Serum fetuin-A Research Articles

Association of fetuin-A levels and left ventricular diastolic dysfunction in patients on haemodialysis.

To identify the relationship between serum fetuin-A levels and left ventricular diastolic dysfunction (LVDD) among maintenance haemodialysis patients. In a cross-sectional study, 75 dialysis patients with end-stage renal disease (ESRD) were recruited, and fetuin-A levels were detected using an enzyme-linked immunosorbent assay (ELISA). Echocardiography measurements were recorded according to the recommendations of the American Society of Echocardiography. The ratio of early diastolic transmitral inflow velocity (E) to early diastolic annular velocity (E') was measured using tissue Doppler imaging and E/E' > 15 was defined as diastolic dysfunction. The association of serum fetuin-A concentrations with echocardiographic parameters was analysed by calculating the bivariate linear correlation. A binary logistic regression analysis was conducted to determine the variables associated with LVDD. Compared to patients without diastolic dysfunction, patients with diastolic dysfunction were older, a higher percentage had a history of coronary artery disease, and presented with a high systolic pressure, high parathyroid hormone level, high N-terminal pro-brain natriuretic peptide (NT-proBNP) level, high LV mass index, high left atrium diameter, and low serum creatinine and fetuin-A levels. Serum fetuin-A levels showed a negative correlation with E/E' (r = -0.299, P = 0.009). Fetuin-A levels were considered an independent predictor of diastolic dysfunction. A decrease in the serum fetuin-A level is associated with an increased risk of LVDD in patients on haemodialysis.

Serum Protein Adsorption Modulates the Toxicity of Highly Positively Charged Hydrogel Surfaces.

Hydrogels formed from peptide self-assembly are a class of materials that are being explored for their utility in tissue engineering, drug and cell delivery, two- and three-dimensional cell culture, and as adjuvants in surgical procedures. Most self-assembled peptide gels can be syringe-injected in vivo to facilitate the local delivery of payloads, including cells, directly to the targeted tissue. Herein, we report that highly positively charged peptide gels are inherently toxic to cells, which would seem to limit their utility. However, adding media containing fetal bovine serum, a common culture supplement, directly transforms these toxic gels into cytocompatible materials capable of sustaining cell viability even in the absence of added nutrients. Multistage mass spectrometry showed that at least 40 serum proteins can absorb to a gel's surface through electrostatic attraction ameliorating its toxicity. Further, cell-based studies employing model gels having only bovine serum albumin, fetuin-A, or vitronectin absorbed to the gel surface showed that single protein additives can also be effective depending on the identity of the cell line. Separate studies employing these model gels showed that the mechanism(s) responsible for mitigating apoptosis involve both the pacification of gel surface charge and adsorbed protein-mediated cell signaling events that activate both the PI3/Akt and MAPK/ERK pathways which are known to facilitate resistance to stress-induced apoptosis and overall cell survival.

Serum level of fetuin-A in systemic lupus erythematosus patients: association with atherosclerosis and disease activity.

We aimed in this study to determine the level of serum fetuin-A level in systemic lupus erythematosus patients, assess the correlation between serum fetuin-A level and the activity of disease and the frequency of musculoskeletal manifestations, and detect the frequency of atherosclerosis among these patients by using carotid ultrasonography. This case-control study was carried out on 31 SLE patients attending the inpatient and outpatient clinics of Rheumatology and Rehabilitation Department, Faculty of Medicine, Zagazig university hospitals and 31 apparently healthy age- and sex-matched controls between January 1,2017, and December 31, 2018. There is a highly significant difference between the two studied groups as regard fetuin-A and carotid intima-media thickness. There is a strong positive significant correlation between fetuin-A with C3 and a negative significant correlation between fetuin-A with Anti-dsDNA, SLEDAI, and carotid intima-media thickness in case group. Fetuin-A levels were decreased in SLE patients, and these levels were inversely correlated with carotid intima-media thickness. Key Points • Fetuin-A level is a biomarker of atherosclerosis and asses disease activity in SLE patients.

