目的探讨血清血清胎球蛋白A(Fetuin-A)联合脂肪酸结合蛋白4(fatty acid binding protein 4,FABP4)预测2型糖尿病患者糖尿病肾病发病风险的价值。方法选取2021年8月至2023年7月西安工会医院收治的2型糖尿病患者107例,男55例,女52例,年龄(...目的探讨血清血清胎球蛋白A(Fetuin-A)联合脂肪酸结合蛋白4(fatty acid binding protein 4,FABP4)预测2型糖尿病患者糖尿病肾病发病风险的价值。方法选取2021年8月至2023年7月西安工会医院收治的2型糖尿病患者107例,男55例,女52例,年龄(61.69±9.05)岁。根据尿白蛋白/肌酐比值将患者分为正常白蛋白尿组48例、微量白蛋白尿组39例、大量白蛋白尿组20例。选择50例健康体检者作为健康对照组,男26例,女24例,年龄(60.87±8.24)岁。比较各组基本资料、FABP4、Fetuin-A、C反应蛋白(C-reactive protein,CRP)、脂联素水平和血脂血糖相关指标水平。采用方差分析、LSD-t检验、χ^(2)检验。结果正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组患者体质量指数(body mass index,BMI)分别为(24.35±3.04)kg/m^(2)、(25.06±3.12)kg/m^(2)、(24.88±2.83)kg/m^(2),均高于健康对照组的(22.48±2.83)kg/m^(2)(均P<0.05);正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组患者血清FABP4水平分别为(7.92±1.76)μg/L、(8.46±1.98)μg/L、(9.23±2.05)μg/L,Fetuin-A水平分别为(330.67±44.32)mg/L、(385.38±49.15)mg/L、(413.10±56.28)mg/L,CRP水平分别为(4.77±1.34)mg/L、(5.83±1.96)mg/L、(6.59±2.17)mg/L,均高于健康对照组的(6.77±1.32)μg/L、(224.56±31.93)mg/L、(2.36±1.11)mg/L(均P<0.05),脂联素水平分别为(7.56±2.31)mg/L、(5.21±2.09)mg/L、(4.33±1.95)mg/L,低于健康对照组的(11.12±2.43)mg/L(均P<0.05);正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组患者空腹血糖(fasting blood glucose,FBG)分别为(8.23±2.79)mmol/L、(8.48±3.18)mmol/L、(8.51±3.26)mmol/L,糖化血红蛋白(glycosylated hemoglobin,type A1C,HbA1c)分别为(8.79±1.35)%、(8.96±1.47)%、(9.04±1.52)%,低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)分别为(3.35±0.71)mmol/L、(3.26±0.72)mmol/L、(3.51±0.77)mmol/L,总胆固醇(total cholesterol,TC)分别为(5.15±0.97)mmol/L、(5.08±0.95)mmol/L、(5.18±0.97)mmol/L,三酰甘油(triacylglycerol,TG)水平分别为(1.69±0.73)mmol/L、(1.82±0.85)mmol/L、(1.84±0.79)mmol/L,均高于健康对照组的(4.52±0.67)mmol/L、(5.18±1.03)%、(2.28±0.57)mmol/L、(4.52±0.85)mmol/L、(1.24±0.42)mmol/L(均P<0.05),高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)水平分别为(1.12±0.47)mmol/L、(1.15±0.50)mmol/L、(1.17±0.48)mmol/L,低于健康对照组的(1.36±0.28)mmol/L(P=0.030);正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组患者餐后2 h血糖差异无统计学意义(P>0.05);2型糖尿病患者肾病发病风险随着血清Fetuin-A、FABP4水平升高而增加(均P<0.05);血清Fetuin-A联合FABP4预测2型糖尿病患者肾病发病风险的曲线下面积(AUC)为0.873(95%CI 0.782~0.963,P<0.001),灵敏度85.17%,特异度84.44%。结论血清Fetuin-A联合FABP4预测2型糖尿病患者肾病发病风险有较高的特异度和灵敏度,具有一定预测价值。展开更多
目的:探讨维持性血液透析患者心脏瓣膜钙化与血清白细胞介素-1β(Interleukin-1β,IL-1β)、超敏C反应蛋白(High sensitive C reactive protein,hs-CRP)、胎球蛋白-A(Fetuin-A)之间的关系。方法:2013年1月~2016年2月,176例维持性血液透...目的:探讨维持性血液透析患者心脏瓣膜钙化与血清白细胞介素-1β(Interleukin-1β,IL-1β)、超敏C反应蛋白(High sensitive C reactive protein,hs-CRP)、胎球蛋白-A(Fetuin-A)之间的关系。方法:2013年1月~2016年2月,176例维持性血液透析治疗患者中,116例并发心脏瓣膜钙化(Ⅰ度钙化46例,Ⅱ度钙化39例,Ⅲ度钙化31例)和60例无心脏瓣膜钙化分别设为钙化组、对照组,分析透析前组间及不同程度钙化患者血清IL-1β、hs-CRP、Fetuin-A浓度的差异及三者之间的关系。结果:(1)相较与对照组,钙化组血清IL-1β、hs-CRP高(P<0.05),血清Fetuin-A低(P<0.05)。(2)血清IL-1β、hs-CRP,Ⅲ度钙化高于Ⅰ、Ⅱ度钙化(P<0.05),Ⅱ度钙化高于Ⅰ度钙化(P<0.05);血清Fetuin-A,Ⅲ度钙化低于Ⅰ、Ⅱ度钙化(P<0.05),Ⅱ度钙化低于Ⅰ度钙化(P<0.05)。(3)钙化组中,血清IL-1β与hs-CRP呈正相关(P<0.05),血清Fetuin-A与IL-1β、hs-CRP呈负相关(P<0.05),对照组三者无明显相关性(P>0.05)。结论:血清IL-1β、hs-CRP、Fetuin-A与维持性血液透析患者心脏瓣膜钙化有关,且三者相关性明确,可考虑联合检测三者以辅助预防心脏瓣膜钙化。展开更多
AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced...AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced age-related macular degeneration(ARMD) in comparison to healthy controls. METHODS: The subjects were 40 patients with choroidal neovascularization(CNV) having a mean age of70.9 ±9.1y and a matched group of 49 apparently healthy control subjects. The ARMD was diagnosed using a slitlamp with superfield lens, fundus photography and fluorescein angiography. Measurement of hs CRP was done by nephelometry method. Levels of Fetuin-A and MGP were measured by enzyme-linked