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

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)