Fetuin-A and incident diabetes mellitus in older persons

Joachim H. Ix, Christina L. Wassel, Alka M. Kanaya, Eric Vittinghoff, Karen Johnson, Annemarie Koster, Jane A. Cauley, Tamara B. Harris, Steven R. Cummings, Michael G. Shlipak

Research output: Contribution to journalArticle

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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 wellfunctioning 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 (≤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.

Original languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalJAMA - Journal of the American Medical Association
Volume300
Issue number2
DOIs
StatePublished - Jul 9 2008

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alpha-2-HS-Glycoprotein
Diabetes Mellitus
Insulin Resistance
Confidence Intervals
Adipokines
Insulin Receptor
Adiposity
Waist Circumference
Serum
C-Reactive Protein
Type 2 Diabetes Mellitus
HDL Cholesterol
Observational Studies
Fasting
Triglycerides
Cohort Studies
Cross-Sectional Studies
Body Weight
Outcome Assessment (Health Care)
Exercise

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Ix, J. H., Wassel, C. L., Kanaya, A. M., Vittinghoff, E., Johnson, K., Koster, A., ... Shlipak, M. G. (2008). Fetuin-A and incident diabetes mellitus in older persons. JAMA - Journal of the American Medical Association, 300(2), 182-188. https://doi.org/10.1001/jama.300.2.182

Fetuin-A and incident diabetes mellitus in older persons. / Ix, Joachim H.; Wassel, Christina L.; Kanaya, Alka M.; Vittinghoff, Eric; Johnson, Karen; Koster, Annemarie; Cauley, Jane A.; Harris, Tamara B.; Cummings, Steven R.; Shlipak, Michael G.

In: JAMA - Journal of the American Medical Association, Vol. 300, No. 2, 09.07.2008, p. 182-188.

Research output: Contribution to journalArticle

Ix, JH, Wassel, CL, Kanaya, AM, Vittinghoff, E, Johnson, K, Koster, A, Cauley, JA, Harris, TB, Cummings, SR & Shlipak, MG 2008, 'Fetuin-A and incident diabetes mellitus in older persons', JAMA - Journal of the American Medical Association, vol. 300, no. 2, pp. 182-188. https://doi.org/10.1001/jama.300.2.182
Ix, Joachim H. ; Wassel, Christina L. ; Kanaya, Alka M. ; Vittinghoff, Eric ; Johnson, Karen ; Koster, Annemarie ; Cauley, Jane A. ; Harris, Tamara B. ; Cummings, Steven R. ; Shlipak, Michael G. / Fetuin-A and incident diabetes mellitus in older persons. In: JAMA - Journal of the American Medical Association. 2008 ; Vol. 300, No. 2. pp. 182-188.
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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 wellfunctioning 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 (≤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.",
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