Association between Serum Osteocalcin and Cardiometabolic Risk Factors in Latent Autoimmune Diabetes in Adults: Insights from Glutamic Acid Decarboxylase Subgroup Analysis.

Abstract

Aims: This study aimed to explore the association between serum osteocalcin and cardiometabolic risk factors in latent autoimmune diabetes in adults (LADA).

Background: Patients with LADA tend to experience poorer glycaemic control, placing them at a higher risk of cardiovascular disease.

Objective: This study aimed to explore the relationship between osteocalcin levels and cardiometabolic risk factors, such as HbA1c, lipids, insulin resistance and obesity, in patients with LADA.

Method: This retrospective study included 110 patients suffering from LADA with high glutamic acid decarboxylase (GAD) levels (≥180 IU/ml) and 286 with low GAD levels (<180 IU/ml) between January 2018 and December 2021. All participants were aged ≥30 years. Blood samples, collected after 8 hours of fasting, were analysed for osteocalcin and other biomarkers using chemiluminescence immunoassay. Logistic regression analysis assessed the relationship between osteocalcin and cardiometabolic risk factors.

Results: The LADA^high group had a lower body mass index (19.5 vs 23.4 kg/m², p = 0.014) and a lower proportion of obesity (19.1% vs 25.2%, p = 0.001) compared with the LADA^low group. Participants in the LADA^high group were slightly older (58.7 vs 58.3 years, p = 0.641). Fasting blood glucose was higher (8.9 vs 8.4 mmol/l, p = 0.068), and C-peptide was lower (1.0 vs 1.8 ng/ml, p = 0.024). Osteocalcin levels were significantly lower in the LADA^high group (12.19 vs 13.96 ng/ml, p = 0.004). Subgroup analyses revealed significant correlations, such as those between osteocalcin and HbA1c in the LADA^low group and an inverse relationship with triglyceride in men from the LADA^high group. Logistic regression analysis indicated that lower osteocalcin levels were significantly associated with a higher risk of poor glycaemic control and increased obesity.

Conclusion: Lower osteocalcin levels in patients with LADA with high GAD are associated with worse cardiometabolic parameters and increased cardiovascular risk. Osteocalcin may be a potential marker for assessing cardiometabolic risk in patients with LADA.