Exercise-induced lowering of fetuin-A may increase hepatic insulin sensitivity

Steven K. Malin, Juan Pablo Del Rincon, Hazel Huang, John P. Kirwan

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Introduction: Fetuin-A is a novel hepatokine, and there is preliminary evidence that it may contribute to the pathogenesis of type 2 diabetes. Exercise reduces fetuin-A, but the specific metabolic effects particularly as they relate to the regulation of insulin resistance are unknown. This led us to examine the effect of exercise training on circulating fetuin-A in relation to skeletal muscle and/or hepatic insulin resistance in obese adults.

Methods: Twenty older adults (66.3 ± 0.9 yr; body mass index, 34.1 ± 1.2 kg·m-2) participated in this prospective 12-wk study and underwent supervised exercise training (5 dIwkj1, 60 min·d-1 at approximately 85% HRmax). Insulin resistance was assessed using the euglycemic-hyperinsulinemic clamp (40 mU·m-2 min-1) with isotope dilution ([6,6-2H2]-glucose). Skeletal muscle insulin sensitivity (rate of glucose disposal), hepatic insulin resistance (rate of glucose appearance × fasting insulin), metabolic flexibility (respiratory quotientclamp j respiratory quotientfasting), fetuin-A, high-molecular weight adiponectin, high-sensitivity C-reactive protein, leptin, and body fat (dual energy x-ray absorptiometry) were measured before and after the intervention.

Results: Exercise reduced body fat, high-sensitivity C-reactive protein, leptin and hepatic as well as skeletal muscle insulin resistance (each, P < 0.05). Fetuin-A was decreased by approximately 8% (pre, 1.01 ± 0.08, vs post, 0.89 ± 0.06 g·L-1; P < 0.05) after the intervention, and lower fetuin-A after exercise correlated with lower hepatic insulin resistance (r = -0.46, P < 0.01), increased metabolic flexibility (r = -0.70, P < 0.01) and high-molecular weight adiponectin (r = -0.57, P < 0.01).

Conclusions: Fetuin-A may contribute to exercise training-induced improvements in hepatic insulin resistance, CHO utilization, and inflammation in older obese adults. Further work is required to determine the cellular mechanism(s) of action for fetuin-A because this hepatokine is related to type 2 diabetes risk.

Original languageEnglish (US)
Pages (from-to)2085-2090
Number of pages6
JournalMedicine and Science in Sports and Exercise
Issue number11
StatePublished - Nov 10 2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation


  • Aging
  • Exercise training
  • Glucose tolerance
  • Inflammation
  • Obesity


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