The capability of plasma osteoprotegerin as a predictor of cardiovascular disease: a systematic literature review.
OBJECTIVE
Osteoprotegerin (OPG) strongly inhibits bone resorption and may also serve as a vascular calcification inhibitor. However, recent studies have indicated that high plasma OPG is a strong predictor of cardiovascular disease (CVD) and mortality. To evaluate this capability, the data concerning OPG as a CVD predictor was gathered through a systematic literature review.


METHODS
Studies investigating OPG as a predictor of CVD or mortality were extracted from Medline and the Cochrane Library, retrieving 187 articles. Non-relevant articles were excluded, resulting in a total of 45 articles. After thorough evaluation of the abstracts, only eight prospective studies containing a follow-up period with a clinical emphasis on CVD were eligible for the literature review.


RESULTS
All studies except one confirmed that OPG measurement adds important prognostic information to the existing markers of CVD and mortality in high-risk populations. Hazard ratios emphasized the significant correlation between plasma OPG concentration and mortality. Due to methodological problems (e.g., population investigated, measurement principle, and statistics performed), meta-analysis could not be performed. As only one study was conducted in a healthy cohort, the results cannot per se be extrapolated to the general population.


CONCLUSIONS
The combined results support plasma OPG as an independent predictor of CVD and mortality in high-risk populations. However, more longitudinal studies in general cohorts are needed before the use of plasma OPG can be evaluated in this regard.
Nybo
Mads
M
Department of Biochemistry, Pharmacology and Genetics, Odense University Hospital, Odense, Denmark. mads.nybo@ouh.regionsyddanmark.dk
Rasmussen
Lars M
LM
D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D053244:Osteoprotegerin / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors
D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human