immunosorbent assay(ELISA) technique.RESULTS: hs CRP [0.45(0.07-2.63) mg/L vs 0.25(0.03-1.2) mg/L, P =0.02)] and Fetuin-A levels(50.27 ±5.04 vs44.99±10.28 ng/m L, P =0.009) were higher in the patients than in the control groups. We could not find significant difference in MGP level between two groups(P =0.08).There was not a significant correlation between MGP with Fetuin-A and hs CRP among the patients(P =0.7, P =0.9respectively). A significant negative correlation of hs CRP with Fetuin-A was observed in both case and control groups(P =0.004, r =-0.33 and P =0.001, r =-0.54,respectively).CONCLUSION: Although our study shows that serum hs CRP and Fetuin-A is increased in CNV patients as well as negatively correlated with both study groups, their direct role on pathogenesis of ARMD required future studies.展开更多
Background and Aims:Accumulated studies have reported the key role of circulating fetuin-A in the development and progression of nonalcoholic fatty liver disease(NAFLD)but the results have not been consistent.In this ...Background and Aims:Accumulated studies have reported the key role of circulating fetuin-A in the development and progression of nonalcoholic fatty liver disease(NAFLD)but the results have not been consistent.In this study,we performed a systematic review and meta-analysis to explore the relationship between circulating fetuin-A level and the development and classification of NAFLD.Methods:The PubMed,EMBASE,and Cochrane Library databases were searched to obtain the potentially relevant studies up to May 2020.Standardized mean differences(SMD)and 95%confidence intervals of circulating fetuin-A levels were extracted and summarized.Sensitivity,subgroup analysis and meta-regression analysis were performed to investigate the potential heterogeneity.Association of circulating fetuin-A level with classification of NAFLD was also reviewed.Results:A total of 17 studies were included,composed of 1,755 NAFLD patients and 2,010 healthy controls.Meta-analysis results showed that NAFLD patients had higher circulating fetuin-A level(SMD=0.43,95%confidence interval[CI]:0.22-0.63,p<0.001)than controls.Subgroup analysis indicated that circulating fetuin-A level was markedly increased in adult NAFLD patients(SMD=0.48,95%CI:0.24-0.72,p<0.001)and not in pediatric/adolescent patients compared to controls.Circulating fetuin-A level was markedly increased in ultrasound-proven NAFLD pediatric/adolescent patients(SMD=0.42,95%CI:0.12-0.72,p=0.007),other than in the liver biopsy-proven NAFLD pediatric/adolescent patients.Body mass index might be the influencing factor to the heterogeneity in adult patients.Circulating fetuin-A level was not associated with the classification of NAFL vs.nonalcoholic steatohepatitis(NASH).Whether the circulating fetuin-A level was associated with the development of fibrosis remains controversial.展开更多
Bisphenol A(BPA)is an endocrine disruptor present in polycarbonate plastics used in food containers and water bottles that resists insulin action and leads to type 2 diabetes mellitus(T2DM).However,there is scant rese...Bisphenol A(BPA)is an endocrine disruptor present in polycarbonate plastics used in food containers and water bottles that resists insulin action and leads to type 2 diabetes mellitus(T2DM).However,there is scant research on the impact of BPA on T2DM-related vascular complications.Fetuin-A(FTA)and osteoprotegerin(OPG)are crucial markers for vascular calcification,which is the primary risk factor for