Прогнозирование тяжести остеопороза у пациентов с ревматоидным артритом путем определения уровня фетуина-А

Aim of study. To investigate the level of dependence of osteoporosis (OP) progression severity on the level of fetuin-A (FA) in order to predict the OP progression severity in RA patients. Material and methods. We have examined a total of 110 RA patients (mean age 54.2+11.97). Th e diagnosis was established based on ACR/EULAR criteria 2010. A total of 30 conventionally healthy subjects were enrolled serving as a control group. Evaluation of bone mineral density (BMD) was performed using DXA (Lunar DPX-NT GE densitometer). The FA level was determined through indirect enzyme-linked immunoassay (Human Fetuin-A ELISA test-system). Results. Mean serum FA in healthy subjects amounted to 653.55-972.19μg/ml. We formed 2 groups of RA patients: with blood serum FA levels <653.55μg/ml (23 patients) and with normal FA values: 653.55μg/ml or higher (87 patients). A lowered FA level was revealed in 20 (86.96 %) subjects in the group of OP patients and only in 3 (13.04 %) patients with RA without OP (р<0.001). Osteoporotic bone fractures were diagnosed in 12 (13.79 %) patients in the group with normal FA levels and were absent in 75 (86.21 %) patients (р<0.001). Apart from that, RA patients with lowered FA had reliably lower mean BMD in the area of femoral neck and vertebral column as well as lower BMD total value (р<0.001). In order to determine the diagnostic accuracy of laboratory tests, the characteristic curve (ROC curve) was applied. Th e area under the ROC-curve was 0.663 with the cut-off point matching the FA level of 660.3μg/ml. Th is value corresponds with 84.72 % specifi city and 47.37 % sensitivity. Conclusion. We have revealed reliable correlations between the serum FA level in RA patients, the frequency of OP development, osteoporotic bone fractures and BMD values (p<0.001). Laboratory evaluation of FA for OP progression severity prediction for RA patients has good quality with the specifi city of 84.72 % and the sensitivity of 47.37 %.

The relationship between calcification inhibitor levels in chronic kidney disease and the development of atherosclerosis

Aim We aimed to investigate the factors affecting the development of atherosclerosis and the role of calcification inhibitors fetuin-A, matrix-Gla protein (MGP), osteoprotegerin (OPG) in atherosclerosis progress. Material and methods The study was planned to investigate the relationship of serum OPG, MGP and fetuin-A levels with the development of atherosclerosis in the stage 2–3–4–5 chronic kidney disease (CKD) patients who did not require dialysis treatment. Results 32 (17 female, 15 male) healthy individuals and 92 (49 females, 43 males) CKD patients were included. The mean carotid intima-media thickness (CIMT), C-reactive protein (CRP), fetuin-A, OPG and MGP of the two groups were compared statistically. In CKD patients, age, body mass index (BMI), CRP, triglyceride, urea, systolic blood pressure (SBP), fasting blood sugar have a positive linear relationship, fetuin-A, OPG, GFR have a negative linear relationship with CIMT. The mean CIMT, right CIMT, left CIMT, blood urea, CRP, urinary albumin excretion creatinine and age show a negative linear relationship with fetuin-A. Conclusion Fetuin-A levels begin to decline from the early stages of CKD and are significantly lower in patients with atherosclerosis as expressed with CIMT. This suggests that fetuin-A may be used as an early marker in CKD for increased cardiovascular risk. Early recognition of these risk factors is important and large-scale studies on vascular calcification inhibitors are needed.

The relationship of fetuin-a, omentin-1, and chemerin with left ventricular ejection fraction in heart failure

