The association between circulating fetuin-A levels and type 2 diabetes mellitus risk: systematic review and meta-analysis of observational studies

Abstract

BACKGROUND AND OBJECTIVE: Fetuin-A is a liver-derived circulating protein that is associated with insulin resistance and diabetes. The objective of this systematic review and meta-analysis of published observational studies was to investigate mean levels of fetuin-A in T2D patients and the relationship between blood fetuin-A levels and T2D risk. MATERIALS AND METHODS: PubMed, Embase, Google Scholar, Web of Science, and The Cochrane Library were systematically searched for potential relevant studies up to 1 December 2016. Natural logarithm-transformed estimate risks, standard mean differences on the basis of Hedges's adjusted g, and 95 confidence intervals (CIs) were calculated for all eligible studies and were combined to measure the pooled data using random-effects model. RESULTS: A total of 32 studies including 27 case-control and 5 cohort studies were included in the current study. Fetuin-A levels in T2D patients were significantly higher than control groups Hedges' g = 1.73, 95% CI (1.25-2.22), P < 0.001, with significant heterogeneity across studies (P < 0.001, I (2) = 98.46%). Findings from meta-analyses of cohort studies showed a statistically significant association between fetuin-A levels and T2D risk rate ratio = 1.62, 95% CI (1.26-2.08), P < 0.001, with no significant heterogeneity (P = 0.10, I (2) = 46.06%). CONCLUSION: We found a significant relationship between the fetuin-A levels with T2D risk. Although fetuin-A may be as a potential screening and prediction biomarker or a therapeutic target in T2D patients, further studies are required in this regard.