Journal of Endocrinological Investigation

, Volume 41, Issue 1, pp 33–47 | Cite as

The association between circulating fetuin-A levels and type 2 diabetes mellitus risk: systematic review and meta-analysis of observational studies

  • F. Roshanzamir
  • M. Miraghajani
  • M. H. Rouhani
  • M. Mansourian
  • R. Ghiasvand
  • S. M. SafaviEmail author


Background and objective

Fetuin-A is a liver-derived circulating protein that is associated with insulin resistance and diabetes. The objective of this systematic review and meta-analysis of published observational studies was to investigate mean levels of fetuin-A in T2D patients and the relationship between blood fetuin-A levels and T2D risk.

Materials and methods

PubMed, Embase, Google Scholar, Web of Science, and The Cochrane Library were systematically searched for potential relevant studies up to 1 December 2016. Natural logarithm-transformed estimate risks, standard mean differences on the basis of Hedges’s adjusted g, and 95% confidence intervals (CIs) were calculated for all eligible studies and were combined to measure the pooled data using random-effects model.


A total of 32 studies including 27 case–control and 5 cohort studies were included in the current study. Fetuin-A levels in T2D patients were significantly higher than control groups [Hedges’ g = 1.73, 95% CI (1.25–2.22), P < 0.001], with significant heterogeneity across studies (P < 0.001, I 2 = 98.46%). Findings from meta-analyses of cohort studies showed a statistically significant association between fetuin-A levels and T2D risk [rate ratio = 1.62, 95% CI (1.26–2.08), P < 0.001], with no significant heterogeneity (P = 0.10, I 2 = 46.06%).


We found a significant relationship between the fetuin-A levels with T2D risk. Although fetuin-A may be as a potential screening and prediction biomarker or a therapeutic target in T2D patients, further studies are required in this regard.


Fetuin-A Type 2 diabetes Meta-analysis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical disclosure

All included studies have been reviewed by the appropriate ethics committee and have, therefore, been performed in accordance with the ethical standards.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by the any of the authors.

Informed consent

All persons gave their informed consent prior to their inclusion in the studies.

Supplementary material

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Copyright information

© Italian Society of Endocrinology (SIE) 2017

Authors and Affiliations

  • F. Roshanzamir
    • 1
    • 2
    • 3
  • M. Miraghajani
    • 4
  • M. H. Rouhani
    • 2
    • 5
  • M. Mansourian
    • 6
  • R. Ghiasvand
    • 2
    • 5
  • S. M. Safavi
    • 2
    • 3
    Email author
  1. 1.Noncommunicable Diseases Research CenterFasa University of Medical SciencesFasaIran
  2. 2.Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
  3. 3.Department of Clinical Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
  4. 4.Cancer Research CenterShahid Beheshti University of Medical SciencesTehranIran
  5. 5.Department of Community Nutrition, School of Nutrition and Food ScienceIsfahan University of Medical SciencesIsfahanIran
  6. 6.Department of Biostatistics and Epidemiology, Health SchoolIsfahan University of Medical SciencesIsfahanIran

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