Background: Heart failure (HF) is a clinical syndrome in which the heart cannot pump enough blood for the needs of the human body in terms of life functions. Some biochemical diagnostic tests as well as echocardiography play a role in the early diagnosis of this syndrome. The complex pathophysiology of HF suggests that many other markers may be useful in diagnosis and follow-up. Aim: After many recent studies, it has been suggested that adipokines fetuin-A, omentin-1, and chemerin may be suitable biomarkers for the diagnosis of HF. Our main aim in this study is to determine the relationship between fetuin-A, omentin-1, and chemerin levels with HF clinical classification. Methods: The patients admitted to the cardiology service with symptomatic HF with HF with preserved ejection fraction (HF-pEF, n = 62), HF with reduced EF (HF-rEF, n = 61) and HF with mid-range EF (HF-mrEF, n = 63) were included in the study. A total of 246 participants were evaluated by taking the control group (n = 60) for comparison. The main characteristics of all groups were recorded, and serum levels of fetuin-A, omentin-1, and chemerin were evaluated. Results: When compared with the control group, there was a significant difference for fetuin-A with the HF-rEF group (452.3 [441.4–528.9]; 555.3 [453.7–615.6] P < 0.001, respectively). When evaluating for omentin-1, there was a significant difference between the control group and HF-rEF. However, there was no significant difference for chemerin between the HF groups and the control group. Significant cutoff value for fetuin-A was found to be 485 in receiver operating characteristic analysis (area under curve: 0.74 sens: 0.72 (95% confidence interval [CI]: 0.57–0.82), spec: 0.69 (95% CI: 0.59–0.83), P < 0.001). Conclusion: Serum fetuin-A levels were found to be high in the HF-mrEF and HF-rEF groups from the HF groups and can be used in the diagnosis of the HF-rEF group.

Fetuin-A gene polymorphism and its serum level association with atherosclerotic vascular disease in type 2 diabetes patients with early diabetic kidney disease

Background: The incidence of type 2 diabetes mellitus (T2DM) is increasing over the past years. Early identification and management of its complications, especially diabetic kidney disease (DKD), is of great importance. Multiple factors play a role in the pathogenesis of T2DM and DKD. We aimed to study Fetuin-A gene polymorphisms and Fetuin-A serum levels in T2DM patients with early DKD.&#x0D; Methods: The present work was conducted on 120 patients with T2DM (60 patients with microalbuminuria and 60 without albuminuria), and 30 healthy subjects (as a control group). Serum Fetuin-A levels were measured with ELISA. Fetuin-A, Thr256Ser and Thr248Met polymorphisms were determined by PCR-RFLP.&#x0D; Results: Patients with T2DM had a significantly higher mean serum Fetuin-A compared to controls (p &lt; 0.001), while no difference was observed when comparing mean serum Fetuin-A in patients with microalbuminuria and patients without albuminuria (p = 0.916). Multivariate regression analysis demonstrated that carotid intima-media thickness (CIMT) and insulin resistance had positive correlations with serum Fetuin-A (p &lt; 0.001 and p &lt; 0.001, respectively). Ankle-brachial pressure index (ABPI) had a negative correlation with serum Fetuin-A (p=0.046), while Fetuin-A levels neither affected eGFR nor albuminuria. The distribution of the alleles of both polymorphisms showed increased frequency of TT (rs248) and GG (rs256) in patients without albuminuria compared to patients with microalbuminuria.&#x0D; Conclusion: Increased serum Fetuin-A is associated with insulin resistance and increased risk of atherosclerosis in patients with T2DM, but is not associated with the development of DKD. TT (rs248) and GG (rs256) polymorphisms may be associated with lower risk of DKD.

A pilot study of the effects of chromium picolinate supplementation on serum fetuin-A, metabolic and inflammatory factors in patients with nonalcoholic fatty liver disease: A double-blind, placebo-controlled trial

