Abstract
BackgroundA deficiency of fetuin A is linked to cardiovascular calcification and mortality in dialysis patients. But, high levels of fetuin A and chemerin correlate with hepatic steatosis and regional adiposity in general population. The association between hepatic steatosis and fetuin A/chemerin levels in hemodialysis (HD) remains unclear.MethodsWe performed a cross-sectional, observational study; 216 prevalent HD patients from a single center were enrolled. Baseline serum fetuin A, chemerin levels, conicity index and anthropometric parameters were checked. Presence of hepatic steatosis was qualified by liver ultrasound and quantified by the hepato-renal index (HRI); central obesity defined by waist circumference (WC). ROC analyses and multivariate logistic regression analyses for prediction of hepatic steatosis and central obesity on the basis of fetuin A/chemerin levels, anthropometric parameters, and other relevant covariates were performed.ResultsData from 103 women and 113 men (mean age 60±12 years) were analyzed. Eighty subjects had hepatic steatosis and their HRIs were significantly higher than those without hepatic steatosis (P<0.001). Serum fetuin A levels were positively associated with HRIs (P<0.001) and chemerin levels (P<0.001). Fetuin A, chemerin and WC were predictors for hepatic steatosis and central obesity by ROC curve. In multivariate logistic regression analysis, fetuin A and WC independently predicted hepatic steatosis defined by HRIs. And chemerin predicted central obesity and regional adiposity after covariate adjustments (all P<0.05).ConclusionsSerum fetuin A levels were higher in prevalent HD patients with hepatic steatosis, and positively correlated with chemerin levels. Chemerin levels predicted central obesity as well as regional adiposity in the HD patients.
Highlights
Fetuin A is a protein exclusively secreted by hepatocytes in humans and a potent inhibitor of vascular calcification [1]
While increased fetuin A levels positively correlated with vascular calcification in diabetic patients and general population [2,3], an inverse relationship was observed in dialysis patients [1,4]
The validity of the hepato-renal index (HRI) for the estimation of the severity of hepatic steatosis was compared with hepatic steatosis which had been confirmed by liver ultrasound
Summary
Fetuin A is a protein exclusively secreted by hepatocytes in humans and a potent inhibitor of vascular calcification [1]. While increased fetuin A levels positively correlated with vascular calcification in diabetic patients and general population [2,3], an inverse relationship was observed in dialysis patients [1,4]. Both chronic inflammation and uremia may contribute to exhausting fetuin A release and a consequent catabolic micro-environment of fetuin A lead dialysis patients to be fetuin A deficiency [5]. Fetuin A deficiency is associated with cardiovascular (CV) calcification and, thereby, a high mortality rate in dialysis patients [1,4]. The association between hepatic steatosis and fetuin A/chemerin levels in hemodialysis (HD) remains unclear
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