Association of Serum Fetuin-A Levels With the Risk of Albuminuria in Middle-Aged and Elderly Chinese.

CONTEXT: Fetuin-A is an important hepatokine associated with many cardiometabolic abnormities. The association between fetuin-A and albuminuria has not been investigated in a prospective cohort.

OBJECTIVE

The objective of the study was to prospectively investigate whether serum fetuin-A levels were associated with albuminuria in middle-aged and elderly Chinese.

DESIGN, SETTING, AND

PARTICIPANTS

A community-based study was conducted at baseline in 2009, including 3102 individuals aged 40 years or older and followed up for 4 years.

MAIN OUTCOME MEASURES: Baseline and follow-up urine samples were collected to measure urinary albumin and creatinine concentrations. Albuminuria was defined as urinary albumin to creatinine ratio (UACR) of 30 mg/g or greater.

RESULTS

A total of 194 participants (8.5%) developed albuminuria during the follow-up. Men who developed albuminuria had significantly higher baseline levels of fetuin-A compared with those who did not (338.2 vs 292.9 mg/L, P = .02). Among men, after adjustment for traditional risk factors, each 1-SD increase of fetuin-A level (131.6 mg/L) was associated with a 32% higher risk for developing albuminuria (odds ratio 1.32, 95% confidence interval 1.07-1.62). In addition, among men, compared with participants in the lowest tertile (<253.1 mg/L) of serum fetuin-A levels, those in the highest tertile (>338.2 mg/L) had a 2-fold risk for developing albuminuria (odds ratio 2.07, 95% confidence interval 1.04-4.12) after multivariate adjustment. No association between fetuin-A levels and incident albuminuria was observed in women.

CONCLUSIONS

High serum fetuin-A levels were independently associated with an increased risk of developing albuminuria in middle-aged and elderly men, whereas no significant associations were found in women.