BackgroundEvaluating the impact of chromium picolinate supplementation on glycemic status, lipid profile, inflammatory markers and fetuin-A in patients with non-alcoholic fatty liver disease (NAFLD). MethodsIn present research, participants (N = 46) were randomized to (400 mcg/day, n = 23) chromium picolinate and placebo (n = 23) for 3 months. ResultsGlucose indices, and lipid profiles, inflammatory biomarker and fetuin-A were measured before and after the intervention. Chromium reduced triglyceride (TG), atherogenic index of plasma (AIP), very-low-density lipoprotein (VLDL), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), high-sensitivity C-reactive protein (hs-CRP), interleukin (IL) -6, tumor necrosis factor-alpha (TNF-α) and fetuin-A significantly compared to placebo group (p < 0.05). Furthermore, chromium significantly increased the quantitative insulin sensitivity check index (QUICKI). There were no significant differences in total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), fasting blood sugar (FBS), Hemoglobin A1c (HbA1C), interleukin (IL)-17 between the two groups (p < 0.05). ConclusionChromium picolinate significantly decreased TG, insulin, HOMA-IR, fetuin-A, the number of inflammatory factors, and increased QUICKI without changing FBS, HbA1C, TC, LDL, HDL, IL-17 levels and liver steatosis intensity in patients with NAFLD. Further studies by examining the effect of different doses of chromium and mechanisms of cellular action, would help further clarify the subject.

Retracted: Serum Fetuin-A Levels in Patients with Cardiovascular Disease: A Meta-Analysis.

[This retracts the article DOI: 10.1155/2014/691540.].

Effect of Lactobacillus delbrueckii Subsp. lactis PTCC1057 on Serum Glucose, Fetuin-A ,and Sestrin 3 Levels in Streptozotocin-Induced Diabetic Mice.

Intake of probiotic bacteria may improve or preserve insulin sensitivity. Fetuin-A and sestrin 3 have emerged as promising candidate biomarkers for crucial roles in insulin signaling pathway. Therefore, the effect of oral supplementation with the probiotic bacterium Lactobacillus delbrueckii subsp. lactis PTCC1057 on proteins involved in insulin signaling pathway was investigated in normal and streptozotocin (STZ)-induced diabetic mice. The 6-8-week-old female mice were divided into a non-diabetic control, diabetic control, and diabetic experimental and non-diabetic experimental groups (5 mice each group). Diabetic and non-diabetic experimental groups treated with 3 × 107 CFU mL-1 L. delbrueckii subsp. lactis PTCC1057 by gavage feeding approach daily for 28days. Serum glucose, fetuin-A, and sestrin 3 levels were measured by standard methods. The result showed that oral administration of L. delbrueckii significantly decreased serum glucose in comparison to diabetic control group (P = 0.01). Serum fetuin-A level was higher in diabetic control group than non-diabetic group and oral administration of L. delbrueckii subsp. lactis PTCC1057 significantly decreased fetuin-A level in diabetic experimental group in comparison with non-diabetic groups (P = 0.001). Sestrin 3 level significantly was lower in diabetic control group than non-diabetic control group (P = 0.03) and it significantly increased in diabetic experimental group in comparison with diabetic control group after intervention of L. delbrueckii subsp. lactis PTCC1057 (P = 0.02). The results show that feeding the STZ-induced diabetic mice with L. delbrueckii subsp. lactis PTCC1057 terminated to decrease in fasting blood glucose and fetuin-A level and increase in serum sestrin 3 level. Therefore, the L. delbrueckii subsp. lactis PTCC1057 can be considered as excellent candidate for future studies on diabetes mellitus.

The Relationship Between Blood Hypoxia-Inducible Factor-1α, Fetuin-A, Fibrinogen, Homocysteine, and Amputation Level.

Reduced life expectancy has resulted from an increased incidence of chronic complications in patients with diabetes. The diabetic foot is one of these complications and generally presents together with diabetic neuropathy and vascular insufficiency. Hypoxia-inducible factor-1α (HIF-1α) is important in developing the adaptation response to hypoxia and facilitates healing through regulation of keratinocyte migration and epithelium restoration in wounds. Fetuin-A is a transporter protein that is synthesized in the liver and inhibits vascular and ectopic calcifications. It has been observed that altered fetuin-A is associated with peripheral artery disease through vascular calcification and is associated with inflammation and metabolic syndrome occurrence in diabetic patients. Fibrinogen is an acute-phase reactant and has a major role in homeostasis, tissue repair, and wound healing. Increased fibrinogen blood level is one of the factors that facilitates the hypercoagulability in diabetics. Homocysteine has atherogenic features and causes vascular toxicity by enhancing low-density lipoprotein oxidation. We evaluated the association of serum HIF-1α, fetuin-A, fibrinogen, and homocysteine levels with amputation in 31 patients diagnosed with diabetes mellitus. According to our evaluation, a negative correlation was determined between fetuin-A and amputation level (P = .012, r = -0.450), which was statistically significant. Unfortunately, there was no significant correlation between HIF-1α, fibrinogen, homocysteine, and amputation level (P > .05). As a result, it was suggested that vascular calcification due to fetuin-A deficiency may be important in the diabetic foot pathogenesis and that fetuin-A levels may be a predictor for amputation level.

