Endocrine Abstracts

Background: Hyperglycaemia produces various changes in the vascular tissue at the cellular level that accelerates the atherosclerosis. There is a direct correlation among carotid arterial stiffness and serum fetuin-A level. Fetuin-A is a marker of the inflammatory nutritional state and acts as a protective agent because it solubilises the calcium phosphate salt.

Aim of this work: To study the role of fetuin A in atherosclerosis and its association with type 2 diabetes.

Subjects and methods: This cross sectional study was conducted on 50 subjects aged from 40 to 60 years old divided into group I: 20 T2DM patients having atherosclerosis. Group II: 20 non diabetic patients having atherosclerosis. Group III: 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, lipid profile, measurement of plasma fetuin-A level using ELISA, and measurement of carotid intimal thickness using duplex ultrasound.

Results: There was a highly significant difference between the three groups as regard SBP, DBP, FBG, PBG, HbA1c, TG, HDL-c, LDL-c, carotid intimal thickness, and fetuin-A level (P<0.001) and on comparing the diabetics with atherosclerosis (group I) with non diabetics with atherosclerosis (group II) we found a highly statistical significant decrease in plasma fetuin-A level (P<0.001) being lower in group (I) and a highly significant increase in carotid intimal thickness, SBP, and LDL-c (P<0.001) in group I. We also found a highly significant negative correlation between fetuin-A and SBP, LDL-c, and carotid intimal thickness (P<0.001). A significant positive correlation was also found between carotid intimal thickness and SBP, HbA1c, and LDL-c (P<0.05). We found that the cutoff point of fetuin-A level using the ROC curve is 125 μg/ml with 100% sensitivity, 90% specificity, 97.1% accuracy, and a positive predictive value of 97.6%.

Conclusion: Our results postulate that there is an association between lower plasma fetuin-A level and the development of atherosclerosis especially in those having type 2 diabetes.