Fetuin-A as an Alternative Marker for Insulin Resistance and Cardiovascular Risk in Prepubertal Children

Aim: Fetuin-A plays a role in insulin resistance and cardiovascular disease. This study aims to determine the relationship between fetuin-A levels and cardiometabolic risk factors, as well as to investigate the effect of serum fetuin-A on insulin resistance indices to determine whether fetuin-A is an additional marker for insulin resistance in prepubertal children. Methods: A total of 99 prepubertal Korean children (59 males) aged from 6.0 to 10.0 years was included in this study. Subjects were divided into underweight/normal-weight and overweight/obese groups. Serum fetuin-A levels were measured using an enzyme-linked immunosorbent assay and were natural logarithm (ln)-transformed. Results: Serum fetuin-A concentrations were significantly elevated in overweight/obese children as compared with underweight/normal-weight children (P=0.029). Ln serum fetuin-A was significantly positively correlated with body mass index (BMI) standard deviation scores (SDSs) (r = 0.239, P=0.017), triglyceride levels (r=0.285, P=0.004), ln insulin (r=0.377, P<0.001), systolic blood pressure (BP) (r = 0.274, P=0.006), and diastolic BP (r = 0.304, P=0.006) and was significantly inversely correlated with high-density lipoprotein cholesterol (HDL-C) levels (r=-0.236, P=0.019). In univariate linear regression analysis, ln fetuin-A was significantly positively associated with the homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.356, P<0.001) and significantly inversely associated with the quantitative insulin sensitivity check index (QUICKI) (r = 0.309, P=0.002). Following adjustment for age, gender, BMI, and lipid profiles in multivariate linear regression analysis, fetuin-A was significantly positively associated with HOMA-IR (P=0.048) and marginally inversely associated with QUICKI (P=0.054). Conclusions: Our results suggest that fetuin-A can be an alternative marker for insulin resistance and cardiovascular risk in prepubertal children.