Relationship between vitamin D receptor gene polymorphism FokI and fetuin A as marker of vascular calcification in Egyptian hemodialysis patients

Background: Vascular calcification is a common complication in end-stage renal disease patients and the leading cause of morbidity and mortality. Aim of the work: The current work aimed to evaluate the possible relationship between vitamin D receptor gene polymorphism FokI with fetuin-A and intact parathormone hormone in Egyptian hemodialysis patients. Patient and Methods: This study is a cross-sectional study including 50 hemodialysis patients attending the hemodialysis unit in Al-Zahra University Hospital and 30 apparently healthy persons as a control group. For all studied subjects, a detailed history was taken, physical examination, carotid intima-media thickness by carotid duplex, echocardiography, Laboratory investigations included serum levels of calcium, phosphorus, iPTH, fetuin, and genotype frequency by PCR Results: There was a highly significant increase in carotid intimal media thickness in the patient group Vs. control group & a highly significant decrease in serum Fetuin-A in the patient's group Vs. control group. There was a significant difference in the genotype distribution of FokI polymorphism among patients and control. There were significant negative relationships between FF genotype and iPTH and a highly significant negative correlation between serum fetuin-A and iPTH in the patient group. Conclusion: Vitamin D receptor gene FokI polymorphism FF genotyping is more frequent in hemodialysis patients who have higher iPTH and lower fetuin-A levels, which could identify the high-risk group susceptible to vascular calcification in hemodialysis patients. Further studies are needed.

Serum Calcification Propensity in Children on Chronic Hemodialysis

Serum Calcification Propensity in Children on Chronic Hemodialysis

P0195THE RELATIONSHIP BETWEEN CALCIFICATION INHIBITOR LEVELS IN CHRONIC KIDNEY DISEASE AND THE DEVELOPMENT OF ATHEROSCLEROSIS

