title: Serum fetuin-A concentration predicts glycaemic outcomes in people with prediabetes: a prospective study from eastern India.
abstract: OBJECTIVE
  To evaluate the role of fetuin-A levels in predicting glycaemic outcomes (progression to diabetes or reversion to normoglycaemia) in people with prediabetes.
  
  
  METHODS
  A total of 2119 people were screened, of whom 144 people with prediabetes, 50 people with normoglycaemia and 66 people with newly diagnosed diabetes underwent estimation of fasting insulin, fetuin-A, interleukin-6, interleukin-1β, tumour necrosis factor-α, lipid and 25-hydroxyvitamin-D levels and assessment of non-alcoholic fatty liver disease using ultrasonography and the fatty liver index. People with prediabetes were followed and analysed according to glycaemic outcome and quartile of fetuin-A level.
  
  
  RESULTS
  Fetuin-A, interleukin-1β, interleukin-6, tumour necrosis factor-α and triglyceride levels and presence of non-alcoholic fatty liver disease increased across the glycaemic spectrum and were highest in people with diabetes. A total of 32 people with prediabetes reverted to normoglycaemia, 23 progressed to diabetes and 65 remained with prediabetes over a mean ± sd follow-up of 32.12 ± 8.4 months. People progressing to diabetes had higher baseline glycaemia rates, fetuin-A levels, interleukin-1β levels, fatty liver index scores and prevalence of non-alcoholic fatty liver disease and lower 25-hydroxyvitamin-D levels. People with prediabetes in the highest fetuin-A quartile had the highest risk of progression to diabetes (relative risk 2.68, 95% CI 0.95-7.55; P = 0.06) and the lowest rate of reversion to normoglycaemia (relative risk 0.27, 95% CI 0.08-0.85; P = 0.03). Fetuin-A levels correlated with interleukin-1β levels (r = 0.420; P < 0.001), interleukin-6 levels (r = 0.231; P = 0.022) and fatty liver index scores (r = 0.319; P < 0.001). Cox regression showed that higher fetuin-A levels and higher BMI and lower 25-hydroxyvitamin-D levels were predictive of lower rates of reversion to normoglycaemia. Age, triglyceride levels, and interleukin-6 and interleukin-1β levels were predictive of progression to diabetes.
  
  
  CONCLUSIONS
  Increased fetuin-A level has an adverse impact on glycaemic outcomes in prediabetes. This study highlights the importance of fetuin-A as a predictor of glycaemic outcomes in prediabetes.
authors: Department of Endocrinology and Metabolism, School of Digestive and Liver Diseases, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Calcutta, India.
authors: D
authors: D
authors: Dutta
authors: S A
authors: SA
authors: Mondal
authors: M
authors: M
authors: Kumar
authors: A H
authors: AH
authors: Hasanoor Reza
authors: D
authors: D
authors: Biswas
authors: P
authors: P
authors: Singh
authors: S
authors: S
authors: Chakrabarti
authors: S
authors: S
authors: Mukhopadhyay
mesh_terms: D000328:Adult; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007333:Insulin Resistance; D053583:Interleukin-1beta / Q000378:metabolism*; D015850:Interleukin-6 / Q000378:metabolism*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology; D011236:Prediabetic State / Q000453:epidemiology / Q000378:metabolism*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014807:Vitamin D / Q000031:analogs & derivatives / Q000378:metabolism; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; C508585:IL1B protein, human; C508600:IL6 protein, human; D053583:Interleukin-1beta; D015850:Interleukin-6; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D060749:alpha-2-HS-Glycoprotein; D014807:Vitamin D; C104450:25-hydroxyvitamin D