周动脉疾病（PAD）。
方法
连续招募了149例有症状的动脉粥样硬化性CVD患者：45例经冠状动脉造影诊断为CAD，104例经多普勒超声和/或计算机断层血管造影和/或血管造影检测为PAD。基于超声检查并排除其他竞争性病因来诊断NAFLD。采用酶联免疫吸附测定法（ELISA）检测血清胎球蛋白-A。
结果
在整个研究组中，54%的患者检测出NAFLD，其中PAD患者（59%）的发生率高于CAD患者（42%）。胎球蛋白-A的中位数为256（111 - 662）μg/mL，CAD患者（378（124 - 662）μg/mL）高于PAD患者（236（111 - 461）μg/mL）。主要发现如下：（1）CAD患者的胎球蛋白-A值较高，且NAFLD的发生率低于PAD患者；（2）NAFLD与胎球蛋白-A值呈正相关；然而，这种关联仅局限于CAD患者；（3）胎球蛋白-A值与CAD和NAFLD均呈正相关。
结论
NAFLD、胎球蛋白-A与动脉粥样硬化之间的致病相互作用可能因动脉部位而异。
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