Pathogenetic role of fetuin-A in formation of metabolic disorders and systemic inflammation in patients with non-alcoholic fatty liver disease

Non‑alcoholic fatty liver disease (NAFLD) remains the leading nosology among hepatic diseases around the world. Its complex pathogenesis is not still clearly understood. Besides metabolic changes one of potential mechanisms of NAFLD development is changes in hepatokines, fetuin‑A in particular, secretion and metabolism. 
Objective — to determine the role of fetuin‑A in the development and progression of NAFLD. 
Materials and methods. The study enrolled 78 NAFLD patients with metabolic disorders and 30 volunteers as a control group. Additionally to routine examination serum concentration of fetuin‑A was determined. Statistical processing was carried out using SPSS 21. 
Results. The results showed a statistically significant increase in fetuin‑A concentrations in NAFLD patients with concomitant MS (p < 0.05). There was a direct correlation between fetuin‑A levels and parameters of abdominal (WC and WHR, p < 0.05) and visceral obesity (VAT %, p < 0.05). Concentrations of fetuin‑A were higher in polymorbid patients, especially in the combination of NAFLD with type 2 diabetes mellitus and obesity. Fetuin‑A levels was associated with changes in carbohydrates and lipids parameters. Fetuin‑A positively correlated with glycated hemoglobin (r = 0.32, p < 0.05) and index HOMA (r = 0.36, p < 0.05). There was a positive correlation between fetuin‑A level and TG (r = 0.44, p < 0.05) and LDL cholesterol (r = 0.37, p < 0.05). Furthermore, an increase in fetuin‑A was associated with an increase in activity of ALT (r = 0.39, p < 0.05) and elevation of the level of TNF‑a (r = 0.33, p < 0.05). NAFLD patients with advanced stages of steatosis and fibrosis also demonstrated higher levels of fetuin‑A (p < 0.05). 
Conclusions. The obtained data indicate a significant pathogenetic role of fetuin‑A in the development and progression of NAFLD. 
 