Human fetuin/α2HS-glycoprotein level as a novel indicator of liver cell function and short-term mortality in patients with liver cirrhosis and liver cancer
ABSTRACT Human fetuin/alpha2HS-glycoprotein (AHSG) is synthesized by hepatocytes. We intended to determine whether liver dysfunction or acute phase reaction is dominant in the regulation of its serum concentrations and to see if decreased AHGS levels are associated with short-term mortality.
We determined the serum AHSG levels in patients with acute alcoholic, acute A, B, and Epstein-Barr virus hepatitis, alcoholic cirrhosis, and hepatocellular cancer and correlated them to conventional laboratory parameters of inflammation and liver function. Patients were followed for 1 month.
Serum AHSG was determined by radial immunodiffusion.
Compared to controls, significantly lower AHSG levels were found in patients with liver cirrhosis and hepatocellular cancer but not the acute viral hepatitides. Strong positive correlation with serum transferrin, albumin and prothrombin was found. Febrile episodes were not associated with significantly decreased AHSG levels. Concentrations below 300 microg/ml were associated with high mortality rate (52.0%; relative risk, 5.497; 95% confidence interval, 2.472-12.23; P < 0.0001). Of all laboratory parameters studied serum AHSG levels showed the greatest difference between deceased and survived patients with cirrhosis and cancer. Moreover, other acute phase reactants did not differ significantly. The multiple logistic regression analysis indicated that the decrease of serum AHSG is independent of all other variables that were found decreased in deceased patients.
Decreased serum AHSG concentration is due rather to hepatocellular dysfunction than the acute phase reaction and is an outstanding predictor of short-term mortality in patients with liver cirrhosis and liver cancer.
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ABSTRACT: Breast and cervical cancers are both common malignancies in Hungarian women. The aim of this study was to evaluate the impact of nationwide screening programs on the incidence and mortality of breast and cervical cancers and to assess the role of primary care providers in this context. Published records from 2000-2011 on breast and cervical cancer screening activities in Hungary were reviewed. Previously unpublished data from the Hungarian National Cancer Registry were also included in this review. Hungarian outcomes were compared to international results. A nationwide screening program for breast cancer was established in Hungary in 2001. A similar program for cervical cancer was subsequently initiated in 2003. As of 2009, 50% of the population at risk took advantage of breast cancer screening, while the exact participation rate for cervical cancer screening could not be established due to deficiencies of reporting by private gynecologists. The Health Visitors Cervical Screening Program, a new initiative within the context of the nationwide cervical screening program, based on involvement of local primary care providers, had encouraging results which substantially raised participation rates. However, deficiencies were identified regarding flow of information between service providers, patients, and family physicians. There was a slight reduction in the incidence of breast cancer and a more pronounced reduction in the incidence of cervical cancer, as well as a reduction in mortality for both breast and cervical cancers associated with these screening initiatives. The inclusion of primary care providers may benefit nationwide screening programs by raising participation rates in the target population.European journal of gynaecological oncology 01/2013; 34(5):419-24. · 0.60 Impact Factor
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ABSTRACT: Human fetuin/alpha(2)-HS-glycoprotein (AHSG) is a 49 kDa serum and tissue protein which is a natural inhibitor of insulin receptor signaling. We investigated serum AHSG levels during pregnancy and whether the protein is involved in insulin resistance observed in healthy pregnant women and patients with gestational diabetes. One hundred and four healthy pregnant women and 23 of their neonates, 30 patients with gestational diabetes and their neonates and 30 healthy age-matched non-pregnant females as a control group were investigated in a case-control cross-sectional study. Serum AHSG was determined by radial immunodiffusion. We observed an increase of serum AHSG concentration in the second and third trimesters. Gestational diabetes patients had significantly higher AHSG levels than healthy pregnant women and non-pregnant controls. There was a highly significant positive correlation between serum AHSG concentration and indirect parameters of insulin resistance, i.e. tumor necrosis factor-alpha (TNF-alpha), leptin, C-peptide and C-peptide/blood glucose ratio. There was also a negative correlation between maternal AHSG, TNF-alpha, leptin levels and head circumference, body length and body weight of newborns. AHSG, TNF-alpha and leptin may contribute to insulin resistance during normal pregnancy and gestational diabetes. AHSG along with these cytokines may also negatively regulate neonatal skeletal development.European Journal of Endocrinology 09/2002; 147(2):243-8. DOI:10.1530/eje.0.1470243 · 3.69 Impact Factor