SERUM FETUIN-A LEVEL IN PATIENTS WITH CHRONIC LIVER DISEASE AND HEPATOCELLULAR CARCINOMA

Introduction: Assessment of the levels of glycoproteins as fetuin-A which provides insights into the pathogenic mechanisms of various liver diseases and improved capability to identify disease-specific profiles of proteins leads to accurate prediction of disease classes and development of novel treatments. Aim of work: The aim of this study was to evaluate the levels of fetuin-A and its relationship with the severity of cirrhosis and hepatocellular carcinoma. Methods: This study included three groups. Group A (n= 30) are patients with liver cirrhosis, Child–Pugh class A (n=10), class B (n=10) and C (n=10). Group B (n=10) are patients with hepatocellular carcinoma. Group C (n=10) are healthy subjects matched for age and sex as a control. All subjects were subjected to : thorough history, clinical examination, routine laboratory investigations including liver function tests, renal function tests, urine analysis, complete blood count, lipid profile, fasting and postprandial blood glucose, hepatitis Bs Ag, hepatitis B core Ab, HCV Ab, alpha-fetoprotein, abdominal ultrasound, abdominal triphasic computed tomography, serum fetuin-A. In addition, cardiac assessment using resting electrocardiography and echocardiography done. Results: Serum levels of fetuin-A showed statistically significant difference among patients with liver cirrhosis; marked decrease in the mean levels with the increased severity of the disease. Fetuin-A (ug/ml) significantly decreased in class C (mean 346.07±10.9) than class B (mean 411.1±17.04) than class A (mean 444.1±40.5). Fetuin-A (ug/ml) was significantly lower in HCC patients (mean 307.2±31.2) in comparison with liver cirrhosis patients (mean 400.4±48.5) than in controls (mean 551.3±42.3). There was significant negative correlation between serum fetuin A with the scores of the Child–Pugh (r= -0.82, p<0.001). There were significant negative correlations of serum fetuin-A-levels with bilirubin (r = -0.68, p <0.001), INR (r = -0.56, p <0.001), the degree of ascites (r = -0.80, p <0.001) and the grade of HE (r = -0.33, p <0.001) while there was high significant positive correlation of serum fetuin-A-levels with the level of albumin (r = 0.61, p <0.001). Conclusion: Fetuin-A was significantly lower in patients with liver cirrhosis and hepatocellular carcinoma than in healthy controls with lower levels in patients with hepatocellular carcinoma than liver cirrhosis. In patients with cirrhosis, marked decrease in the mean levels with the increased severity of the disease noticed