title: Levels of fetuin-A relate to the levels of bone turnover biomarkers in male and female patients with type 2 diabetes.
abstract: OBJECTIVE
  To evaluate the relationship of plasma fetuin-A levels with markers of bone turnover in male and female type 2 diabetic subjects.
  
  
  BACKGROUND
  Fetuin-A, which is a serum protein produced by the liver and promotes bone mineralization, is an independent risk factor for type 2 diabetes, whilst type 2 diabetes is associated with an increased incidence of osteoporosis or fractures. It is not known how fetuin-A levels relate to parameters of bone metabolism in type 2 diabetes.
  
  
  METHODS
  Eighty patients with type 2 diabetes [40 men and 40 women matched for age, body mass index (BMI) and time since diagnosis of diabetes] were studied. Fetuin-A together with metabolic parameters and levels of serum carboxy-terminal telopeptide of type 1 collagen (C-telopeptide), osteocalcin, procollagen type 1 amino-terminal propeptide (P1NP), bone alkaline phosphatase (ALP) and sex hormones was determined in all participants.
  
  
  RESULTS
  Fetuin-A levels did not differ significantly between male and female diabetic subjects. In a model adjusted for age, BMI, fatty liver index (FLI), time since diagnosis of diabetes, HbA(1c) , antidiabetic and lipid-lowering drug therapies, smoking, total serum protein, creatinine, gamma glutamyl-transferase, parathyroid hormone, C-reactive protein, glomerular filtration rate, and presence of micro-, cardio-, and peripheral vascular diabetic complications, fetuin-A showed a significant positive association with levels of bone ALP (r = 0·71, P = 0·006) in men. In women, fetuin-A was significantly negatively associated with C-telopeptide (r = -0·60, P = 0·03) levels.
  
  
  CONCLUSIONS
  Results suggest an independent association of fetuin-A levels with markers of bone turnover in male and female patients with type 2 diabetes. More studies are needed to determine whether fetuin-A could serve as a new marker for fracture risk or osteoporosis in type 2 diabetes and to explore its potential sexually dimorphic effects.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Unit of Gender Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Sazan
authors.initials: S
authors.lastname: Rasul
authors.forename: Aysegul
authors.initials: A
authors.lastname: Ilhan
authors.forename: Marie H
authors.initials: MH
authors.lastname: Reiter
authors.forename: Jelena
authors.initials: J
authors.lastname: Todoric
authors.forename: Serdar
authors.initials: S
authors.lastname: Farhan
authors.forename: Harald
authors.initials: H
authors.lastname: Esterbauer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
mesh_terms: D000368:Aged; D000469:Alkaline Phosphatase / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D024042:Collagen Type I / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010455:Peptides / Q000097:blood; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D024042:Collagen Type I; D010455:Peptides; D060749:alpha-2-HS-Glycoprotein; C052929:collagen type I trimeric cross-linked peptide; D015675:Osteocalcin; D002097:C-Reactive Protein; D000469:Alkaline Phosphatase