title: Elevated Fetuin-A concentrations in morbid obesity decrease after dramatic weight loss.
abstract: BACKGROUND
  Morbid obesity (MO) is a risk factor for cardiovascular morbidity, mortality, and diabetes, which can be effectively reduced by bariatric surgery. The liver-secreted protein Fetuin-A is elevated in insulin resistance, is an independent predictor of type 2 diabetes and is associated with atherosclerosis.
  
  
  OBJECTIVE
  We studied Fetuin-A concentrations in patients with MO before and after weight loss induced by gastric bypass.
  
  
  METHODS
  We conducted a cross-sectional study and a 16-month longitudinal study.
  
  
  METHODS
  This study was performed in secondary care. PATIENTS, SUBJECTS, AND INTERVENTION: We included 75 MO patients [65 women, body mass index (BMI) 45.6 ± 8.1 kg/m(2)] and 38 healthy controls (21 women, BMI 26.0 ± 5.5 kg/m(2)) in a cross-sectional study and investigated them before and about 16 months after gastric bypass surgery.
  
  
  METHODS
  Apart from measurements of blood pressure and routine laboratory parameters, a 75-g oral glucose tolerance test was performed. Insulin resistance was calculated by using homeostatic model assessment (HOMA).
  
  
  RESULTS
  Fetuin-A levels were significantly higher in MO (877 ± 318 μg/ml) than in controls (295 ± 61 μg/ml; P < 0.001). After surgery-induced weight loss (BMI 31.6 ± 6.8 vs. 45.6 ± 8.1 kg/m(2); P < 0.001), HOMA (2.0 ± 1.2 vs. 6.6 ± 6.3; P < 0.001) and Fetuin-A (710 ± 350 vs. 877 ± 318 μg/ml; P < 0.001) decreased. Delta (Δ) Fetuin-A concentrations correlated with Δfasting insulin (r = 0.710; P = 0.001), Δ2-h insulin (r = 0.693; P = 0.005), and HOMA-insulin resistance (r = 0.684; P = 0.001).
  
  
  CONCLUSIONS
  Fetuin-A is markedly increased in patients with MO. The reduction of Fetuin-A after weight loss could play an important role in the beneficial effects of gastric bypass surgery.
authors.affiliation: Department of Medicine 1, Rudolfstiftung Hospital, Vienna, Juchgasse 25, Vienna, Austria.
authors.forename: Johanna Maria
authors.initials: JM
authors.lastname: Brix
authors.forename: Harald
authors.initials: H
authors.lastname: Stingl
authors.forename: Florian
authors.initials: F
authors.lastname: Höllerl
authors.forename: Gerit Holger
authors.initials: GH
authors.lastname: Schernthaner
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Kopp
authors.forename: Guntram
authors.initials: G
authors.lastname: Schernthaner
mesh_terms: D001786:Blood Glucose; D001794:Blood Pressure; D001798:Blood Proteins / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D015390:Gastric Bypass; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D015431:Weight Loss / Q000502:physiology*; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001786:Blood Glucose; D001798:Blood Proteins; D008055:Lipids; D060749:alpha-2-HS-Glycoprotein