Association of high alpha2-Heremans–Schmid glycoprotein/fetuin concentration in serum and intima-media thickness in patients with atherosclerotic vascular disease and low bone mass

AbstractObjective: Alpha2-Heremans–Schmid glycoprotein (AHSG; fetuin), a member of the cystatin superfamily of cysteine protease inhibitorsinvolved in vascular pathology and bone metabolism, has been reported to be reduced in patients with atherosclerosis and medial calcificationrelated to end stage renal disease or dialysis. No data on fetuin in patients with peripheral artery disease associated with low bone mass andnormal renal function are available in the literature. In the present study we evaluated serum fetuin concentrations, bone mass, and markersof bone turnover in patients with atherosclerosis of peripheral vessels and normal kidney function.Patients and methods: Ninety consecutive patients with evidence of atherosclerotic plaques at the common carotid or femoral artery werestudied. Severity grade of disease was documented by ultrasound measurement of intima-media thickness (IMT). Fasting serum levels offetuin were measured by sandwich enzyme immunoassay.Main results: The mean patient serum concentration of fetuin was 57.68±13.6 ng/ml, significantly higher than that of control subjects(41.6±7.6 ng/ml; p < 0.001). The mean serum concentration of bone-specific alkaline phosphatase (BAP) were 8.4±2.3g/l, significantlylower than controls (13.6±1.6g/l; p < 0.001). Fetuin was correlated with IMT (r = 0.8530; p < 0.0001) and inversely correlated with BAP(r =−0.5503; p < 0.0001). Patients had a vertebral and femoral bone mass significantly lower than controls.Conclusion: This study documented for the first time that, in patients with atherosclerosis of peripheral vessels, serum fetuin levels werehigher than in healthy subjects, and correlated with the severity of disease; further studies are required to analyse the role of AHSG as anindependent predictor of atherosclerotic disease and low bone mass in patients with normal renal function.© 2006 Elsevier Ireland Ltd. All rights reserved.