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J Diabetes. 2012 Dec;4(4):351-8. doi: 10.1111/1753-0407.12000.

Positive correlation between chronic hyperglycemia and serum fetuin-A levels in middle-aged and elderly Chinese.

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  • 1Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai, China.



The aim of the present study was to evaluate the association between HbA1c and serum fetuin-A levels in middle-aged and elderly Chinese.


A total of 3790 subjects (1519 men; 2271 women) aged ≥40 years were enrolled in this cross-sectional study in the Songnan community of Baoshan District, Shanghai, China. HbA1c levels were used to determine the presence of chronic hyperglycemia. Subjects were divided into three groups based on HbA1c levels: <6.5%, 6.5% ≤ HbA1c < 7.0%, and HbA1c ≥ 7.0%. "Elevated" fetuin-A levels were defined as serum levels in the upper quartile (i.e. ≥367.39 mg/L).


Mean serum fetuin-A levels were higher in subjects with HbA1c ≥ 7.0% compared with those in whom HbA1c was <6.5% (309.32 vs 290.83 mg/L, respectively). Multivariate linear regression analysis revealed a significant positive correlation between HbA1c and serum fetuin-A levels (β = 0.07; SE = 0.03; P = 0.04). After adjustment for possible confounders, an increased percentage of subjects with elevated fetuin-A levels was found in the group with HbA1c ≥ 7.0% compared with the group in which HbA1c was <6.5% (odds ratio 1.38; 95% confidence interval 1.09-1.74). Interactions were found between HbA1c and both insulin resistance and the urinary albumin-to-creatinine ratio for the percentage of elevated fetuin-A levels (P(interaction) = 0.002 and 0.05, respectively).


In Chinese adults, a positive correlation was found between chronic hyperglycemia and serum fetuin-A levels. Further research into the mechanisms underlying fetuin-A regulation is needed to identify potential drug targets.

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