Osteoprotegerin is a Better Serum Biomarker of Coronary Artery Calcification than Osteocalcin in Type 2 Diabetes.
Osteoprotegerin is a Better Serum Biomarker of Coronary Artery Calcification than Osteocalcin in Type 2 Diabetes.
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DOI：
10.4158/ep14229.or
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Pohlig RT
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文献类型：
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作者：
Maser RE;Lenhard MJ;Sneider MB;Pohlig RT
冠状动脉钙化(CAC)是动脉粥样硬化的一个显著特征，与心血管事件有关。体外研究表明，骨保护素(OPG)和骨钙素(OC)在血管壁具有抗钙化作用。本研究的目的是调查2型糖尿病患者CAC与血清骨生物标记物之间的关系。我们检查了50名2型糖尿病患者。CAC成像采用多层螺旋CT。以阿加斯顿单位表示的CAC评分≥10被认为是异常的。用双抗体夹心酶联免疫吸附测定法测定OC、低羧化OC(UcOC)和OPG水平。在研究队列中，存在CAC评分的异常。CAC评分异常者OPG水平显著升高(5.5±2.0pmol/L vs.4.2±1.7pmol/L；P=0.026)。未发现OC或ucOC的单变量差异。Logistic回归分析显示，血清OPG水平的增加与CAC评分的增加显著相关(优势比，3.324；95%可信区间，1.321至8.359；P=.011)。糖尿病病程较长是一个显著的协变量(P=.026)，而最终模型中的非显著协变量是年龄、性别、收缩压、体重指数、由胰岛素抵抗的稳态模型评估确定的胰岛素抵抗、瘦素、脂联素和血糖控制。该模型的Nagelkerke R2为0.66。OC和ucOC均不与CAC评分升高显著相关。我们的结果表明，OPG是一种比OC或ucOC更有用的血清生物标记物，用于识别2型糖尿病动脉钙化风险增加的患者。
Coronary artery calcification (CAC) is a prominent feature of atherosclerosis and is associated with cardiovascular events. In vitro studies have suggested that osteoprotegerin (OPG) and osteocalcin (OC) exert anticalcification potential in the vessel wall. The objective of this study was to investigate the association of CAC and serum bone biomarkers in persons with type 2 diabetes. We examined 50 individuals with type 2 diabetes. CAC imaging was performed by multidetector computed tomography. CAC scores ≥10, expressed in Agatston units, were considered abnormal. OC, undercarboxylated OC (ucOC), and OPG levels were determined by enzyme-linked immunosorbent assay. Abnormal CAC scores were found for 64% of the study cohort. OPG levels were significantly elevated (5.5 ± 2.0 pmol/L vs. 4.2 ± 1.7 pmol/L; P = .026) for those with abnormal CAC scores. No univariate differences were found for OC or ucOC. Logistic regression analyses revealed that an increase in serum OPG level was significantly associated with an increase in CAC score (odds ratio, 3.324; 95% confidence interval, 1.321 to 8.359; P = .011). Longer duration of diabetes was a significant covariate (P = .026), whereas nonsignificant covariates in the final model were age, gender, systolic blood pressure, body mass index, insulin resistance determined by the homeostasis model assessment for insulin resistance, leptin, adiponectin, and glycemic control. The Nagelkerke R2 for the model was 0.66. Neither OC nor ucOC were significantly associated with elevated CAC scores. Our results suggest that OPG is a more useful serum biomarker than OC or ucOC for identifying those at increased risk of arterial calcification in type 2 diabetes.