Fetuin-A levels and risk of type 2 diabetes mellitus: a systematic review and meta-analysis

Vivian Yawei Guo, Bing Cao, Chunyan Cai, Kenneth King yip Cheng, Bernard Man Yung Cheung

Research output: Journal article publicationJournal articleAcademic researchpeer-review

38 Citations (Scopus)


Aims: Fetuin-A has been linked to insulin resistance and obesity. Its role in the pathogenesis of type 2 diabetes (T2DM) has also been discussed. We aimed to investigate the prospective association of fetuin-A and the risk of T2DM in a systematic review and meta-analysis. Methods: A systematic search of studies from the MEDLINE, EMBASE, Pubmed and Web of Science using fetuin-A, diabetes and various synonyms was conducted up to June 5, 2017. Relevant studies were extracted by two reviewers independently. The quality of studies was assessed using Newcastle–Ottawa scales. Overall estimates were pooled using fixed effect with inverse variance meta-analysis. Subgroup analyses by gender, study population, techniques of assessing fetuin-A, diabetes ascertainment methods, follow-up duration and measures of association were conducted. Results: Seven studies comprising a total of 11,497 individuals and 2176 cases of T2DM were included in the systematic review and meta-analysis. Overall, one SD increment of fetuin-A level was associated with a 23% greater risk of incident T2DM (RR: 1.23, 95% CI 1.16–1.31). No significant heterogeneity or publication bias was found. The association was relatively stable across different subgroups. However, the association seemed only evident in women, but not in men. Conclusions: Higher circulating fetuin-A levels were associated with increased risk of T2DM. However, the causality deserved further analysis.

Original languageEnglish
Pages (from-to)87-98
Number of pages12
JournalActa Diabetologica
Issue number1
Early online date11 Nov 2017
Publication statusPublished - Jan 2018


  • Diabetes mellitus
  • Fetuin-A
  • Meta-analysis
  • Systematic review

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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