International Ophthalmology

, Volume 38, Issue 6, pp 2445–2450 | Cite as

Elevated serum fetuin-A levels are associated with grades of retinopathy in type 2 diabetic patients

  • Ahu YilmazEmail author
  • Tolga Yilmaz
  • Murat Gunay
Original Paper



Fetuin-A is a physiological inhibitor of insulin receptor tyrosine kinase and thus associated with insulin resistance, metabolic syndrome, and an increased risk for type 2 diabetes mellitus (T2DM). This study aims to investigate the possible relation between the serum fetuin-A levels and the stages of diabetic retinopathy (DR) in patients with T2DM.


This prospective study included 82 patients with T2DM and 19 age- and gender-matched healthy controls (HCs) (group 1). Diabetic patients were subclassified into three groups according to ocular findings: without DR (group 2; n = 26); non-proliferative DR (group 3; n = 29), and proliferative DR (group 4; n = 27). Serum fetuin-A levels were determined by a spectrophotometric technique using an immulite chemiluminescent immunometric assay. The data were analyzed using a Mann–Whitney U test, and the results were expressed as mean ± standard deviation.


Mean fetuin-A values were 256.4 ± 21.3 μg/ml in group 1, 263.5 ± 24.2 μg/ml in group 2, 282.2 ± 31.1 μg/ml in group 3, and 296.3 ± 26.2 μg/ml in group 4. Group 2 had higher mean fetuin-A level compared with group 1, but the difference was not statistically significant (p > 0.05). Serum fetuin-A levels were significantly higher in groups 3 and 4 compared with HCs (both p < 0.05). Compared with group 2, both DR groups had higher fetuin-A levels with a significant difference (both p < 0.05); and patients with proliferative DR had significantly higher serum fetuin-A levels compared with non-proliferative DR (p < 0.05). The mean serum fetuin-A levels increased with the stage of DR, and the highest levels were found in patients with proliferative DR.


Our findings suggest an association between fetuin-A levels and DR stage. In diabetic patients, the risk of retinopathy development increases with higher fetuin-A values. Fetuin-A may play an important role in the pathophysiology and progression of DR.


Fetuin-A Type 2 diabetes mellitus Diabetic retinopathy Insulin resistance 


Compliance with ethical standards

Conflict of interests

The authors declare that there are no conflicts of interest.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  1. 1.Department of OphthalmologyBagcilar Education and Research HospitalIstanbulTurkey
  2. 2.Department of OphthalmologyBeyoglu Eye Education and Research HospitalIstanbulTurkey
  3. 3.Department of BiochemistryMengucek Gazi Education and Research HospitalErzincanTurkey

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