Do Nonalcoholic Fatty Liver Disease and Fetuin-A Play Different Roles in Symptomatic Coronary Artery Disease and Peripheral Arterial Disease?

BACKGROUND AND AIMS

Nonalcoholic fatty liver disease (NAFLD) is strongly associated with both atherosclerotic cardiovascular disease (CVD) and Fetuin-A. However, the association of Fetuin-A with atherosclerosis is more controversial. We hypothesized that the pathogenic interplay of NAFLD, Fetuin-A and atherosclerosis varies based on arterial site. Accordingly, we aimed to assess NAFLD prevalence, Fetuin-A values and their relationship with symptomatic atherosclerosis occurring in different localizations: coronary artery disease (CAD) vs. peripheral arterial disease (PAD).

METHODS

One hundred and forty-nine consecutive patients with symptomatic atherosclerotic CVD were recruited: 45 with CAD diagnosed by coronary angiography and 104 with PAD detected by doppler-ultrasound and/or computed tomography angiography and/or angiography. NAFLD was diagnosed based on both ultrasonography and exclusion of competing etiologies. Serum Fetuin-A was measured with ELISA.

RESULTS

NAFLD was detected in 54% of the overall group, with higher rates in PAD (59%) than CAD (42%) patients. Median Fetuin-A values were 256 (111-662) μg/mL, higher in patients with CAD (378 (124-662) μg/mL) than those with PAD (236 (111-461) μg/mL). The main findings were: (1) CAD patients had higher Fetuin-A values and less frequently NAFLD than PAD patients; (2) NAFLD was positively associated with Fetuin-A values; however, this association was limited to CAD patients only; (3) Fetuin-A values were positively associated with both CAD and NAFLD.

CONCLUSION

The pathogenic interplay of NAFLD, Fetuin-A and atherosclerosis probably varies according to the arterial site.

Atrial fibrillation following therapy with high-dose i.v. methylprednisolone: A brief case-based review

Atrial fibrillation following high-dose i.v. steroids for treatment of severe immune-mediated diseases has been rarely reported in the literature. Here we report a further case of atrial fibrillation following high-dose i.v. methylprednisolone (HDIVMP) therapy of severe thrombocytopenia in a female patient with a flare-up of systemic lupus erythematosus (SLE). The available literature on this topic is reviewed as well.