Format

Send to

Choose Destination
JAMA. 2008 Jul 9;300(2):182-8. doi: 10.1001/jama.300.2.182.

Fetuin-A and incident diabetes mellitus in older persons.

Author information

1
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@ucsd.edu

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.

PMID:
18612115
PMCID:
PMC2779582
DOI:
10.1001/jama.300.2.182
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center