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Comparative Study
. 2008 Jul 9;300(2):182-8.
doi: 10.1001/jama.300.2.182.

Fetuin-A and incident diabetes mellitus in older persons

Joachim H Ix  1 , Christina L Wassel, Alka M Kanaya, Eric Vittinghoff, Karen C Johnson, Annemarie Koster, Jane A Cauley, Tamara B Harris, Steven R Cummings, Michael G Shlipak; Health ABC Study
Collaborators, Affiliations
Comparative Study

Fetuin-A and incident diabetes mellitus in older persons

Joachim H Ix et al. JAMA. .

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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Conflict of interest statement

COMPETING FINANCIAL INTERESTS: None

Figures

Figure 1
Figure 1
Case Cohort Study Design
Figure 2
Figure 2
Distribution of Fetuin-A among a Random Sample of Health ABC Participants (N=406)
See this image and copyright information in PMC

Comment in

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