Serum level of fetuin-A as a biomarker for vascular complications and severity of insulin resistance in individuals with type 2 diabetes

Background: Fetuin-A is one of the hepatokines that are capable of preventing vascular calcification. Furthermore, it induces metabolic dysfunction, IR and accompanied by elevated risk of DM. However, It remains a mystery whether fetuin-A is accompanied by risk of vascular complications in diabetics or not.Aim of the work: To assess the association of serum fetuin-A, severity of IR and vascular complications in T2DM cases.Patients and methods: In this cross sectional study we tested 160 T2DM cases; 80 patients with at least one of vascular complications and 80 patients without any vascular complications recruited from Endocrinology and metabolism unit, Internal Medicine Department, Tanta University Hospitals. Patients were assessed for DM vascular complications (Nephropathy, retinopathy, peripheral neuropathy and peripheral arterial disease).Serum fetuin-A level was assessed by ELISA, and the IR was evaluated via HOMA-IR.Results: Lower fetuin-A level was accompanied by increased risk of vascular complications among T2DM cases and serum Fetuin-A had significant sensitivity 97.68% as a diagnostic marker to vascular complications among T2DM cases especially diabetic nephropathy (P=0.0001) with cut off value of 556.40 with +ve predictive values of 91.66% and -ve predictive values of 64.46%. Also low serum fetuin a level can be considered as a significant predictor and risk factor for vascular complications among type 2 diabetic patients. Increased serum fetuin-A level is accompanied by severity of IR as evaluated by HOMA-IR and it positively correlated with HOMAIR but without clinical significanceConclusion: Lower serum fetuin a level is useful as a diagnostic biomarker and a significant predictor and risk factor for vascular complications among T2DM cases.