title: The associations of fetuin-A with subclinical cardiovascular disease in community-dwelling persons: the Rancho Bernardo Study.
abstract: OBJECTIVE
  The aim of this study was to determine the association of fetuin-A with subclinical cardiovascular disease (CVD) in community-living individuals.
  
  
  BACKGROUND
  Fetuin-A is a hepatic secretory protein that inhibits arterial calcium deposition in vitro. Lower fetuin-A levels are associated with arterial calcification and death in end-stage renal disease populations. The association of fetuin-A with subclinical CVD in the general population is unknown.
  
  
  METHODS
  Among 1,375 community-living individuals without prevalent clinical CVD, we measured plasma fetuin-A concentrations. Peripheral arterial disease (PAD) was defined by ankle brachial index <0.90, coronary artery calcification (CAC) was measured by computed tomography, and common and internal intima-media thickness (cIMT) were measured by carotid ultrasound. PAD was measured concurrent with fetuin-A, and CAC and cIMT were measured 4.6 years (mean) later.
  
  
  RESULTS
  Mean age was 70 ± 11 years, and 64% were women. Fetuin-A levels were inversely associated with CAC severity. When evaluated as CAC categories (0, 1 to 100, 101 to 300, >300) with ordinal logistic regression, each SD higher fetuin-A was associated with 31% lower odds of CAC severity (proportional odds ratio: 0.69; 95% confidence interval: 0.46 to 0.92; p = 0.008) in models adjusted for demographic data, lifestyle factors, traditional CVD risk factors, and kidney function. In contrast, no association of fetuin-A was observed with PAD or high common or internal cIMT in adjusted models.
  
  
  CONCLUSIONS
  Lower fetuin-A levels are independently associated with greater CAC severity but not PAD or cIMT. If confirmed, fetuin-A might mark calcium deposition within the vasculature but not atherosclerosis per se.
authors: Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California 92161, USA. joeix@ucsd.edu
authors: Joachim H
authors: JH
authors: Ix
authors: Elizabeth
authors: E
authors: Barrett-Connor
authors: Christina L
authors: CL
authors: Wassel
authors: Kevin
authors: K
authors: Cummins
authors: Jaclyn
authors: J
authors: Bergstrom
authors: Lori B
authors: LB
authors: Daniels
authors: Gail A
authors: GA
authors: Laughlin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002140:California / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D060749:alpha-2-HS-Glycoprotein