Endocrine Abstracts

Background: Diabetes is a risk factor for both PAD and PAD-associated mortality. Diabetic patients have worse arterial disease and a poorer outcome than nondiabetic patients. Fetuins are blood proteins made in the liver more abundant in fetal blood. Fetuin-A is regarded as an inhibitor of systemic calcification.

Aim of this work: To assess the relationship between plasma fetuin-A levels and peripheral vascular disease in type 2 diabetes mellitus.

Subjects and methods: This cross sectional study was conducted on 50 subjects aged from 50 to 65 years old divided into group 1: 20 T2DM patients with PVD. Group 2: 20 T2DM patients without PVD. Group 3: ten healthy subjects as control group. They were subjected to full clinical history, thorough clinical examination, laboratory investigations including fasting and 2-h postprandial blood glucose level, HbA1c, measurement of plasma fetuin-A level using ELISA and arterial Doppler ultrasound on peripheral vasculature for assessment of ankle peak systolic velocity (APSV).

Results: There was a highly significant increase in weight and BMI, FBG, and PBG in group 1 (diabetics with PVD) and group 2 (diabetics without PVD) than group 3 (control) (P<0.001). While there was a highly significant decrease in plasma fetuin-A level and APSV in diabetics with PVD when compared with diabetics without PVD and also when compared with control (P<0.001) While there was no statistical significant difference between group 2 (diabetics without PVD) and group 3 (control) as regard fetuin-A level (P=0.065). There was a highly statistical significant decrease in plasma fetuin-A level and APSV (P<0.001) being lower in group 1 than group 2 but there was no statistical significant difference as regard weight, height, BMI, FBG, PBG, and HbA1c. There was a highly significant positive correlation between fetuin-A and APSV (r=0.737, P<0.001) but a negative non-significant correlation between fetuin-A and the other parameters.

Conclusion: These results postulate an association between lower plasma fetuin-A level and peripheral vascular disease in type 2 diabetic patients.