Fetuin-A and change in body composition in older persons.
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.
Ix
Joachim H
JH
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
Wassel
Christina L
CL
Chertow
Glenn M
GM
Koster
Annemarie
A
Johnson
Karen C
KC
Tylavsky
Frances A
FA
Cauley
Jane A
JA
Cummings
Steven R
SR
Harris
Tamara B
TB
Shlipak
Michael G
MG
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
C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein; D011972:Receptor, Insulin