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Association of serum fetuin A with truncal obesity and dyslipidemia in non-diabetic hemodialysis patients

¹ Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, 21, Nan-Ya S. Road, Sec.2 Pan-Chiao, Taipei 200, Taiwan ROC² Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan South Road, Taipei 100, Taiwan ROC

(Correspondence should be addressed to K-Y Hung; Email: kyhung{at}ntu.edu.tw)

Background: Fetuin A, a predictor of cardio-vascular (CV) mortality in dialysis patients has been associated with dyslipidemia in non-diabetic coronary artery disease. Truncal obesity is linked to dyslipidemia and also predicts CV mortality. This study had aimed to investigate the associations among fetuin A, truncal obesity, and dyslipidemia in hemodialysis (HD) patients.

Methods: One hundred and nine non-diabetic HD patients were evaluated. Waist circumference, highly sensitive C-reactive protein (hs-CRP), fetuin A, and lipoprotein levels (i.e. total cholesterol (T-CHO), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), non-HDL-C, and triglyceride (TG)) were measured for analysis of correlations. The patients were divided into tertiles by fetuin A concentrations.

Results: Data from 63 women and 46 men aged 60±13 years were analyzed. Patients in the highest tertile of fetuin A (0.33–0.51 g/l) had higher serum creatinine, albumin, T-CHO, LDL-C, non-HDL-C, and TG, more truncal obesity and lower hs-CRP than patients in the lowest tertile (all P<0.05). In multi-variable linear regression analysis, fetuin A was independently associated with TG level and total iron binding capacity after adjustments for age, hemoglobin, albumin, calcium, body mass index, and hs-CRP. Patients in the highest fetuin A tertile had 3.2- and 4.4-fold higher incidence of truncal obesity (P=0.038) and hyper-triglyceridemia (P=0.015) independent of nutritional status and inflammation.

Conclusion: Fetuin A is positively associated with truncal obesity and dyslipidemia, which are independent of malnutrition and inflammation. It may predict visceral adiposity and dyslipidemia, especially TG and TG-rich lipoproteins, in HD patients.