TY  - JOUR
A1  - Birukov, Anna
A1  - Polemiti, Elli
A1  - Jaeger, Susanne
A1  - Stefan, Norbert
A1  - Schulze, Matthias B.
T1  - Fetuin-A and risk of diabetes-related vascular complications
BT  - a prospective study
JF  - Cardiovascular diabetology
N2  - Background
Fetuin-A is a hepatokine which has the capacity to prevent vascular calcification. Moreover, it is linked to the induction of metabolic dysfunction, insulin resistance and associated with increased risk of diabetes.
It has not been clarified whether fetuin-A associates with risk of vascular, specifically microvascular, complications in patients with diabetes. 
We aimed to investigate whether pre-diagnostic plasma fetuin-A is associated with risk of complications once diabetes develops. 

Methods 
Participants with incident type 2 diabetes and free of micro- and macrovascular disease from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort (n = 587) were followed for microvascular and macrovascular complications (n = 203 and n = 60, respectively, median follow-up: 13 years).
Plasma fetuin-A was measured approximately 4 years prior to diabetes diagnosis. Prospective associations between baseline fetuin-A and risk of complications were assessed with Cox regression. 

Results 
In multivariable models, fetuin-A was linearly inversely associated with incident total and microvascular complications, hazard ratio (HR, 95% CI) per standard deviation (SD) increase: 0.86 (0.74; 0.99) for total, 0.84 (0.71; 0.98) for microvascular and 0.92 (0.68; 1.24) for macrovascular complications. After additional adjustment for cardiometabolic plasma biomarkers, including triglycerides and high-density lipoprotein, the associations were slightly attenuated: 0.88 (0.75; 1.02) for total, 0.85 (0.72; 1.01) for microvascular and 0.95 (0.67; 1.34) for macrovascular complications. No interaction by sex could be observed (p > 0.10 for all endpoints). 

Conclusions 
Our data show that lower plasma fetuin-A levels measured prior to the diagnosis of diabetes may be etiologically implicated in the development of diabetes-associated microvascular disease.
KW  - Fetuin-A
KW  - biomarkers
KW  - epidemiology
KW  - Type 2 diabetes
KW  - vascular disease;
KW  - vascular calcification
KW  - microvascular complications
Y1  - 2022
U6  - https://doi.org/10.1186/s12933-021-01439-8
SN  - 1475-2840
VL  - 21
IS  - 1
PB  - BMC
CY  - London
ER  -