Abstract 16168: The Association of Fetuin-a With Incident Cardiovascular Disease Differs by Glycemic Status: The Multi-Ethnic Study of Atherosclerosis
Background: Fetuin-A is a hepatic secretory protein that both promotes insulin resistance and inhibits arterial calcification. Previous studies have suggested that the association of fetuin-A with CVD might depend on glycemic status.
Objectives: To evaluate the associations of fetuin-A concentration with CVD risk among participants with normal fasting plasma glucose (FPG <100 mg/dL), and abnormal FPG (FPG ≥100 mg/dL or use of medications for DM) in the Multi-Ethnic Study of Atherosclerosis, a cohort of U.S. men and women aged 45-85 years of Caucasian, Chinese, African, and Hispanic descent who were free of clinical CVD.
Methods: Using a case-cohort design, fetuin-A concentrations were measured in all 213 incident CVD cases as of May 2007 (includes MI, resuscitated cardiac arrest, stroke, and CVD death), and a random sub-cohort of 2450 participants at baseline (2000-2002).
Results: In multivariable Cox regression models using the bottom quartile as the reference group, the top quartile of fetuin-A was associated with greater CVD risk among participants with abnormal FPG (HR 2.19; 95% CI, 1.19-4.05), but not among participants who had normal FPG (HR 0.92; 95% CI, 0.56-1.49)(Figure). The HR between extreme quartiles of fetuin-A was similarly elevated (HR 2.66; 95% CI, 1.23-5.76) when the abnormal FPG group was restricted to participants with T2DM (FPG ≥126 mg/dL or use of DM medications, n=331). The HRs per SD higher fetuin-A concentration (0.1 g/L) were 1.19 (95% CI, 0.97-1.46) in the abnormal FPG group, and 0.91 (95% CI, 0.75-1.10) in the normal FPG group (p for interaction = 0.04). No statistically significant interactions by sex or race/ethnicity were detected.
Conclusions: This multiethnic study of men and women further confirms that the association of fetuin-A with risk of CVD appears to be modified by glycemic status.
Author Disclosures: D.E. St-Jules: None. S.A. Aroner: None. R. Katz: None. M.G. Shlipak: None. M.H. Criqui: None. B. Kestenbaum: None. D.S. Siscovick: None. I.H. de Boer: None. N.S. Jenny: None. M.J. Budoff: None. J.H. Ix: None. M.K. Jensen: None.
- © 2014 by American Heart Association, Inc.