Association of Lower Plasma Fetuin-A Levels With Peripheral Arterial Disease in Type 2 Diabetes
- Luis H. Eraso, MD1,
- Naeema Ginwala, BA1,
- Atif N. Qasim, MD1,
- Nehal N. Mehta, MD1,
- Rachel Dlugash, BA1,
- Shiv Kapoor, PHD1,
- Stanley Schwartz, MD2,
- Mark Schutta, MD2,
- Nayyar Iqbal, MD2,
- Emile R. Mohler III, MD1,3 and
- Muredach P. Reilly, MB1,2,3
- 1Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;
- 2Institute of Diabetes Obesity and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania;
- 3Institute for Translational Medicine and Therapeutics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
- Corresponding author: Muredach P. Reilly, muredach{at}mail.med.upenn.edu.
Abstract
OBJECTIVE Fetuin-A is an inhibitor of vascular calcification and a mediator of insulin resistance. This study evaluated the association of plasma fetuin-A and peripheral arterial disease (PAD).
RESEARCH DESIGN AND METHODS A total of 738 individuals with type 2 diabetes (mean age 58.7 years, 37.1% female) without known cardiovascular or kidney disease were included in this cross-sectional analysis.
RESULTS Subjects with PAD had a significantly lower fetuin-A (264.3 vs. 293.4 ng/dl, P < 0.001). In multivariable analysis, a 1-SD decrease in fetuin-A increased the odds of PAD (odds ratio 1.6, P = 0.02). Subgroup analysis revealed an increased odds even in subjects with glomerular filtration rate >80 (odds ratio 1.9, P = 0.05) or high-sensitivity C-reactive protein <3 mg/dl (odds ratio 2.7, P = 0.002).
CONCLUSIONS Lower circulating fetuin-A is associated with PAD in type 2 diabetes beyond traditional and novel cardiovascular risk factors. Our findings suggest a potentially unique role for fetuin-A deficiency as a biomarker of PAD in patients with type 2 diabetes.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received August 17, 2009.
- Accepted October 28, 2009.
- © 2010 by the American Diabetes Association.
