Fetuin-A and incident diabetes mellitus in older persons.

Full Abstract

CONTEXT:
Fetuin-A is a hepatic secretory protein that binds the insulin receptor and inhibits insulin action in vitro. In prior cross-sectional studies in humans, higher fetuin-A levels were associated with insulin resistance. However, the longitudinal association of fetuin-A with incident type 2 diabetes mellitus is unknown.

OBJECTIVE:
To determine whether fetuin-A levels are associated with incident diabetes in older persons. DESIGN, SETTING,

AND PARTICIPANTS:
Observational study among 3075 well-functioning persons aged 70 to 79 years. In this case-cohort study, we retrospectively measured fetuin-A levels in baseline serum among 406 randomly selected participants without prevalent diabetes, and all participants who developed incident diabetes mellitus during a 6-year follow-up (to August 31, 2005).

MAIN OUTCOME MEASURE:
Incident diabetes mellitus.

RESULTS:
Incident diabetes developed in 135 participants (10.1 cases/1000 person-years). Participants with fetuin-A levels within the highest tertile (> 0.97 g/L) had an increased risk of incident diabetes (13.3 cases/1000 person-years) compared with participants in the lowest tertile (< or = 0.76 g/L) (6.5 cases/1000 person-years) in models adjusted for age, sex, race, waist circumference, body weight, physical activity, blood pressure level, fasting glucose level, high-density lipoprotein cholesterol concentration, triglyceride concentration, and C-reactive protein level (adjusted hazard ratio, 2.41; 95% confidence interval, 1.28-4.53; P = .007). The association was not affected by adipocytokine levels but was moderately attenuated by adjustment for visceral adiposity (adjusted hazard ratio of highest vs lowest tertile 1.72; 95% confidence interval, 0.98-3.05; P = .06).

CONCLUSION:
Among well-functioning older persons, serum fetuin-A is associated with incident diabetes, independent of other markers of insulin resistance.

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Author information

Author/s: Ix, Joachim H (JH); Wassel, Christina L (CL); Kanaya, Alka M (AM); Vittinghoff, Eric (E); Johnson, Karen C (KC); Koster, Annemarie (A); Cauley, Jane A (JA); Harris, Tamara B (TB); Cummings, Steven R (SR); Shlipak, Michael G (MG); Health ABC Study;

Affiliation: Division of Nephrology and Hypertension, Department of Medicine, University of California, San Diego, and San Diego Veterans Affairs Healthcare System, 3350 La Jolla Village Dr, Mail Code 111-H, San Diego, CA 92161, USA. joeix(-atsign-)ucsd.edu

Grants: N01-AG-6-2101 (Agency:United States NIA) ; N01-AG-6-2103 (Agency:United States NIA) ; N01-AG-6-2106 (Agency:United States NIA)

Journal and publication information

Publication Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't

Journal: JAMA : the journal of the American Medical Association (JAMA), published in United States. (Language: eng)

Reference: 2008-Jul; vol 300 (issue 2) : pp 182-8

Dates: Created 2008/07/09; Completed 2008/07/18;

PMID: 18612115, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Abdominal Fat
Adiposity
Age Factors
Aged
Biological Markers - blood
Blood Proteins - metabolism
Body Composition
Case-Control Studies
Diabetes Mellitus - metabolism

Diabetes Mellitus, Type 2 - metabolism
Female
Follow-Up Studies
Health Status
Humans
Insulin Resistance
Male
Retrospective Studies
Risk Factors

Associated Chemicals: Biological Markers (0) ; Blood Proteins (0) ; alpha2HS glycoprotein (0)

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