Published online before print March 27, 2006, doi: 10.1161/CIRCULATIONAHA.105.588723
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(Circulation. 2006;113:1760-1767.)
© 2006 American Heart Association, Inc.
Epidemiology |
Association Between Human Fetuin-A and the Metabolic Syndrome
Data From the Heart and Soul Study
From the Division of Nephrology (J.H.I.), Department of Medicine (J.H.I., M.G.S., M.A.W.), and Department of Epidemiology and Biostatistics (M.G.S., M.A.W.), University of California, San Francisco; Section of General Internal Medicine, VA Medical Center, San Francisco, Calif (M.G.S., S.A., M.A.W.); and the Department of Nephrology and Clinical Immunology, University Hospital of the RWTH Aachen, Aachen, Germany (V.M.B., M.K.).
Correspondence to Joachim H. Ix, MD, Division of Nephrology, Department of Medicine, Box 0532, HSE 672, University of California, San Francisco, San Francisco, CA 94143-0532. E-mail jix{at}medicine.ucsf.edu
Received May 20, 2005; de novo received September 12, 2005; revision received January 26, 2006; accepted February 3, 2006.
Background— Fetuin-A is a multifunctional hepatic secretory protein that inhibits the action of insulin in experimental animals. We evaluated the association between human serum fetuin-A and the metabolic syndrome (MetS) in a cohort of persons with coronary artery disease.
Methods and Results— We defined MetS by the National Cholesterol Education Program criteria among 711 nondiabetic outpatients with coronary artery disease. The mean age was 67 years, and 82% were male. We divided participants into quartiles by serum fetuin-A concentrations. A total of 45% of participants (80 of 177) in the highest quartile of fetuin-A had MetS compared with 24% of participants (42 of 177) in the lowest quartile (odds ratio, 2.7; 95% confidence interval, 1.7 to 4.2; P<0.001). This association persisted after adjustment for potential confounding variables, including hypertension, body mass index, and inflammatory biomarkers (adjusted odds ratio, 2.0; 95% confidence interval, 1.1 to 3.5; P=0.02). Higher fetuin-A quartiles were also strongly and independently associated with higher low-density lipoprotein, non–high-density lipoprotein (HDL), and triglyceride concentrations and lower HDL concentrations (all P<0.01).
Conclusions— Higher human fetuin-A concentrations are strongly associated with MetS and an atherogenic lipid profile. Future studies should evaluate whether fetuin-A predicts coronary artery disease risk.
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