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Serum fetuin‐A concentration predicts glycaemic outcomes in people with prediabetes: a prospective study from eastern India
Author(s) -
Dutta D.,
Mondal S. A.,
Kumar M.,
Hasanoor Reza A. H.,
Biswas D.,
Singh P.,
Chakrabarti S.,
Mukhopadhyay S.
Publication year - 2014
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12539
Subject(s) - prediabetes , medicine , fatty liver , diabetes mellitus , endocrinology , quartile , type 2 diabetes , prospective cohort study , gastroenterology , disease , confidence interval
Aim 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.