Associations of serum osteoprotegerin levels with diabetes, stroke, bone density, fractures, and mortality in elderly women.
Osteoprotegerin (OPG) and its ligand are cytokines that regulate osteoclastogenesis and that may be involved in the regulation of vascular calcification. We examined whether serum OPG levels were associated with stroke, mortality, and cardiovascular risk factors, including diabetes, as well as with bone mineral density and fractures in a sample of 490 participants in a prospective cohort of white women, at least 65 yr of age. We found that OPG levels, assayed blinded from serum obtained at baseline, were about 30% greater in women with diabetes (mean +/- SD, 0.30 +/- 0.17 ng/mL) than in those without diabetes (0.23 +/- 0.10 ng/mL; P = 0.0001). OPG levels were associated with all-cause mortality [age-adjusted odds ratio, 1.4/SD (0.11 ng/mL) increase in serum OPG level; 95% confidence interval, 1.2--1.8] and cardiovascular mortality (odds ratio, 1.4; 95% confidence interval, 1.1--1.8); these effects were not confounded by diabetes. OPG levels were not associated with baseline bone mineral density or with subsequent strokes or fractures. The association of serum OPG levels with diabetes and with cardiovascular mortality raises the possibility that OPG may be a cause of or a marker for vascular calcification.
Browner
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General Internal Medicine Section, San Francisco Veterans Affairs Medical Center, University of California, San Francisco, California 94143, USA. warren@cooper.cpmc.org
Lui
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Cummings
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SR
D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015519:Bone Density; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000097:blood* / Q000453:epidemiology; D015914:Estrogen Replacement Therapy; D005260:Female; D050723:Fractures, Bone / Q000097:blood* / Q000453:epidemiology; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D009026:Mortality; D015588:Observer Variation; D016017:Odds Ratio; D053244:Osteoprotegerin; D011446:Prospective Studies; D018160:Receptors, Cytoplasmic and Nuclear / Q000097:blood*; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D012307:Risk Factors; D012495:San Francisco; D012907:Smoking; D020521:Stroke / Q000097:blood* / Q000453:epidemiology; D044465:White People
D015415:Biomarkers; D006023:Glycoproteins; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C506030:TNFRSF11B protein, human