Plasma fetuin- A is associated with endothelial dysfunction and subclinical atherosclerosis in subjects with nonalcoholic fatty liver disease.

Objective Nonalcoholic fatty liver disease ( NAFLD), a hepatic manifestation of metabolic syndrome ( Met S) is closely associated with an increased risk of cardiovascular disease. Fetuin- A is associated with Met S and NAFLD. We investigated the relationship of circulating fetuin- A level with markers of endothelial dysfunction and presence of carotid atherosclerosis in subjects with NAFLD. Methods The consecutive 115 patients with NAFLD and age-matched 74 healthy subjects were enrolled. Plasma levels of fetuin- A and markers of endothelial dysfunction [asymmetric dimethyl arginine ( ADMA) and adiponectin] were measured by ELISA method. Insulin sensitivity was determined by homeostasis model assessment of insulin resistance ( HOMA- IR) index. Carotid artery intima-media thickness ( cIMT) was assessed by high-resolution ultrasonography. Results Fetuin- A and ADMA were higher and, adiponectin was lower in NAFLD group than the control group ( P = 0·004, P < 0·001 and P < 0·001, respectively). In addition, NAFLD group had greater c IMT measurements than the controls ( P < 0·001). However, no difference was found for fetuin- A, ADMA, adiponectin and c IMT between two groups when the findings were adjusted according to the glucose, lipids and HOMA- IR index. In correlation analysis, fetuin- A was found to be positively correlated with triglyceride ( r = 0·23, P = 0·001), HOMA- IR ( r = 0·29, P < 0·001), ADMA ( r = 0·24, P = 0·001), c IMT ( r = 0·3, P = 0·003) and, negatively correlated with HDL- C ( r = −0·17, P = 0·02) and adiponectin ( r = −0·19, P = 0·01) levels. Multiple linear regression analysis showed that fetuin- A was independently associated with ADMA and c IMT levels. Conclusion This study demonstrated for the first time that circulating fetuin- A in NAFLD is independently associated with endothelial dysfunction and subclinical atherosclerosis. [ABSTRACT FROM AUTHOR]