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Levels of fetuin‐A relate to the levels of bone turnover biomarkers in male and female patients with type 2 diabetes

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Objective  To evaluate the relationship of plasma fetuin‐A levels with markers of bone turnover in male and female type 2 diabetic subjects.

Background  Fetuin‐A, which is a serum protein produced by the liver and promotes bone mineralization, is an independent risk factor for type 2 diabetes, whilst type 2 diabetes is associated with an increased incidence of osteoporosis or fractures. It is not known how fetuin‐A levels relate to parameters of bone metabolism in type 2 diabetes.

Design and patients  Eighty patients with type 2 diabetes [40 men and 40 women matched for age, body mass index (BMI) and time since diagnosis of diabetes] were studied. Fetuin‐A together with metabolic parameters and levels of serum carboxy‐terminal telopeptide of type 1 collagen (C‐telopeptide), osteocalcin, procollagen type 1 amino‐terminal propeptide (P1NP), bone alkaline phosphatase (ALP) and sex hormones was determined in all participants.

Results  Fetuin‐A levels did not differ significantly between male and female diabetic subjects. In a model adjusted for age, BMI, fatty liver index (FLI), time since diagnosis of diabetes, HbA 1c , antidiabetic and lipid‐lowering drug therapies, smoking, total serum protein, creatinine, gamma glutamyl‐transferase, parathyroid hormone, C‐reactive protein, glomerular filtration rate, and presence of micro‐, cardio‐, and peripheral vascular diabetic complications, fetuin‐A showed a significant positive association with levels of bone ALP (r = 0·71, P = 0·006) in men. In women, fetuin‐A was significantly negatively associated with C‐telopeptide (r = −0·60, P = 0·03) levels.

Conclusions  Results suggest an independent association of fetuin‐A levels with markers of bone turnover in male and female patients with type 2 diabetes. More studies are needed to determine whether fetuin‐A could serve as a new marker for fracture risk or osteoporosis in type 2 diabetes and to explore its potential sexually dimorphic effects.
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Document Type: Research Article

Affiliations: 1: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Unit of Gender Medicine, Medical University of Vienna 2: Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna 3: Department of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna 4: Department of Cardiology and Emergency Medicine, Wilhelminen Hospital, Vienna, Austria

Publication date: April 1, 2012

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