title: Association of lower plasma fetuin-a levels with peripheral arterial disease in type 2 diabetes.
abstract: OBJECTIVE
  Fetuin-A is an inhibitor of vascular calcification and a mediator of insulin resistance. This study evaluated the association of plasma fetuin-A and peripheral arterial disease (PAD).
  
  
  METHODS
  A total of 738 individuals with type 2 diabetes (mean age 58.7 years, 37.1% female) without known cardiovascular or kidney disease were included in this cross-sectional analysis.
  
  
  RESULTS
  Subjects with PAD had a significantly lower fetuin-A (264.3 vs. 293.4 ng/dl, P < 0.001). In multivariable analysis, a 1-SD decrease in fetuin-A increased the odds of PAD (odds ratio 1.6, P = 0.02). Subgroup analysis revealed an increased odds even in subjects with glomerular filtration rate >80 (odds ratio 1.9, P = 0.05) or high-sensitivity C-reactive protein <3 mg/dl (odds ratio 2.7, P = 0.002).
  
  
  CONCLUSIONS
  Lower circulating fetuin-A is associated with PAD in type 2 diabetes beyond traditional and novel cardiovascular risk factors. Our findings suggest a potentially unique role for fetuin-A deficiency as a biomarker of PAD in patients with type 2 diabetes.
authors.affiliation: Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. muredach@mail.med.upenn.edu
authors.forename: Luis H
authors.initials: LH
authors.lastname: Eraso
authors.forename: Naeema
authors.initials: N
authors.lastname: Ginwala
authors.forename: Atif N
authors.initials: AN
authors.lastname: Qasim
authors.forename: Nehal N
authors.initials: NN
authors.lastname: Mehta
authors.forename: Rachel
authors.initials: R
authors.lastname: Dlugash
authors.forename: Shiv
authors.initials: S
authors.lastname: Kapoor
authors.forename: Stanley
authors.initials: S
authors.lastname: Schwartz
authors.forename: Mark
authors.initials: M
authors.lastname: Schutta
authors.forename: Nayyar
authors.initials: N
authors.lastname: Iqbal
authors.forename: Emile R
authors.initials: ER
authors.lastname: Mohler
authors.forename: Muredach P
authors.initials: MP
authors.lastname: Reilly
mesh_terms: D000328:Adult; D000368:Aged; D001798:Blood Proteins / Q000172:deficiency / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003925:Diabetic Angiopathies / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000097:blood*; D012044:Regression Analysis; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein; D002097:C-Reactive Protein