The evolving roles of fetuin-A in type 2 diabetes mellitus and its potential clinical implications: a review

Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition marked by insulin resistance, decreased insulin production, and persistent low-grade inflammation. The prevalence of T2DM has increased significantly in recent decades; as a result, it is now regarded as one of the fastest-growing public health concerns worldwide. Long-term micro- and macrovascular problems such as nephropathy, retinopathy, neuropathy, and cardiovascular disease can be caused by poor blood glucose control. Therefore, developing reliable diagnostic indicators for early diagnosis and investigating new treatment targets are critical for addressing the increasing prevalence of T2DM. Several novel diagnostic approaches have been created by targeting endogenous proteins, with fetuin-A being one of the most promising targets. Human fetuin-A, also referred to as alpha-2-Heremans Schmid glycoprotein, is a liver-produced glycoprotein that is abundantly secreted into the bloodstream and seems to be involved in insulin resistance, metabolic syndrome, and inflammation. Clinical studies have shown that circulating fetuin-A levels are closely associated with T2DM and its complications, underscoring its potential as both a biomarker and a therapeutic target. This narrative review provides a detailed overview of the evolving role of fetuin-A in the development of T2DM and its associated complications, as well as its future perspectives.