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To the Editor: In the case-cohort study of participants in the Health, Aging, and Body Composition (ABC) Study, Dr Ix and colleagues¹ found that higher circulating levels of the liver-derived protein fetuin-A were associated with increased risk of developing type 2 diabetes in older individuals. Although fetuin-A was positively correlated with the amount of visceral fat assessed by computed tomographic scanning, the relationship to incident diabetes was only marginally attenuated after adjustment for visceral adiposity. Adjustment for the circulating adipokines adiponectin and leptin, as well as for circulating cytokines, did not affect the results, suggesting an independent effect of fetuin-A on diabetes risk.

In agreement with these findings, the European Prospective Investigation into Cancer and Nutrition (EPIC)–Potsdam cohort study found that high levels of fetuin-A were positively associated with diabetes risk after adjustment for body mass index, waist circumference, -glutamyltransferase, high sensitivity C-reactive protein levels, and other lifestyle and metabolic . . . [Full Text of this Article]

Norbert Stefan, MD
norbert.stefan@med.uni-tuebingen.de

Hans-Ulrich Häring, MD
Department of Internal Medicine
Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry
University of Tübingen
Tübingen, Germany

Matthias B. Schulze, DRPH
Public Health Nutrition Unit
Center of Life and Food Sciences Weihenstephan
Technische Universität München
Munich, Germany

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