title: Fetuin-A and BMD in older persons: the Health Aging and Body Composition (Health ABC) study.
abstract: Fetuin-A is a hepatic secretory protein that promotes bone mineralization in vitro. Whether fetuin-A levels are associated with BMD in humans is unknown. The Health Aging and Body Composition study enrolled 3075 well-functioning black and white persons 70-79 yr of age and measured BMD. This cross-sectional study measured serum fetuin-A using ELISA among a random sample of 508 participants within sex and race strata. Multivariate linear regression analysis evaluated the associations of fetuin-A with BMD. Among women (n = 257), higher fetuin-A levels were significantly associated with higher total hip (p = 0.02), lumbar spine (p = 0.03), and whole body BMD (p = 0.01) in models adjusted for age, race, diabetes, alcohol and tobacco use, physical activity, body mass index, C-reactive protein levels, calcium supplement, and estrogen use. For example, each SD (0.38 g/liter) higher level of fetuin-A was associated with 0.016 g/cm(2) higher total hip areal BMD. The association was of similar magnitude and direction for femoral neck BMD but did not reach statistical significance (p = 0.11). In contrast, among men (n = 251), fetuin-A had no significant associations with total hip (p = 0.79), lumbar spine (p = 0.35), whole body (p = 0.46), or femoral neck BMD (p = 0.54) in multivariable models. We conclude that higher fetuin-A levels are independently associated with higher BMD among well-functioning community-dwelling older women but not older men. Future studies should evaluate whether fetuin-A may refine fracture risk assessment in older women.
authors.affiliation: Division of Nephrology, Department of Medicine, University of California San Diego, San Diego, California, USA. joeix@ucsd.edu
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.forename: Christina L
authors.initials: CL
authors.lastname: Wassel
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
authors.forename: Damon
authors.initials: D
authors.lastname: Toroian
authors.forename: Frances A
authors.initials: FA
authors.lastname: Tylavsky
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Paul A
authors.initials: PA
authors.lastname: Price
authors.forename: Steven R
authors.initials: SR
authors.lastname: Cummings
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
mesh_terms: D000368:Aged; D000375:Aging / Q000378:metabolism*; D001798:Blood Proteins / Q000378:metabolism*; D001823:Body Composition; D015519:Bone Density; D003710:Demography; D005260:Female; D006262:Health; D006801:Humans; D008297:Male; D012727:Sex Characteristics; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein