Association of Bone Turnover Biomarkers and Subclinical Atherosclerosis in Subjects with Type 2 Diabetes: A Case-Control Study

Pub Date : 2024-03-01 DOI:10.5603/cd.98236

N. Lachine, Eman Y. Morsy, A. Elnekiedy, Mohamed A. Sadaka, G. I. Khalil, Hesham G. Imam, H. Kassab, Noha G. Amin

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Abstract

Objective: The current study aims to assess the relationship between serum osteocalcin (OCN) and osteoprotegerin (OPG) levels and subclinical atherosclerosis. Material and methods: This case-control study included 80 male subjects divided into 2 groups: 40 subjects with type 2 diabetes (T2D) without coronary artery disease and 40 control subjects without diabetes. To assess the association of OCN and OPG with subclinical atherosclerosis (defined as carotid intima-media thick - ness (cIMT) ≥ 0.9mm), multivariable linear regression models were applied. Results: The mean age in the diabetes group was 54.1 ± ± 5.1 years while in the control group, it was 53.7 ± ± 6.6 years. The mean serum OCN level was signifi - cantly negatively correlated with hs-CRP, cIMT, HbA1c and FPG in the total sample (p = 0.001, < 0.001, < 0.001 and 0.006 respectively) while OPG level was significantly positively correlated with age and HbA1c (p = 0.047 and 0.009 respectively) in the total sample. Age and HbA1c were the only independent risk factors identifying subclinical atherosclerosis in multivariate analysis. A cut-off value of serum OCN level of ≤ 22 ng/mL was able to discriminate patients with subclinical atherosclerosis in the total sample (p = 0.003 * ) using receiver operator characteristic (ROC) curve analysis. Serum OCN level was significantly lower in the subclini - cal atherosclerosis group than in the control while OPG showed no significant difference between both groups. Conclusions: OCN may be a better marker for subclinical atherosclerosis than OPG. This effect is attenuated in the presence of DM. (Clin Diabetol 2024; 13, 1: 43–51)

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2 型糖尿病患者骨转换生物标志物与亚临床动脉粥样硬化的关系：病例对照研究

研究目的本研究旨在评估血清骨钙素（OCN）和骨保护素（OPG）水平与亚临床动脉粥样硬化之间的关系。材料与方法这项病例对照研究纳入了 80 名男性受试者，分为两组：40 名无冠状动脉疾病的 2 型糖尿病（T2D）受试者和 40 名无糖尿病的对照受试者。为了评估 OCN 和 OPG 与亚临床动脉粥样硬化（定义为颈动脉内膜中层厚度（cIMT）≥ 0.9 毫米）的关系，采用了多变量线性回归模型。结果显示糖尿病组的平均年龄为（54.1 ± ± 5.1）岁，对照组为（53.7 ± ± 6.6）岁。在所有样本中，平均血清 OCN 水平与 hs-CRP、cIMT、HbA1c 和 FPG 呈显著负相关（分别为 p = 0.001、< 0.001、< 0.001 和 0.006），而 OPG 水平与年龄和 HbA1c 呈显著正相关（分别为 p = 0.047 和 0.009）。在多变量分析中，年龄和 HbA1c 是识别亚临床动脉粥样硬化的唯一独立风险因素。通过接收器操作特征曲线（ROC）分析，血清 OCN 水平≤ 22 纳克/毫升的临界值能够区分总样本中的亚临床动脉粥样硬化患者（p = 0.003 * ）。亚临床动脉粥样硬化组的血清 OCN 水平明显低于对照组，而 OPG 在两组间无明显差异。结论：OCN与 OPG 相比，OCN 可能是亚临床动脉粥样硬化的更好标记物。如果存在糖尿病，这种效果会减弱。(Clin Diabetol 2024; 13, 1: 43-51)

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