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Elevated Level of Certain Protein Linked With Risk for Diabetes E-mail
Written by Jeff Behar   
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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