Serum fetuin-A levels in patients with type 2 diabetes mellitus

Fetuin-A is a multifunctional circulating glycoprotein that inhibits ectopic vascular calcification and induces insulin resistance in animals and humans. Low fetuin-A levels in dialysed patients are associated with cardiovascular mortality due to accelerating vascular calcification. The most serious complications of diabetes are atherosclerotic heart disease, cerebrovascular disease, and renal disease. The most common cause of death with diabetes mellitus is myocardial infarction. In this work we determined serum concentration of fetuin-A to elucidate its role in the development of cardiovascular complications in diabetic patients. We studied 51 patients with type 2 diabetes mellitus and 30 healthy humans. Macrovascular complications were present in 30 and microvascular in 19 diabetic patients, In these groups we determined serum concentration of fetuin-A, fibrinogen, CRP, total cholesterol, triglicerydes, cholesterol HDL and LDL. We found that serum levels of fetuin-A were decreased in the group of diabetic patients compared to control subjects, In patients with low fetuin-A concentration (below 22.44 ng/L) high levels of C-reactive protein (>5 mg/L) were found in 56 % and high concentration of fibrinogen (>4 g/L) in 75% of cases. In the group of patients with all of three risk factors the frequency of macrovascular complications was 100%. Our data suggest that fetuin-A is an independent risk factor of the development of macrovascular but not microvascular complications in type 2 diabetes mellitus patients. We concluded that determination of serum fetuin concentration together with high sensitivity CRP and fibrinogen levels may be a useful indicator of pending pathological process in cardiovascular system.