Background Fetuin A, synthesized in hepatocyte, is a circulatory inhibitor of precipitation
of calcium and phosphate and links to cardiovascular calcification and mortality in dialysis
patients; besides, it is associated with insulin resistance in general population. Hepatic
fat accumulation enhanced fetuin A secretion in animal model.
Objects This study is designed to investigate the association of fetuin A level, insulin
resistance and hepatic fat content in dialysis patients. Besides, we planed to observe the
survival of dialysis patient with different hepatic fat content.
Methods. This is a prospective observational study. Three hundred and fifty ESRD patients
undergoing maintenance HD or PD will be recruited for this prospective investigation. All the
participants will receive baseline abdominal ultrasound for estimation of hepatic fat
content. Hepatic fat content will be estimated as minimal, mild, moderate or severe according
to the Hepburn classification. Besides, all participants also check baseline fetuin A,
HOMA-IR, hs-CRP, adiponectin, leptin and lipid profiles (T-CHO, TG, LDL-C, HDL-C),
nutritional parameter and other biochemical parameters. All participants will be followed for
4 years for survival analysis. The outcomes are all-cause mortality and composite CV
Expected results Dialysis patients with higher hepatic fat may have higher fetuin A levels
which may lead to long-term survival benefits.