Association between human fetuin-A and the metabolic syndrome: data from the Heart and Soul Study.
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.


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.
Ix
Joachim H
JH
Division of Nephrology, Department of Medicine, University of California, San Francisco, CA 94143-0532, USA. jix@medicine.ucsf.edu
Shlipak
Michael G
MG
Brandenburg
Vincent M
VM
Ali
Sadia
S
Ketteler
Markus
M
Whooley
Mary A
MA
D000368:Aged; D001798:Blood Proteins / Q000378:metabolism*; D016001:Confidence Intervals; D003327:Coronary Disease / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000453:epidemiology; D009203:Myocardial Infarction / Q000097:blood; D009391:Nephelometry and Turbidimetry / Q000379:methods; D012495:San Francisco / Q000453:epidemiology; D060749:alpha-2-HS-Glycoprotein
C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein