title: Association of plasma fetuin-a levels with peripheral arterial disease and lower extremity arterial calcification in subjects with type 2 diabetes mellitus.
abstract: OBJECTIVE
  Fetuin-A is a hepatic glycoprotein that is involved in insulin resistance and atherosclerosis. Herein we examined the association of plasma fetuin-A levels with peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  A total of 71 patients with T2DM and 57 non-diabetic individuals were recruited. Diagnosis of PAD was based on the absence of triphasic waveform at pedal arteries, while ankle-brachial index (ABI) was calculated. Radiographs of both feet and ankles were taken for the assessment of lower extremity arterial calcification (LEAC). Plasma fetuin-A levels were measured using ELISA.
  
  
  RESULTS
  Patients with T2DM had higher fetuin-A levels than non-diabetic participants. Participants with diabetes and PAD had lower fetuin-A levels than non-PAD diabetic patients. In subjects with T2DM fetuin-A levels were associated with ABI. Multivariate analysis demonstrated that in patients with T2DM the odds of PAD increased with long diabetes duration, smoking, presence of arterial hypertension and dyslipidemia, as well as with lower fetuin-A levels. A trend towards higher fetuin-A levels in subjects with less severe LEAC was found.
  
  
  CONCLUSIONS
  Plasma fetuin-A levels are lower in patients with T2DM and PAD and are associated with PAD, irrespective of traditional cardiovascular risk factors. Moreover, fetuin-A may be involved in arterial calcification.
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece. Electronic address: ielefth@med.uoa.gr.
authors.forename: Ioanna
authors.initials: I
authors.lastname: Eleftheriadou
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Pinelopi
authors.initials: P
authors.lastname: Grigoropoulou
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kokkinos
authors.affiliation: Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Iordanis
authors.initials: I
authors.lastname: Mourouzis
authors.affiliation: Laboratory for Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Perrea
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Katsilambros
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Petros P
authors.initials: PP
authors.lastname: Sfikakis
authors.affiliation: First Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tentolouris
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D015536:Down-Regulation; D005260:Female; D006115:Greece / Q000453:epidemiology; D006784:Hospitals, Teaching; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011859:Radiography; D012307:Risk Factors; D061205:Vascular Calcification / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
chemical_list: C556354:AHSG protein, human; D060749:alpha-2-HS-Glycoprotein
keywords: Ankle-brachial index; Diabetes mellitus; Fetuin-a; Lower extremity arterial calcification; Peripheral arterial disease