title: Fetuin-A is inversely associated with coronary artery calcification in community-living persons: the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Fetuin-A is a hepatic secretory protein that inhibits arterial calcification in vitro. The association of fetuin-A with coronary arterial calcification (CAC) in the general population is uncertain.
  
  
  METHODS
  Among 2457 community-living individuals without cardiovascular disease (CVD), we measured serum fetuin-A concentrations by ELISA and evaluated the cross-sectional association of fetuin-A with CAC prevalence (any vs none) and severity; on follow-up 3.2 years (median) later, we evaluated the association of fetuin-A with CAC incidence and progression.
  
  
  RESULTS
  The mean age was 62 (SD 10) years, and the mean fetuin-A concentration was 0.48 (0.10) g/L. At baseline, 1200 individuals (49%) had CAC, and 272 individuals developed CAC during follow-up. At baseline, there was a threshold effect at the lowest fetuin-A quartile with CAC prevalence. In models adjusted for demographics, traditional cardiovascular disease (CVD) risk factors and kidney function, the lowest fetuin-A quartile had 7% (95% CI 1%-13%; P = 0.04) greater CAC prevalence compared with quartiles 2-4. Similar associations were observed with CAC severity at baseline, but the association was more linear. Each SD (0.10 g/L) lower fetuin-A was associated with a 12% (95% CI 3%-21%; P = 0.01) greater CAC severity in adjusted models. There was no significant association of fetuin-A with CAC incidence or progression.
  
  
  CONCLUSIONS
  Fetuin-A is inversely associated with CAC severity among community-living individuals without CVD. Whether fetuin-A concentrations are associated with incident CVD event in the general population requires future study.
authors.affiliation: Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, CA 92161, USA. joeix@ucsd.edu
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Ian H
authors.initials: IH
authors.lastname: de Boer
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Kestenbaum
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Peralta
authors.forename: Nancy S
authors.initials: NS
authors.lastname: Jenny
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Allison
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.forename: David
authors.initials: D
authors.lastname: Siscovick
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D044465:White People; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
chemical_list: C556354:AHSG protein, human; D060749:alpha-2-HS-Glycoprotein