developing vascular complications.This study aims to link external factor BPA levels with the vascular calcification markers FTA and OPG in diabetic subjects with and without vascular complications.Therefore,120 study subjects were included and divided as control(n=30),T2DM with cardiovascular diseases(CVD)(n=30),T2DM with diabetic nephropathy(DN)(n=30),and T2DM without vascular complications(n=30).Serum and urinary FTA,OPG,and BPA levels were measured using an ELISA.FTA(AHSG)and OPG(TNFRSF11B)gene expression were analyzed using qPCR.Both serum(p<0.001)and urinary BPA(p<0.001)were found higher in T2DM with CVD and DN than T2DM without vascular complications and control.Also,T2DM with CVD and DN patients had lower serum and urinary FTA protein levels and increased serum and urinary OPG(p<0.001)levels than T2DM without vascular complications and control.Moreover,FTA(AHSG)gene expression was negatively associated with serum BPA(p<0.001)and urinary BPA(p<0.01).Likewise,OPG(TNFRSF11B)gene expression was positively significant with serum BPA(p<0.001)and urinary BPA(p<0.01)in the study groups.These findings suggest that elevated blood and urinary BPA levels contribute to the severity of vascular complications in T2DM patients through vascular calcification.展开更多
文摘目的:探讨维持性血液透析患者心脏瓣膜钙化与血清白细胞介素-1β(Interleukin-1β,IL-1β)、超敏C反应蛋白(High sensitive C reactive protein,hs-CRP)、胎球蛋白-A(Fetuin-A)之间的关系。方法:2013年1月~2016年2月,176例维持性血液透析治疗患者中,116例并发心脏瓣膜钙化(Ⅰ度钙化46例,Ⅱ度钙化39例,Ⅲ度钙化31例)和60例无心脏瓣膜钙化分别设为钙化组、对照组,分析透析前组间及不同程度钙化患者血清IL-1β、hs-CRP、Fetuin-A浓度的差异及三者之间的关系。结果:(1)相较与对照组,钙化组血清IL-1β、hs-CRP高(P<0.05),血清Fetuin-A低(P<0.05)。(2)血清IL-1β、hs-CRP,Ⅲ度钙化高于Ⅰ、Ⅱ度钙化(P<0.05),Ⅱ度钙化高于Ⅰ度钙化(P<0.05);血清Fetuin-A,Ⅲ度钙化低于Ⅰ、Ⅱ度钙化(P<0.05),Ⅱ度钙化低于Ⅰ度钙化(P<0.05)。(3)钙化组中,血清IL-1β与hs-CRP呈正相关(P<0.05),血清Fetuin-A与IL-1β、hs-CRP呈负相关(P<0.05),对照组三者无明显相关性(P>0.05)。结论:血清IL-1β、hs-CRP、Fetuin-A与维持性血液透析患者心脏瓣膜钙化有关,且三者相关性明确,可考虑联合检测三者以辅助预防心脏瓣膜钙化。
基金Supported by the vice-chancellor for research of Tabriz University of Medical Sciences, Tabriz, Iran
文摘AIM: To evaluate the high sensitivity C-reactive protein(hs CRP), Fetuin-A and matrix γ-carboxyglutamate protein(MGP) as the main factors for vascular calcification and inflammation in serum of patients with advanced age-related macular degeneration(ARMD) in comparison to healthy controls. METHODS: The subjects were 40 patients with choroidal neovascularization(CNV) having a mean age of70.9 ±9.1y and a matched group of 49 apparently healthy control subjects. The ARMD was diagnosed using a slitlamp with superfield lens, fundus photography and fluorescein angiography. Measurement of hs CRP was done by nephelometry method. Levels of Fetuin-A and MGP were measured by enzyme-linked immunosorbent assay(ELISA) technique.RESULTS: hs CRP [0.45(0.07-2.63) mg/L vs 0.25(0.03-1.2) mg/L, P =0.02)] and Fetuin-A levels(50.27 ±5.04 vs44.99±10.28 ng/m L, P =0.009) were higher in the patients than in the control groups. We could not find significant difference in MGP level between two groups(P =0.08).There was not a significant correlation between MGP with Fetuin-A and hs CRP among the patients(P =0.7, P =0.9respectively). A significant negative correlation of hs CRP with Fetuin-A was observed in both case and control groups(P =0.004, r =-0.33 and P =0.001, r =-0.54,respectively).CONCLUSION: Although our study shows that serum hs CRP and Fetuin-A is increased in CNV patients as well as negatively correlated with both study groups, their direct role on pathogenesis of ARMD required future studies.
