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Plasma fetuin-A levels and the risk of type 2 diabetes.

Stefan N, Fritsche A, Weikert C, Boeing H, Joost HG, Häring HU, Schulze MB - Diabetes (2008)

Bottom Line: The association remained significant after adjustment for sex, BMI, waist circumference, and lifestyle risk factors (RR for 10 mug/ml 1.03 [1.01-1.06]).Adjustment for glucose, triglycerides, HDL cholesterol, A1C, gamma-glutamyltransferase, or high-sensitivity C-reactive protein or mutual adjustment for these biomarkers did not appreciably change this result (RR for 10 mug/ml full adjusted model 1.05 [1.02-1.07]).Furthermore, fetuin-A was associated with increased diabetes risk particularly in individuals with elevated plasma glucose.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, University of Tübingen, Tübingen, Germany.

ABSTRACT

Objective: The liver-secreted protein fetuin-A induces insulin resistance in animals, and circulating fetuin-A is elevated in insulin resistance and fatty liver in humans. We investigated whether plasma fetuin-A levels predict the incidence of type 2 diabetes in a large prospective, population-based study.

Research design and methods: A case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study comprising 27,548 subjects was designed. We randomly selected a subcohort of 2,500 individuals of whom 2,164 were diabetes free at baseline and had anamnestic, anthropometrical, and metabolic data for analysis. Of the 849 incident diabetic case subjects identified in the full cohort during 7 years of follow-up, 703 remained for analyses after similar exclusions.

Results: Plasma fetuin-A levels were positively associated with diabetes risk after adjustment for age (relative risk [RR] for extreme quintiles 1.75 [95% CI 1.32-2.31]; RR for 10 mug/ml 1.04 [1.03-1.06]). The association remained significant after adjustment for sex, BMI, waist circumference, and lifestyle risk factors (RR for 10 mug/ml 1.03 [1.01-1.06]). Adjustment for glucose, triglycerides, HDL cholesterol, A1C, gamma-glutamyltransferase, or high-sensitivity C-reactive protein or mutual adjustment for these biomarkers did not appreciably change this result (RR for 10 mug/ml full adjusted model 1.05 [1.02-1.07]). Furthermore, fetuin-A was associated with increased diabetes risk particularly in individuals with elevated plasma glucose.

Conclusions: Our data suggest that fetuin-A is an independent risk factor of type 2 diabetes.

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Related in: MedlinePlus

Age-adjusted RR of type 2 diabetes by quintiles of plasma fetuin-A (μg/ml) among men and women in the EPIC-Potsdam Study. P for trend <0.001. Medians (ranges) for quintiles are as follows: quintile 1, 162 μg/ml (14–184); quintile 2, 202 μg/ml (185–214); quintile 3, 227 μg/ml (215–240); quintile 4, 255 μg/ml (241–271); quintile 5, 295 μg/ml (272–442).
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f1: Age-adjusted RR of type 2 diabetes by quintiles of plasma fetuin-A (μg/ml) among men and women in the EPIC-Potsdam Study. P for trend <0.001. Medians (ranges) for quintiles are as follows: quintile 1, 162 μg/ml (14–184); quintile 2, 202 μg/ml (185–214); quintile 3, 227 μg/ml (215–240); quintile 4, 255 μg/ml (241–271); quintile 5, 295 μg/ml (272–442).

Mentions: Baseline characteristics and metabolic traits across quintiles of fetuin-A of the random subcohort are presented in Table 1. Participants with higher fetuin-A concentrations were younger, were less likely to be men, and drank smaller amounts of alcohol compared with participants with lower fetuin-A concentrations. Supplementary Fig. 1 shows the frequency distribution for men and women across the range of plasma fetuin-A levels (14–442 μg/ml [mean ± SD 129 ± 53 μg/ml]).


Plasma fetuin-A levels and the risk of type 2 diabetes.

Stefan N, Fritsche A, Weikert C, Boeing H, Joost HG, Häring HU, Schulze MB - Diabetes (2008)

Age-adjusted RR of type 2 diabetes by quintiles of plasma fetuin-A (μg/ml) among men and women in the EPIC-Potsdam Study. P for trend <0.001. Medians (ranges) for quintiles are as follows: quintile 1, 162 μg/ml (14–184); quintile 2, 202 μg/ml (185–214); quintile 3, 227 μg/ml (215–240); quintile 4, 255 μg/ml (241–271); quintile 5, 295 μg/ml (272–442).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2551687&req=5

f1: Age-adjusted RR of type 2 diabetes by quintiles of plasma fetuin-A (μg/ml) among men and women in the EPIC-Potsdam Study. P for trend <0.001. Medians (ranges) for quintiles are as follows: quintile 1, 162 μg/ml (14–184); quintile 2, 202 μg/ml (185–214); quintile 3, 227 μg/ml (215–240); quintile 4, 255 μg/ml (241–271); quintile 5, 295 μg/ml (272–442).
Mentions: Baseline characteristics and metabolic traits across quintiles of fetuin-A of the random subcohort are presented in Table 1. Participants with higher fetuin-A concentrations were younger, were less likely to be men, and drank smaller amounts of alcohol compared with participants with lower fetuin-A concentrations. Supplementary Fig. 1 shows the frequency distribution for men and women across the range of plasma fetuin-A levels (14–442 μg/ml [mean ± SD 129 ± 53 μg/ml]).

Bottom Line: The association remained significant after adjustment for sex, BMI, waist circumference, and lifestyle risk factors (RR for 10 mug/ml 1.03 [1.01-1.06]).Adjustment for glucose, triglycerides, HDL cholesterol, A1C, gamma-glutamyltransferase, or high-sensitivity C-reactive protein or mutual adjustment for these biomarkers did not appreciably change this result (RR for 10 mug/ml full adjusted model 1.05 [1.02-1.07]).Furthermore, fetuin-A was associated with increased diabetes risk particularly in individuals with elevated plasma glucose.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Endocrinology, Diabetology, Nephrology, Vascular Disease and Clinical Chemistry, University of Tübingen, Tübingen, Germany.

ABSTRACT

Objective: The liver-secreted protein fetuin-A induces insulin resistance in animals, and circulating fetuin-A is elevated in insulin resistance and fatty liver in humans. We investigated whether plasma fetuin-A levels predict the incidence of type 2 diabetes in a large prospective, population-based study.

Research design and methods: A case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study comprising 27,548 subjects was designed. We randomly selected a subcohort of 2,500 individuals of whom 2,164 were diabetes free at baseline and had anamnestic, anthropometrical, and metabolic data for analysis. Of the 849 incident diabetic case subjects identified in the full cohort during 7 years of follow-up, 703 remained for analyses after similar exclusions.

Results: Plasma fetuin-A levels were positively associated with diabetes risk after adjustment for age (relative risk [RR] for extreme quintiles 1.75 [95% CI 1.32-2.31]; RR for 10 mug/ml 1.04 [1.03-1.06]). The association remained significant after adjustment for sex, BMI, waist circumference, and lifestyle risk factors (RR for 10 mug/ml 1.03 [1.01-1.06]). Adjustment for glucose, triglycerides, HDL cholesterol, A1C, gamma-glutamyltransferase, or high-sensitivity C-reactive protein or mutual adjustment for these biomarkers did not appreciably change this result (RR for 10 mug/ml full adjusted model 1.05 [1.02-1.07]). Furthermore, fetuin-A was associated with increased diabetes risk particularly in individuals with elevated plasma glucose.

Conclusions: Our data suggest that fetuin-A is an independent risk factor of type 2 diabetes.

Show MeSH
Related in: MedlinePlus