Serum fetuin A/α2HS-glycoprotein levels in patients with non-alcoholic fatty liver disease: relation with liver fibrosis

Abstract

Background: Serum concentrations of fetuin A/a2HS-glycoprotein (AHSG) have been linked to human metabolic alterations and can serve as an indicator of liver cell function. We assayed serum levels of AHSG in patients with non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of the metabolic syndrome, and examined their association with clinical, biochemical and histological phenotypes. Methods: Serum AHSG levels were determined by enzyme linked immunosorbent assay in 99 patients with biopsy-proven NAFLD and 75 age-and gender-matched controls. Results: Serum AHSG levels were significantly higher in patients with NAFLD (940 + 120 mg/mL) compared with healthy controls (800 + 130 mg/mL, Student's t test, P , 0.001). Bivariate analyses (Spearman's rank correlation) in patients with NAFLD showed a statistically significant association between AHSG levels and insulin resistance as assessed by the HOMA (homeostasis model assessment) index (r ¼ 0.31, P , 0.01) and the liver fibrosis score index (r ¼ 0.36, P , 0.001). The association between AHSG and fibrosis remained statistically significant even after adjustment for potential confounders, including the HOMA index ([beta] ¼ 1.65, t ¼ 2.38, P , 0.05). Conclusion: Serum AHSG levels are significantly increased in adult patients with biopsy-proven NAFLD and are associated with insulin resistance. Importantly, our pilot data indicate that serum AHSG levels may identify NAFLD patients with higher fibrosis scores.

Fetuin-A as a Possible Marker of Nonalcoholic Fatty Liver Disease in Patients with Non-Surgical Weight Loss

“…However, the positive correlation between BMI and FLI might be caused by the reduction of BMI itself as one of the main variables in calculating FLI [23]. Our results neither show a positive correlation between FLI and NASH-Score to fetuin-A at T0 nor over time from T0 to T2 supporting the controversial results of former studies [36,41,42]. Few studies were able to show a significant correlation between serum fetuin-A levels to fat accumulation in the liver by magnetic resonance spectroscopy [41] while liver fat content was not associated with serum fetuin-A levels in other studies [36].…”

“…Few studies were able to show a significant correlation between serum fetuin-A levels to fat accumulation in the liver by magnetic resonance spectroscopy [41] while liver fat content was not associated with serum fetuin-A levels in other studies [36]. Additionally, an association of serum fetuin-A levels with liver fibrosis score index but not with histological NASH-Score was shown [42]. Although fetuin-A has been shown to mediate lipid induced insulin resistance as an endogenous ligand of toll-like receptor 4, our data confirms this with a significant decrease in HOMA-IR from T0 to T2 independent of fetuin-A reduction, suggesting different mechanisms of insulin resistance [26].…”

Fetuin A in nonalcoholic fatty liver disease: in vivo and in vitro studies

“…However, a significant correlation between plasma levels of fetuin A and liver fat in subjects with increased risk of the metabolic syndrome has been reported (10), and recently, a modest elevation of fetuin A serum levels was found in 99 adult patients with biopsy-proven NAFLD (11). Based on this finding as well as the role of fetuin A in inflammation and insulin resistance, we hypothesized that fetuin A could be involved in the pathogenesis of NAFLD.…”

Fetuin-A (AHSG) and its usefulness in clinical practice. Review of the literature

“…The situation is different in the case of diseases with fat accumulation in the liver, i.e. hepatic manifestation of the metabolic syndrome 35,36 . In human serum fetuin-A levels were positively correlated with liver fat measured by H magnetic resonance spectroscopy 5 .…”