基金supported by grants from the National Natural Science Foundation of China(No.31770837).
文摘Background and Aims:Accumulated studies have reported the key role of circulating fetuin-A in the development and progression of nonalcoholic fatty liver disease(NAFLD)but the results have not been consistent.In this study,we performed a systematic review and meta-analysis to explore the relationship between circulating fetuin-A level and the development and classification of NAFLD.Methods:The PubMed,EMBASE,and Cochrane Library databases were searched to obtain the potentially relevant studies up to May 2020.Standardized mean differences(SMD)and 95%confidence intervals of circulating fetuin-A levels were extracted and summarized.Sensitivity,subgroup analysis and meta-regression analysis were performed to investigate the potential heterogeneity.Association of circulating fetuin-A level with classification of NAFLD was also reviewed.Results:A total of 17 studies were included,composed of 1,755 NAFLD patients and 2,010 healthy controls.Meta-analysis results showed that NAFLD patients had higher circulating fetuin-A level(SMD=0.43,95%confidence interval[CI]:0.22-0.63,p<0.001)than controls.Subgroup analysis indicated that circulating fetuin-A level was markedly increased in adult NAFLD patients(SMD=0.48,95%CI:0.24-0.72,p<0.001)and not in pediatric/adolescent patients compared to controls.Circulating fetuin-A level was markedly increased in ultrasound-proven NAFLD pediatric/adolescent patients(SMD=0.42,95%CI:0.12-0.72,p=0.007),other than in the liver biopsy-proven NAFLD pediatric/adolescent patients.Body mass index might be the influencing factor to the heterogeneity in adult patients.Circulating fetuin-A level was not associated with the classification of NAFL vs.nonalcoholic steatohepatitis(NASH).Whether the circulating fetuin-A level was associated with the development of fibrosis remains controversial.
文摘Bisphenol A(BPA)is an endocrine disruptor present in polycarbonate plastics used in food containers and water bottles that resists insulin action and leads to type 2 diabetes mellitus(T2DM).However,there is scant research on the impact of BPA on T2DM-related vascular complications.Fetuin-A(FTA)and osteoprotegerin(OPG)are crucial markers for vascular calcification,which is the primary risk factor for developing vascular complications.This study aims to link external factor BPA levels with the vascular calcification markers FTA and OPG in diabetic subjects with and without vascular complications.Therefore,120 study subjects were included and divided as control(n=30),T2DM with cardiovascular diseases(CVD)(n=30),T2DM with diabetic nephropathy(DN)(n=30),and T2DM without vascular complications(n=30).Serum and urinary FTA,OPG,and BPA levels were measured using an ELISA.FTA(AHSG)and OPG(TNFRSF11B)gene expression were analyzed using qPCR.Both serum(p<0.001)and urinary BPA(p<0.001)were found higher in T2DM with CVD and DN than T2DM without vascular complications and control.Also,T2DM with CVD and DN patients had lower serum and urinary FTA protein levels and increased serum and urinary OPG(p<0.001)levels than T2DM without vascular complications and control.Moreover,FTA(AHSG)gene expression was negatively associated with serum BPA(p<0.001)and urinary BPA(p<0.01).Likewise,OPG(TNFRSF11B)gene expression was positively significant with serum BPA(p<0.001)and urinary BPA(p<0.01)in the study groups.These findings suggest that elevated blood and urinary BPA levels contribute to the severity of vascular complications in T2DM patients through vascular calcification.
