Fetuin-A and arterial stiffness in patients with normal kidney function

Aim: To evaluate the association between fetuin-A level (AHSG), its encoding gene (Thr256Ser) and arterial function in subjects with normal kidney function. Introduction: The aortic pulse wave velocity (aPWV) is a predictor for cardiovascular mortality. Fetuin-A is a calcification inhibitor and correlates negatively with increased vascular stiffness in dialysis patients. The fetuin-A polymorphism (Thr256Ser) is associated with reduced fetuin levels and accelerated vascular calcification in dialysis patients. Little is known about the role of fetuin-A as an independent predictor for the development of arterial stiffness in healthy subjects. Materials and methods: We studied 116 subjects with normal kidney function (age 47 ± 12 years, 50 females and 66 males) of the FLEMENGHO study. Calcium measurements, plasma fetuin-A, its encoding gene (Thr256Ser) and indexes of arterial stiffness, such as aPWV and arterial distensibility, were determined. Results: Fetuin-A levels were negatively correlated with aPWV (r = - 0.21, p = 0.029). After an adjustment for multiple covariables, fetuin-A levels were independently associated with aPWV (r = - 0.30, p = 0.022) in males but not in females. Male fetuin-A SerSer carrier had lower fetuin-A levels and higher aPWV (fetuin-A: 61.9 ± 29.0 μg/ml; aPWV: 14.3 ± 0.9 m/s) as compared to ThrThr (fetuin-A: 109.9 ± 54.9 μg/ml; aPWV: 6.4 ± 1.3 m/s) and ThrSer carrier (fetuin-A: 100.8 ± 52.5 μg/ml; aPWV: 6.6 ± 1.3 m/s). Other calcium variables were not significantly associated with arterial stiffness. Conclusion: With respect to common calcium variables, only fetuin-A level showed an inverse relation with aPWV in men with normal renal function. Male fetuin-A SerSer carriers demonstrate particularly high aortic stiffness, possibly implying a status of increased cardiovascular risk.