Low fetuin-A linked with macrovascular complications in Type 2 diabetes
MedWire News: A low serum concentration of fetuin-A is a significant independent predictor of reduced ankle-brachial index (ABI) in patients with Type 2 diabetes, show study results.
Fetuin-A is a an inhibitor of vascular calcification and a mediator of insulin resistance, low levels of which have previously been associated with cardiovascular disease, as reported by MedWire News.
In this study, Marcel Roos (Klinikum rechts der Isar, Munich, Germany) and colleagues recruited 153 patients with Type 2 diabetes and early diabetic nephropathy to assess links between fetuin-A and inflammatory, metabolic, and vascular markers. Atherosclerotic burden was also evaluated using the ABI and by measurement of carotid intima-media thickness (IMT).
Fetuin-A levels were a mean of 0.51 g/l, and ranged from 0.30 to 1.07 g/l. Age was significantly and inversely associated with fetuin-A levels. Concentrations were also significantly lower in men than women, at 0.49 vs 0.56 g/l.
Adiponectin, but no other metabolic variable, was inversely and significantly associated with fetuin-A.
No links with carotid IMT were observed, but patients with an ABI below 0.9 had significantly lower fetuin-A levels than those with an ABI of 0.9-1.3 or higher, at 0.43 versus 0.52 and 0.54 g/l, respectively.
The researchers also found that there was a trend for lower levels of fetuin-A in patients with a prior history of macrovascular disease.
When fetuin-A levels were measured in 69 diabetic patients with prevalent polyneuropathy (PNP) and 84 diabetic controls without PNP, concentrations were not significantly different between the two groups, at 0.50 and 0.52 µg/ml, respectively.
Further analysis showed that only fetuin-A and total cholesterol concentration were significant independent predictors of having an ABI below 0.9.
"This study demonstrates that lower fetuin-A levels seem to be associated with prevalent macrovascular disease in Type 2 diabetes, but not with carotid IMT as a surrogate marker of atherosclerotic burden," write the authors in the journal Cardiovascular Diabetology.
"Furthermore, we could show for the first time, that fetuin-A serum levels are not associated with microvascular complications in patients with early diabetic nephropathy," they conclude.
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By Helen Albert