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Having a higher than normal level of fetuin-A, a protein produced in
the liver and secreted into the blood stream, is associated with an
increased risk of the development of diabetes, according to a study in
the July 9 , 2008 issue of JAMA.
Type 2 Diabetes mellitus has become a
global epidemic and the increased prevalence of obesity is a major
contributing factor. However, diabetes does not develop in all obese
individuals and there is a strong genetic contribution to risk.
Studies have shown however, that there is a
direct relationship between the degree of obesity and the risk of developing
type 2 diabetes, and this holds true in children as well as adults. It is
estimated that the chance to develop diabetes doubles for every 20% increase
over desirable body weight.
Despite
significant recent advances, mechanisms responsible for individual
differences in clinical phenotype remain largely unknown,” the authors
write. Previous studies have found an association between higher
fetuin-A levels and insulin resistance, but the association with
incident Type 2 Diabetes mellitus is unknown.
The Diabetes Fetuin-A Link
Joachim H. Ix,
M.D., M.A.S., of the University of California, San Diego, and San Diego
Veterans Affairs Healthcare System, and colleagues conducted a study to
examine whether higher fetuin-A levels are associated with the
occurrence of diabetes in older persons. The study included 406 persons
(age 70 to 79 years) without diabetes at the start of the study, and
who had fetuin-A levels measured at baseline, and had six years of
follow-up. Diabetes developed in 135 participants (10.1 cases/1,000
person-years [the number of individuals in the study times the number
of years of follow-up per person]).
Analysis indicated a graded
increase in the incidence of diabetes with increased fetuin-A levels.
The third of the group with the highest levels had more than twice the
incidence rate compared with the lowest third (13.3 vs. 6.5 cases/1,000
person-years). The association was independent of physical activity,
inflammatory biomarkers, and other commonly available measures of insulin resistance and was irrespective of sex, race, and obesity
status. The association was moderately weakened by adjustment for
visceral adiposity (fat accumulation around the abdomen).
“Future
studies should evaluate whether the results may generalize to
middle-aged individuals in whom the [diabetes] incidence rate is
highest. If confirmed in future studies, fetuin-A may ultimately prove
useful as a target for therapeutics, and its study may provide novel
insights to glucose metabolism in humans,” the authors conclude.
Reference: JAMA. 2008;300[2]:182-188.
About Type 2 Diabetes
Type 2 diabetes is also referred to as non-insulin dependent diabetes mellitus (NIDDM),
or adult onset diabetes mellitus (AODM). Type 2 diabetes affects
nearly 21 million in the United States and nearly 200 million people
worldwide.
Type 2 diabetes is
characterized by high levels of blood sugar, caused by the body's inability to
utilize insulin to move blood sugar into the cells for energy. In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately
for their body's needs, particularly in the face of insulin
resistance as
discussed above. In many cases this actually means the pancreas produces larger
than normal quantities of insulin.
Diabetes is a major cause of heart disease and stroke, as well
as the most common cause of blindness, kidney failure and amputations in U.S.
adults.
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