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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

RR of type 2 diabetes per 1 SD of plasma fetuin-A for subgroups of sex, fasting status, abdominal obesity, and glucose levels in the EPIC-Potsdam Study. RRs were adjusted for age, sex BMI, waist circumference, education (in or no training, vocational training, technical school, or technical college or university degree), occupational activity (light, moderate, or heavy), sport activity (0, 0.1–4, or >4 h/week), cycling (0, 0.1–2.4, 2.5–4.9, or ≥5 h/week), smoking (never, past, or current <20 cigarettes/day or current ≥20 cigarettes/day), and alcohol intake (0, 0.1–5, 5.1–10, 10.1–20, 20.1–40, or >40 g/day), HDL cholesterol, triglycerides, glucose, A1C, γ-glutamyltransferase, and hs-CRP (all log transformed). Abdominal obesity was defined as waist ≥102 cm among men or ≥88 cm among women. High glucose was defined as ≥100 mg/dl.
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f3: RR of type 2 diabetes per 1 SD of plasma fetuin-A for subgroups of sex, fasting status, abdominal obesity, and glucose levels in the EPIC-Potsdam Study. RRs were adjusted for age, sex BMI, waist circumference, education (in or no training, vocational training, technical school, or technical college or university degree), occupational activity (light, moderate, or heavy), sport activity (0, 0.1–4, or >4 h/week), cycling (0, 0.1–2.4, 2.5–4.9, or ≥5 h/week), smoking (never, past, or current <20 cigarettes/day or current ≥20 cigarettes/day), and alcohol intake (0, 0.1–5, 5.1–10, 10.1–20, 20.1–40, or >40 g/day), HDL cholesterol, triglycerides, glucose, A1C, γ-glutamyltransferase, and hs-CRP (all log transformed). Abdominal obesity was defined as waist ≥102 cm among men or ≥88 cm among women. High glucose was defined as ≥100 mg/dl.

Mentions: We next evaluated the associations between fetuin-A and the risk of type 2 diabetes in several subgroups (Fig. 3). The associations appeared to be stronger in men compared with women and among fasted compared with nonfasted participants. However, the tests for interactions were not significant. Similar associations were observable across strata of abdominal obesity. In contrast, glucose levels modified the association between fetuin-A levels and diabetes risk with a strong association observable among participants with elevated glucose (RR for 1 SD 1.62 [95% CI 1.31–2.00]), whereas there was no significant association among participants with normal glucose values (P value for interaction 0.023).


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)

RR of type 2 diabetes per 1 SD of plasma fetuin-A for subgroups of sex, fasting status, abdominal obesity, and glucose levels in the EPIC-Potsdam Study. RRs were adjusted for age, sex BMI, waist circumference, education (in or no training, vocational training, technical school, or technical college or university degree), occupational activity (light, moderate, or heavy), sport activity (0, 0.1–4, or >4 h/week), cycling (0, 0.1–2.4, 2.5–4.9, or ≥5 h/week), smoking (never, past, or current <20 cigarettes/day or current ≥20 cigarettes/day), and alcohol intake (0, 0.1–5, 5.1–10, 10.1–20, 20.1–40, or >40 g/day), HDL cholesterol, triglycerides, glucose, A1C, γ-glutamyltransferase, and hs-CRP (all log transformed). Abdominal obesity was defined as waist ≥102 cm among men or ≥88 cm among women. High glucose was defined as ≥100 mg/dl.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3: RR of type 2 diabetes per 1 SD of plasma fetuin-A for subgroups of sex, fasting status, abdominal obesity, and glucose levels in the EPIC-Potsdam Study. RRs were adjusted for age, sex BMI, waist circumference, education (in or no training, vocational training, technical school, or technical college or university degree), occupational activity (light, moderate, or heavy), sport activity (0, 0.1–4, or >4 h/week), cycling (0, 0.1–2.4, 2.5–4.9, or ≥5 h/week), smoking (never, past, or current <20 cigarettes/day or current ≥20 cigarettes/day), and alcohol intake (0, 0.1–5, 5.1–10, 10.1–20, 20.1–40, or >40 g/day), HDL cholesterol, triglycerides, glucose, A1C, γ-glutamyltransferase, and hs-CRP (all log transformed). Abdominal obesity was defined as waist ≥102 cm among men or ≥88 cm among women. High glucose was defined as ≥100 mg/dl.
Mentions: We next evaluated the associations between fetuin-A and the risk of type 2 diabetes in several subgroups (Fig. 3). The associations appeared to be stronger in men compared with women and among fasted compared with nonfasted participants. However, the tests for interactions were not significant. Similar associations were observable across strata of abdominal obesity. In contrast, glucose levels modified the association between fetuin-A levels and diabetes risk with a strong association observable among participants with elevated glucose (RR for 1 SD 1.62 [95% CI 1.31–2.00]), whereas there was no significant association among participants with normal glucose values (P value for interaction 0.023).

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