Abstract
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.
Highlights
Patients with nonalcoholic fatty liver disease (NAFLD) are prone to developing atherosclerotic cardiovascular disease (CVD) independently of classical cardiovascular risk factors, and CVD is a leading cause of mortality in NAFLD [1,2,3]
We have three main findings: (a) NAFLD is highly prevalent among all patients with definite atherosclerotic disease, though the highest prevalence rates are found among those patients with peripheral arterial disease (PAD); (b) despite a lower prevalence of NAFLD, patients with coronary artery disease (CAD) have higher values of Fetuin-A than patients with PAD; (c) Fetuin-A is positively associated with NAFLD in
Our findings are fully consistent with previous studies [5,6,7] and, for the first time, extend the positive association of Fetuin-A with NAFLD to a group of patients with established atherosclerotic
Summary
Patients with nonalcoholic fatty liver disease (NAFLD) are prone to developing atherosclerotic cardiovascular disease (CVD) independently of classical cardiovascular risk factors, and CVD is a leading cause of mortality in NAFLD [1,2,3]. Nonalcoholic fatty liver disease (NAFLD) is strongly associated with both atherosclerotic cardiovascular disease (CVD) and Fetuin-A. We hypothesized that the pathogenic interplay of NAFLD, Fetuin-A and atherosclerosis varies based on arterial site. 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). 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. 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). Conclusion: The pathogenic interplay of NAFLD, Fetuin-A and atherosclerosis probably varies according to the arterial site
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