A Study of Fetuin A in Fatty Liver (NAFLD) With and Without Chronic Kidney Disease
Authors: Makhlouf Mohamed A , Allah Ahmed M , Ahmed Ghada A , Ahmed Ahmed E 
Published: October 2021

Abstract

Background
Obesity and insulin resistance are known risk factors for both chronic kidney disease (CKD) and nonalcoholic fatty liver disease (NAFLD). Further studies identify mechanisms common to both diseases linked through an inter-organ communication orchestrated by fetuin-A and adiponectin.

Aim of the Work
to determine the serum level of Fetuin A in cases of non- alcoholic fatty liver disease (NAFLD), as compared to normal controls. Also, as a main objective, is to determine the serum level of Fetuin A in cases of chronic kidney disease (CKD), as compared to normal controls, and try to correlate it to the severity of the disease.

Patients and Methods
This cross sectional cohort study was conducted on 80 persons divided into 4 groups: Group I: Includes 20 Healthy adult normal controls, Group II: Includes 20 adult patients with NAFLD, Group III: Includes 20 adult patients with CKD & NAFLD and Group IV: Includes 20 adult patients with CKD.

Results
We detected that there is statistically significant difference between the four studied groups regarding Weight, Height & BMI (P &lt; 0.05). However there is a statistically insignificant difference between the four studied groups regarding Age & Gender (P &gt; 0.05). That there is statistically significant difference between the four studied groups regarding Serum Feutin-A (P &lt; 0.05). There is statistically significant positive correlation between Serum Feutin-A & (Weight, BMI, Systolic BP, Urea, Creatinine, Sodium, Calcium, Phosphorous, Cholesterol, Triglyceride, LDL, ALT, AST, FBS, 2hr PP & RBS); In addition to that there is a statistically significant negative correlation between Serum Feutin-A & (Height, HDL & Albumin) (P &lt; 0.05). There is statistically significant negative correlation between Serum Feutin-A & (HDL) in Group I “Adult Normal Controls” (P &lt; 0.05). The results revealed a statistically significant positive correlation between Serum FeutinA & (FBS); In addition to that there is a statistically significant negative correlation between Serum Feutin-A & (Diastolic BP) (P &lt; 0.05). We detected that there is statistically significant positive correlation between Serum Feutin-A & (FBS), (2 hr PP)(RBS), Serum urea &Creatinine and potassium.; In addition to that there is a statistically significant negative correlation between Serum Feutin-A & (Diastolic BP) and (Systolic BP) (P &lt; 0.05). We detected that there is statistically significant positive correlation between Serum Feutin-A & (LDL, Calcium, Triglyceride & Creatinine); In addition to that there is a statistically significant negative correlation between Serum Feutin-A & (HR) (P &lt; 0.05).

Conclusions
Fetuin-A is a glycoprotein in the liver and a potent inhibitor of vascular calcification in the blood circulation in patients with chronic renal failure and end-stage kidney failure. It is also known as a vascular disease marker in patients with type 2 diabetes. It is increased during insulin resistance and non-alcoholic fatty liver, as well. Serum Fetuin-A concentrations are significantly reduced in patients with CKD. This decrease in Fetuin-levels is progressive, beginning from the early stages of CKD.