Serum fetuin-B is positively associated with intrahepatic triglyceride content and increases the risk of insulin resistance in obese Chinese adults: A cross-sectional study

Background: Fetuin-B impairs insulin action in myotubes and hepatocytes and causes glucose intolerance in mice. This study explored the correlation between serum fetuin-B and intrahepatic triglyceride (IHTG) content, and the association between fetuin-B and the risk of insulin resistance in the general adult population. Methods: A cross-sectional study of 1318 obese adults who underwent serum fetuin-B testing and hepatic ultrasonography was conducted in Xiamen, China. The IHTG content was determined in 428 subjects by magnetic resonance spectroscopy. Results: Non-alcoholic fatty liver disease prevalence was significantly higher in those with the highest serum fetuin-B concentrations and the highest IHTC content (Tertile 3) than in subjects in Tertiles 1 and 2 (62.6% vs 60.7% and 54.3%, respectively [P = 0.032], and 15.3% vs 12.8% and 12.7%, respectively [P = 0.049]). There was a significant association between increasing serum fetuin-B tertiles and both increasing fasting insulin concentrations (mean [+/- SD] 11.9 +/- 6.8, 12.7 +/- 7.6, and 13.3 +/- 6.4 mIU/L in Tertiles 1, 2 and 3, respectively; P = 0.006) and prevalence of insulin resistance (54.4%, 58.9%, and 64.5% in Tertiles 1, 2 and 3, respectively; P = 0.010). In linear regression analysis, IHTG content was independently and positively correlated with serum fetuin-B (regression coefficient 0.015; P = 0.045). With adjustment for potential confounders, serum fetuin-B was independently associated with increased risk of insulin resistance, with an adjusted odds ratio per standard deviation increase in fetuin-B of 1.14 (95% confidence interval 1.01-1.30; P = 0.031). Conclusions: The results demonstrate the role of fetuin-B linking liver fat accumulation to insulin resistance in humans.