Abstract Background and Aims Atherosclerosis and its associated cardiovascular diseases starting from the early stages of chronic kidney disease (CKD) are the most important cause of increased morbi-mortality in the CKD process. In studies performed in patients with end-stage renal disease (ESRD), it is observed that the calcification occured in the vascular structures was an important component of the atero-arteriolosclerosis process. The number of studies investigating the relationship between vascular calcification and the development of atherosclerosis and increased morbi-mortality in the process of CKD are quite small and limited to patients undergoing hemodialysis (HD) treatment for ESRD. We aimed to investigate the factors affecting the development of atherosclerosis and the role of calcification inhibitors fetuin-A, matrix-Gla protein (MGP), osteoprotegerin (OPG) in atherosclerosis progress. Method Our study was planned to investigate the relationship of serum OPG, MGP and fetuin-A levels with the development of atherosclerosis in the stage 2-3-4-5 chronic kidney patients who did not require dialysis treatment. Thirty-two (17 female, 15 male) healthy individuals and 92 (49 females, 43 males) CKD cases were included. The healthy control group did not have a history of regular use of medication for any reason, known acute or chronic disease. Chronic kidney disease group, with no acute disease, no history of known malignancy and cerebrovascular disease. The patients' GFR was also calculated with CKD-EPI Formula. The mean carotid artery intima media thickness was calculated by dividing the sum of right and left carotid artery intima media thickness. Statistical analysis was performed with IBM SPSS Statistics 20.0.0. Results The laboratory data of the healthy control group, stage 2 CKD group, stage 3 CKD group, stage 4 CKD group and stage 5 CKD groups were statistically compared with the healthy control group, between themselves and the whole CKD group, the results were given in Table-1. Chronic kidney disease group divided into two groups; carotid artery intima media thickness less than 0.750 millimeters (without subclinical atherosclerosis) and those above 0.750 millimeters (with subclinical atherosclerosis). The mean C-IMT, CRP, FETUIN-A, OPG and MGP of the two groups were compared statistically and the results are shown in Table-2. In chronic kidney patients, age (r = 0.493, p &amp;lt;0.001), BMI (r = 0.337, p = 0.001), CRP (r = 0.301, p = 0.004), TG (r = 0.245, p = 0.019 ), urea (r = 0.228, p = 0.029), SBP (r = 0.212, p = 0.043), fasting blood sugar (r = 0.212, p = 0.043) have positive linear relationship, fetuin-A (r = -0.409, P = 0.001), OPG (r = -0.235, p = 0.024), GFR (r = -0.209, p = 0.046) have a negative linear relationship with CIMT. The multiple relationships between CIMT and other variables are given in Table-3. The mean CIMT (r =-0.417, p = 0.001), right CIMT (r = -0.412, p = 0.001), left CIMT (r = -0.410, p = 0.001), urea (r = -353, p = 0.007), CRP (r = -0.322, p = 0.014), UPE (r = -0.301, p = 0.022), creatinine (r = -0.277, p = 0.035), age (r = -0.262, p = 0.047) show a negative linear relationship with Fetuin-A. Multiple relationships between fetuin-A and other variables are given in Table-4. Conclusion Our study shows that; In particular, fetuin-A levels, which is a vascular calcification inhibitor, begin to decline from the early stages of CKD and is significantly lower in patients with atherosclerosis. This suggests that fetuin-A may be used as an early marker in CKD with increased cardiovascular mortality. On the other hand, contradictions related to the levels of OPG and MGP in CKD and its role in the development of atherosclerosis continue. The results in our study also support this situation. Reducing mortality and morbidity in CKD primarily depends on reducing the risk of cardiovascular events. Pre-recognition of these risks is important, so large-scale studies on vascular calcification inhibitors are needed.

Positive Correlation between Circulating Fetuin-A and Severity of Coronary Artery Disease in Men.

Fetuin-A serves a dual function; its high levels are associated with metabolic syndrome, type 2 diabetes, obesity, insulin resistance, and nonalcoholic fatty liver disease, and on the other hand, it serves as a potent inhibitor of ectopic vascular calcification. Due to the opposing findings, the aim of the current study was to investigate serum fetuin-A levels in men with coronary artery disease (CAD). In the case-control study, anthropometric and biochemical parameters were determined in 83 men (43 CAD patients and 40 control subjects). At last, the serum fetuin-A levels were measured using the fetuin-A human enzyme-linked immunosorbent assay (ELISA) kit. A significant difference was detected among the two groups for triglyceride and cholesterol levels (P=0.003 and P=0.002, respectively). The mean fetuin-A levels were determined 230.57 ± 63.76 and 286.35 ± 64.07 μg/ml for the control group and the CAD patients, respectively (P<0.001). Fetuin- A was significantly correlated to the severity of CAD (r 0.393, P<0.001) and associated with the risk of CAD in subjects (OR [CI] = 1. 144 [1.060-1. 235]; p = 0.001). A cut-off value of 237.4 μg/ml had good sensitivity (76.7%) and specificity (65.0%) for differentiating between two groups [area under curve (AUC) = 0.732 (CI=0.621-0.842); p < 0.001]. Our results indicated that fetuin-A levels were positively correlated to the severity of CAD. The findings suggest that there is a possible link between pathogenic mechanisms of atherosclerosis and fetuin-A; however, more investigations are needed in this regard.

