Plasma osteoprotegerin is related to carotid and peripheral arterial disease, but not to myocardial ischemia in type 2 diabetes mellitus

Abstract

BackgroundCardiovascular disease (CVD) is frequent in type 2 diabetes mellitus patients due to accelerated atherosclerosis. Plasma osteoprotegerin (OPG) has evolved as a biomarker for CVD. We examined the relationship between plasma OPG levels and different CVD manifestations in type 2 diabetes.MethodsType 2 diabetes patients without known CVD referred consecutively to a diabetes clinic for the first time (n = 305, aged: 58.6 ± 11.3 years, diabetes duration: 4.5 ± 5.3 years) were screened for carotid arterial disease, peripheral arterial disease, and myocardial ischemia by means of carotid artery ultrasonography, peripheral ankle and toe systolic blood pressure measurements, and myocardial perfusion scintigraphy (MPS). In addition, plasma OPG concentrations and other CVD-related markers were measured.ResultsThe prevalence of carotid arterial disease, peripheral arterial disease, and myocardial ischemia was 42%, 15%, and 30%, respectively. Plasma OPG was significantly increased in patients with carotid and peripheral arterial disease compared to patients without (p < 0.001, respectively), however, this was not the case for patients with myocardial ischemia versus those without (p = 0.71). When adjusted for age, HbA1c and U-albumin creatinine ratio in a multivariate logistic regression analysis, plasma OPG remained strongly associated with carotid arterial disease (adjusted OR: 2.12; 95% CI: 1.22-3.67; p = 0.008), but not with peripheral arterial disease or myocardial ischemia.ConclusionsIncreased plasma OPG concentration is associated with carotid and peripheral arterial disease in patients with type 2 diabetes, whereas no relation is observed with respect to myocardial ischemia on MPS. The reason for this discrepancy is unknown.Trial registration numberat http://www.clinicaltrial.gov: NCT00298844

Polymorphism rs2073618 of the osteoprotegerin gene as a potential marker of subclinical carotid atherosclerosis in Caucasians with type 2 diabetes mellitus

“…Several treatments are known to aff ect OPG concentrations, such as insulin, glitazones, and statins [25]. It has also been reported that an increased OPG concentration is associated with carotid and peripheral arterial disease in type 2 DM [20,26]. Our data could, however, not demonstrate the existence of a meaningful linear relationship between any of the ultrasonographic markers of subclinical atherosclerosis and serum OPG level in T2DM subjects.…”

“…However, sparse data are available on the relationship between plasma OPG levels and markers of subclinical atherosclerosis in subjects with T2DM. Furthermore, increased plasma OPG concentration is associated with carotid and peripheral arterial disease in T2DM [20].…”

Osteoprotegerin is Associated With Endothelial Function and Predicts Early Carotid Atherosclerosis in Patients With Coronary Artery Disease

“…[33][34][35] The present study showed the serum OPG levels not to be associated with the severity or extent of coronary atherosclerosis. Interestingly, Poulsen, et al 35) showed that an increased OPG concentration was related to carotid and peripheral artery disease, but not to myocardial ischemia, in patients with type 2 diabetes.…”

Impaired immune phenotype of circulating endothelial-derived microparticles in patients with metabolic syndrome and diabetes mellitus

“…In our study, inflammatory cytokines statistically significantly increased CD31+/annexin V+ EMPs to CD62E+ EMPs ratio in T2DM patients. As well known, hs-CRP and OPG appear to be sufficiently increased in T2DM when compared with MetS and may be compensatorily up-regulated in the atherogenic process and in vascular inflammation [42]. In this study we enrolled dysmetabolic patients without angiographic evidences of coronary artery atherosclerosis that allowed us to suggest that the existing vascular inflammation was one of the causal factors contributing to impaired phenotype of EMPs and reflected "vascular competence".…”