title: Plasma levels of fetuin-A and risk of coronary heart disease in US women: the Nurses' Health Study.
abstract: BACKGROUND
  Fetuin-A may be involved in the etiology of coronary heart disease (CHD) through opposing pathways (ie, promoting insulin resistance and inhibiting ectopic calcification). We aimed to explicitly examine whether systemic inflammation, a factor leading to elevated vascular calcification, may modify the association between fetuin-A and CHD risk.
  
  
  RESULTS
  During 16 years of follow-up (1990-2006), we prospectively identified and confirmed 466 incident fatal or nonfatal CHD case in the Nurses' Health Study. For each case, 1 healthy control was selected using risk-set sampling from 26 245 eligible participants. Cases and controls were matched for age, smoking status, fasting status, and date of blood draw. After multivariate adjustment for lifestyle factors, body mass index, diet, and blood lipids, fetuin-A levels were not associated with CHD risk in the whole population: odds ratio (OR) (95% CI) comparing extreme quintiles of fetuin-A was 0.79 (0.44 to 1.40). However, a significant inverse association was observed among participants with higher C-reactive protein levels (Pinteraction=0.04). The OR (95% CI) comparing highest versus lowest quintiles of fetuin-A was 0.50 (0.26 to 0.97; Ptrend=0.004) when C-reactive protein levels were above population median (0.20 mg/dL), whereas among the remainder of the participants, the corresponding OR (95% CI) was 1.09 (0.58 to 2.05; Ptrend=0.75).
  
  
  CONCLUSIONS
  In this population of US women, fetuin-A levels were associated with lower CHD risk when C-reactive protein levels were high, but null association was observed among participants with lower C-reactive protein levels. This divergent pattern of association needs replication in future studies.
authors: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (Q.S., M.K.T., E.B.R., J.A.E.M.) Department of Nutrition, Harvard School of Public Health, Boston, MA (Q.S., E.B.R.).
authors: Qi
authors: Q
authors: Sun
authors: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., J.A.E.M., C.M.A., K.M.R.).
authors: Monik C
authors: MC
authors: Jiménez
authors: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (Q.S., M.K.T., E.B.R., J.A.E.M.).
authors: Mary K
authors: MK
authors: Townsend
authors: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (Q.S., M.K.T., E.B.R., J.A.E.M.) Department of Nutrition, Harvard School of Public Health, Boston, MA (Q.S., E.B.R.) Department of Epidemiology, Harvard School of Public Health, Boston, MA (E.B.R., J.A.E.M.).
authors: Eric B
authors: EB
authors: Rimm
authors: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (Q.S., M.K.T., E.B.R., J.A.E.M.) Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., J.A.E.M., C.M.A., K.M.R.) Department of Epidemiology, Harvard School of Public Health, Boston, MA (E.B.R., J.A.E.M.).
authors: JoAnn E
authors: JE
authors: Manson
authors: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., J.A.E.M., C.M.A., K.M.R.).
authors: Christine M
authors: CM
authors: Albert
authors: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (M.C.J., J.A.E.M., C.M.A., K.M.R.).
authors: Kathryn M
authors: KM
authors: Rexrode
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D005260:Female; D060748:Fetuins / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D009726:Nurses / Q000706:statistics & numerical data; D016017:Odds Ratio; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D060748:Fetuins
keywords: coronary heart disease; fetuin‐A; inflammation