Serum Fetuin-A levels are increased and associated with insulin resistance in women with polycystic ovary syndrome

BackgroundInsulin resistance (IR) is a common characteristic of women with polycystic ovary syndrome (PCOS). It has been reported that circulating Fetuin-A levels were associated with IR and type 2 diabetes mellitus (T2DM). However, previous reports were inconsistent.MethodsTwo hundred seven subjects were screened for PCOS according to the diagnostic guideline of the Rotterdam consensus criterion. Serum Fetuin-A levels were measured using an ELISA kit. An independent t-test or Nonparametric test was used to detect differences between PCOS and control groups. Spearman’s correlation analysis was used to examine the association of the serum Fetuin-A with other parameters.ResultsOur findings showed that circulating Fetuin-A concentration ranged from 196.6 to 418.2 μg/L for most women without PCOS (95%). Women with PCOS had higher circulating Fetuin-A levels than healthy women (437.9 ± 119.3 vs. 313.8 ± 60.5 μg/L; p < 0.01). Serum Fetuin-A was positively correlated with BMI, WHR, TG, TC, LDL-C, HOMA-IR, LH, T, and DHEA-S. Multivariate regression analysis showed that WHR, TG, HOMA-IR, and DHEA-S were independent predictors of the levels of circulating Fetuin-A. Binary logistic regression revealed that serum Fetuin-A was associated with the occurrence of PCOS. In addition, our ROC curve analysis found that the cutoff values for Fetuin-A to predict PCOS and IR were 366.3 and 412.6 μg/L.ConclusionBlood Fetuin-A may be a useful biomarker for screening women for PCOS and IR.

AHSG Thr256Ser Gene Polymorphism as a Predictor of Low Serum Fetuin-A Levels in Indonesian Maintenance Hemodialysis Patients

BACKGROUND: Vascular calcification (VC) is a risk factor for cardiovascular morbidity and mortality in maintenance hemodialysis (MHD) patients. The effect of alpha2-Heremans Schmid glycoprotein (AHSG) Thr256Ser gene polymorphism toward serum fetuin-A levels as one of the VC inhibitors in MHD patients is still unclear.&#x0D; OBJECTIVE: This study aims to investigate the relationship between AHSG Thr256Ser gene polymorphism toward serum fetuin-A levels in MHD patients in Indonesia.&#x0D; METHODS: The research study design used was cross-sectional. Serum fetuin-A levels were assessed by enzyme-linked immunosorbent assay method, and polymerase chain reaction-restriction fragment length polymorphism determined AHSG Thr256Ser gene polymorphism. Multivariate linear regression analysis was used to analyze the factors related to serum fetuin-A levels. p &lt; 0.05 was considered as statistically significant.&#x0D; RESULTS: Median value of serum fetuin-A levels was 235.0 pg/ml (ranging 78–756) with mean 259.99 ± 119.36 pg/ml. Out of 106 patients involved, the distribution of AHSG Thr256Ser genotype frequency was 54 (50.9%) respondents had CG genotype, 46.2% had CC genotype, and the others (2.8%) had GG genotype. Patients with homozygous C allele (CC genotype) were 0.1 times more protected (CI 95%: 0.1–0.3) to have low serum fetuin-A levels, compared with patients with G allele either in a homozygote (GG genotype) or in the heterozygote (CG genotype). From the multivariate analysis results, it can be obtained a formulation in predicting serum fetuin-A level, which is: Serum fetuin-A level prediction = 276,59 + 150,49 DM - 0,26 serum interleukin -6 level - 43,58 AHSG Thr256Ser gene polymorphism&#x0D; CONCLUSIONS: AHSG Thr256Ser gene polymorphism had a significant relationship with serum fetuin-A levels in MHD patients in Indonesia. Subjects with G allele (CG and GG genotypes) had lower serum fetuin-A levels than those with CC genotype.

Fetuin-A as a Marker of Insulin Resistance in Type 2 Diabetic Patients in Zagazig University

