Increased fetuin-A concentrations in impaired glucose tolerance with or without nonalcoholic fatty liver disease, but not impaired fasting glucose.
BACKGROUND
Fetuin-A, a liver-derived glycoprotein that impairs insulin signaling, is associated with nonalcoholic fatty liver disease (NAFLD), diabetes, and the risk of cardiovascular diseases. Both prediabetes and NAFLD are associated with increased cardiovascular risk, and their concurrence significantly impairs hepatic and adipose tissue insulin sensitivity.


OBJECTIVE
Our objective was to investigate the relationship between serum fetuin-A levels and prediabetes in subjects with or without NAFLD.


METHODS
This was a cross-sectional case-control study.


METHODS
A total of 510 age- and sex-matched subjects with normal glucose tolerance (NGT), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) with or without NAFLD were recruited. Each subject was assessed by abdominal ultrasound to diagnose NAFLD.


METHODS
Serum fetuin-A concentrations were compared between groups. The association with clinico-metabolic parameters was examined.


RESULTS
The presence of NAFLD significantly increases fetuin-A levels in subjects with NGT and prediabetes. As compared with NGT, IGT, but not IFG, significantly increases fetuin-A levels in subjects with or without NAFLD. Serum fetuin-A concentrations were positively related to postload 2-h glucose, body mass index, triglyceride, and homeostasis model assessment of insulin resistance but negatively associated with age, high-density lipoprotein cholesterol, and adiponectin. In multiple regression analysis, age, IGT vs. NGT, and IGT with NAFLD vs. NGT were independently associated with fetuin-A levels after adjustment for cardiovascular risk factors and adiponectin.


CONCLUSIONS
IGT with or without NAFLD was independently associated with fetuin-A levels after adjustment for cardiometabolic risk factors. The elevated fetuin-A levels could have a clinical implication in the increased cardiovascular risk and insulin resistance associated with NAFLD and IGT.
Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Tainan 70403, Taiwan.
Horng-Yih
HY
Ou
Yi-Ching
YC
Yang
Hung-Tsung
HT
Wu
Jin-Shang
JS
Wu
Feng-Hwa
FH
Lu
Chih-Jen
CJ
Chang
D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005215:Fasting / Q000097:blood* / Q000378:metabolism; D005234:Fatty Liver / Q000097:blood* / Q000150:complications; D005260:Female; D018149:Glucose Intolerance / Q000097:blood* / Q000150:complications; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009994:Osmolar Concentration; D015854:Up-Regulation; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis* / Q000378:metabolism
D001786:Blood Glucose; D060749:alpha-2-HS-Glycoprotein