Fetuin-A, type 2 diabetes, and risk of cardiovascular disease in older adults: the cardiovascular health study.

Abstract

OBJECTIVE:

Fetuin-A, a hepatic secretory protein that simultaneously inhibits arterial calcification and insulin action, is associated with type 2 diabetes, but its association with cardiovascular disease (CVD) is uncertain. Preliminary studies suggest that the association of fetuin-A with CVD might differ among individuals with or without type 2 diabetes.

RESEARCH DESIGN AND METHODS:

This was a prospective study of 3,810 community-living individuals older than 65 years (511 with type 2 diabetes) and free of CVD in 1992 when fetuin-A levels were measured. Participants were followed-up for incident CVD through June 2008.

RESULTS:

Mean age was 75 years, and 61% were women; 1,456 participants had an incident CVD event (248 among individuals with type 2 diabetes). The association of fetuin-A with CVD was modified by type 2 diabetes (P interaction = 0.02). Higher fetuin-A was associated with lower CVD risk among persons without type 2 diabetes [hazard ratio per SD 0.1 g/L higher fetuin-A, 0.93 (95% CI, 0.88-0.99)], whereas a trend in the opposite direction was observed among individuals with type 2 diabetes, although it was not statistically significant [1.07 (0.93-1.22)]. Among individuals without type 2 diabetes, similar effect modification was observed by obesity and insulin resistance. Consistently, higher fetuin-A was associated with lower CVD risk only in the subgroups without obesity or with HOMA-IR below the median [0.91 (0.85-0.97) and 0.87 (0.79-0.95), respectively].

CONCLUSIONS:

The association of fetuin-A with risk of CVD differs among elderly individuals with and without insulin resistance or type 2 diabetes.

• Authors: Majken K Jensen, Traci M Bartz, Kenneth J Mukamal, Luc Djoussé, Jorge R Kizer, Russell P Tracy, Susan J Zieman, Eric B Rimm, David S Siscovick, Michael Shlipak, Joachim H Ix
• Journal: Diabetes care (Diabetes Care) Vol. 36 Issue 5 Pg. 1222-8 (May 2013) ISSN: 1935-5548 [Electronic] United States
• PMID: 23250801 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Fetuins

Topics

• Aged
• Aged, 80 and over
• Cardiovascular Diseases (epidemiology, metabolism)
• Diabetes Mellitus, Type 2 (epidemiology, metabolism)
• Female
• Fetuins (metabolism)
• Humans
• Incidence
• Longitudinal Studies
• Male
• Risk Factors