Background: Fetuin-A is responsible for instigating insulin resistance by inhibiting tyrosine kinase receptors. Objective: To investigate the relationship of fetuin-A with and insulin resistance in type- II diabetics either obese or non-obese of Zagazig University, Shatkia Governorate, Egypt. Patients and Methods: This is a case-control study that was conducted at the Internal Medicine Department of Zagazig University. Seventy-five participants were divided into three groups. Group-A (n =25) normal healthy individual, Group-B (n =25) non-obese type 2 diabetic patients and Group C (n=25) obese type 2 diabetic patients. Type 2 diabetic patients with no morbidities. Serum fetuin-A and insulin levels were performed by ELISA kits while fasting blood glucose (FBG), 2HPP and HA1C were determined by the enzymatic kit method. A comparison of groups was done and correlation was achieved by using Spearman correlation. Results: The results demonstrated a significant difference in mean values of fetuin-A, BMI, WHR, fasting blood glucose (FBG), 2HPP, HA1C, insulin level and Homoeostasis Model Assessment of Insulin resistance (HOMAIR) in type-II diabetics when compared to normal healthy individuals and obese type-II diabetics (p<0.01). The fetuin-A level was higher in obese more than non-obese type II diabetics. Conclusion: The study concluded that fetuin-A might be accountable for insulin resistance in type-II diabetes mellitus either obese or non-obese. So the high levels of Fetuin-A responsible for insulin resistance.

Fetuin-A as a Marker of Insulin Resistance in Type 2 Diabetic Patients in Zagazig University

Background: Fetuin-A is responsible for instigating insulin resistance by inhibiting tyrosine kinase receptors. Objective: To investigate the relationship of fetuin-A with and insulin resistance in type- II diabetics either obese or non-obese of Zagazig University, Shatkia Governorate, Egypt. Patients and Methods: This is a case-control study that was conducted at the Internal Medicine Department of Zagazig University. Seventy-five participants were divided into three groups. Group-A (n =25) normal healthy individual, Group-B (n =25) non-obese type 2 diabetic patients and Group C (n=25) obese type 2 diabetic patients. Type 2 diabetic patients with no morbidities. Serum fetuin-A and insulin levels were performed by ELISA kits while fasting blood glucose (FBG), 2HPP and HA1C were determined by the enzymatic kit method. A comparison of groups was done and correlation was achieved by using Spearman correlation. Results: The results demonstrated a significant difference in mean values of fetuin-A, BMI, WHR, fasting blood glucose (FBG), 2HPP, HA1C, insulin level and Homoeostasis Model Assessment of Insulin resistance (HOMAIR) in type-II diabetics when compared to normal healthy individuals and obese type-II diabetics (p<0.01). The fetuin-A level was higher in obese more than non-obese type II diabetics. Conclusion: The study concluded that fetuin-A might be accountable for insulin resistance in type-II diabetes mellitus either obese or non-obese. So the high levels of Fetuin-A responsible for insulin resistance.

Recurrent implantation failure is associated with increased levels of fetuin-A/alpha2-Heremans-Schmid-glycoprotein

ObjectiveRecurrent implantation failure is defined as the absence of implantation, after two or three consecutive cycles of in-vitro fertilization (IVF), intracytoplasmic sperm injection or frozen embryo replacement. Human fetuin-A/alpha2-Heremans-Schmid-glycoprotein is a plasma protein secreted by the liver that modulates insulin action in adipocytes. Increased fetuin-A promotes adipocyte dysfunction which results in decreased adiponectin and increased fatty acids and inflammatory cytokines. Fatty acids and inflammatory cytokines were previously reported in implantation failure. Also, fetuin-A inhibits receptor tyrosine kinase activity in trophoblast growth factors which decrease trophoblast viability and invasion. In this study, we aimed to find the association between fetuin-A and implantation failure. Study designA total of 78 women were included in this case-control study. Serum fetuin-A concentrations were measured in 42 women with recurrent IVF failure and 36 healthy women with regular cycles. ResultsThe mean serum fetuin-A levels of implantation failure and control women were 257.77 ± 32.18 and 219.59 ± 48.86 respectively with a p-value <0.001 (independent samples t-test). Our results showed a statistically significant difference between serum fetuin-A levels of implantation failure women and controls. ConclusionSo far reasons for implantation failure are only partially understood. The current study reveals the association between implantation failure and fetuin-A. Further studies with large population sizes are needed to investigate whether fetuin-A can be used as a marker before controlled ovarian stimulation began or regulation of fetuin-A levels with treatment or lifestyle interventions can improve implantation success.