Studies conducted in humans have reported elevated concentrations of fetuin-A in subjects with the metabolic syndrome or with insulin resistance, two conditions predictive of an increased cardiovascular disease risk. In a case-cohort study of the EPIC-Potsdam Study, the relationship between fetuin-A and myocardial infarction as well as ischemic stroke was investigated. Plasma fetuin-A concentrations were measured in 227 individuals who developed myocardial infarction, in 168 individuals who developed ischemic stroke, and in 2,198 individuals who remained free of cardiovascular events during the study follow-up (about 8 years). After adjusting for age and sex, subjects in the highest quintile of plasma fetuin-A had an increased risk of myocardial infarction (relative risk=3.80, 95% CI: 2.37-6.10, p<0.0001) and ischemic stroke (relative risk=3.93, 95% CI: 2.17-7.12, p<0.0001). In a fully adjusted model (smoking status, body mass index, waist girth, alcohol consumption, educational level, physical activity, hypertension, diabetes, cholesterol, HDL cholesterol, and C-reactive protein), relative risks were marginally affected (relative risk for myocardial infarction=3.25, 95% CI: 2.01-5.28, p<0.0001; relative risk for ischemic stroke=3.78, 95% CI: 2.06-6.94, p<0.0001). Although study results showed a relationship between fetuin-A and myocardial infarction or ischemic stroke, additional studies will have to be conducted to clarify the mechanisms involved in this association.
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