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 Dlugash1,
- Shiv Kapoor, PhD1,
- Stanley Schwartz, MD2,
- Mark Schutta, MD2,
- Nayyar Iqbal, MD2,
- Emile R. Mohler III, MD1,3 and
- Muredach P. Reilly, MB (muredach{at}mail.med.upenn.edu)1,2,3
- The Cardiovascular Institute1, the Institute of Diabetes Obesity and Metabolism
- 2 and the Institute for Translational Medicine and Therapeutics
- 3, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
Abstract
Objectives: Fetuin-A is an inhibitor of vascular calcification and a mediator of insulin resistance. This study evaluated the association of low 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 one standard deviation decrease in fetuin-A increased the odds of PAD (OR 1.6, p=0.02). Subgroup analysis revealed an increased odds even in subjects with eGFR >80 (OR 1.9, p=0.05) or hsCRP <3 mg/dl (OR=2.7, p=0.002).
Conclusion: 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
-
- Received August 17, 2009.
- Accepted October 28, 2009.
- Copyright © American Diabetes Association
