title: Fetuin-A and change in body composition in older persons.
abstract: BACKGROUND
  Fetuin-A inhibits the insulin receptor in vitro. Higher serum fetuin-A concentrations are associated with type 2 diabetes longitudinally and greater adiposity in cross-sectional analyses. Whether higher fetuin-A concentrations are associated with accumulation of adiposity over time is unknown.
  
  
  OBJECTIVE
  To determine the association of fetuin-A levels with changes in body composition over 5 yr.
  
  
  METHODS
  Observational cohort study nested in the Health Aging and Body Composition Study.
  
  
  METHODS
  Serum fetuin-A levels.
  
  
  RESULTS
  Visceral adipose tissue (VAT), abdominal sc adipose tissue, and thigh muscle area by computed tomography, and waist circumference and body mass index were measured at baseline and again after 5 yr. Percent change and extreme change (>1.5 sds) in each measure were calculated.
  
  
  RESULTS
  Over 5 yr, subjects lost body mass in each measure, including 6% decline in VAT. Yet each sd (0.42 g/liter) higher fetuin-A concentration was associated with a 5.5% increase in VAT over 5 yr (95% confidence interval 1.9-9.2%; P = 0.003) in models adjusted for age, sex, race, clinical site, diabetes, physical activity, triglycerides, kidney function, and the baseline VAT score. Similarly, higher fetuin-A concentrations were associated with extreme VAT gain (relative risk 1.70, 95% confidence interval 1.12-2.60, P = 0.01). Fetuin-A concentrations were not statistically significant associated with change in any other measures of body composition (P > 0.20).
  
  
  CONCLUSIONS
  Higher fetuin-A concentrations are associated with the accumulation of VAT in well-functioning, community-living older persons. The mechanisms linking fetuin-A, VAT, and insulin resistance remain to be determined.
authors.affiliation: Division of Nephrology, Department of Medicine, and Division of Preventive Medicine, University of California San Diego, Veterans Affairs San Diego Healthcare System, San Diego, California 92161, 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: Glenn M
authors.initials: GM
authors.lastname: Chertow
authors.forename: Annemarie
authors.initials: A
authors.lastname: Koster
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.forename: Frances A
authors.initials: FA
authors.lastname: Tylavsky
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Steven R
authors.initials: SR
authors.lastname: Cummings
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
mesh_terms: D000273:Adipose Tissue / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D000368:Aged; D000375:Aging / Q000502:physiology*; D001798:Blood Proteins / Q000378:metabolism* / Q000494:pharmacology; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D044469:Racial Groups; D011972:Receptor, Insulin / Q000037:antagonists & inhibitors; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein; D011972:Receptor, Insulin