| Title | Fetuin-A and incident diabetes mellitus in older persons. | | Author(s) | Ix JH, Wassel CL, Kanaya AM, Vittinghoff E, Johnson KC, Koster A, Cauley JA, Harris TB, Cummings SR, Shlipak MG, Health ABC Study | | Institution | 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 | | Source | JAMA 2008 Jul 9; 300(2):182-8. | | MeSH | Abdominal Fat
Adiposity
Age Factors
Aged
Biological Markers
Blood Proteins
Body Composition
Case-Control Studies
Diabetes Mellitus
Diabetes Mellitus, Type 2
Female
Follow-Up Studies
Health Status
Humans
Insulin Resistance
Male
Retrospective Studies
Risk Factors
| | 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. | | Language | eng | | Pub Type(s) | Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't
| | PubMed ID | 18612115 |
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