Endocrine Abstracts

Introduction: It is known that type 2 diabetes increases the risk of cardiovascular disease. Fetuin-A is a multifunctional serum glycoprotein and its role in the pathogenesis of type 2 diabetes, atherosclerosis and cardiovascular disease is still discussed.

Material and methods: The study was conducted in 36 patients (12 F and 24 M) with type 2 diabetes mellitus (DM2) and acute coronary syndrome (ACS), aged mean 70.22±7.62. The group was divided into subgroups: 26 subjects with myocardial infarction (MI) and ten subjects with unstable angina (UA) as well as nine subjects with uncomplicated course of ACS and 27 subjects with complications including cardiac arrhythmias, pulmonary oedema, cardiac arrerst. The control group was composed of 17 patients (6 F and 11 M) with type 2 diabetes and without cardiovascular disease aged mean 56.06±11.77. Determinations of serum fetuin-A levels with the use of Human Fetuin-A ELISA Kit (an assay sensitivity of 3.5 μg/ml) were performed. For statistical analysis, Statistica 8.0 StatSoft was used (Mann–Whitney U test and Spearman’s test were applied).

Results: Patients with DM2 and ACS had decreased fetuin-A concentrations compared to subjects in control group (0.515±0.149 vs 0.608±0.153 g/l; Z=1.984; P<0.05). Subjects with DM2 and MI had lower fetuin-A levels than patients with DM2 and UA (0.483±0.147 vs 0.597±0.126 g/l; Z=2.101; P<0.05). The inverse statistically significant (P=0.003; 0.042; 0.039 respectively) correlations between fetuin-A concentration and troponin, CK-MB and myoglobin levels, measured few hours after myocardial infarction, have been observed. Higher fetuin-A levels have been noted in subjects with DM2 and complications in the course of ACS compared to those without complications (0.547±0.143 vs 0.418±0.129 g/l; Z=2.155; P<0.05).

Conclusions: Fetuin-A concentration is decreased in patients with diabetes and acute coronary syndrome. It correlates negative with severity of myocardial ischemia as well. Fetuin-A deficiency may be a predictor of cardiovascular risk and a marker of ischemia’s severity in patients with type 2 diabetes.