title: Osteoprotegerin and coronary artery disease in type 2 diabetic patients with microalbuminuria.
abstract: OBJECTIVE
  Plasma osteoprotegerin (P-OPG) is an independent predictor of cardiovascular disease in diabetic and other populations. OPG is a bone-related glycopeptide produced by vascular smooth muscle cells and increased P-OPG may reflect arterial damage. We investigated the correlation between P-OPG and coronary artery disease (CAD) in asymptomatic type 2 diabetic patients with microalbuminuria.
  
  
  METHODS
  P-OPG was measured in 200 asymptomatic diabetic patients without known cardiac disease. Patients with P-NT-proBNP >45.2 ng/l and/or coronary calcium score (CCS) ≥400 were stratified as high risk of CAD (n = 133), and all other patients as low risk patients (n = 67). High risk patients were examined by myocardial perfusion imaging (MPI; n = 109), and/or CT-angiography (n = 20), and/or coronary angiography (CAG; n = 86). Significant CAD was defined by presence of significant myocardial perfusion defects at MPI and/or >70% coronary artery stenosis at CAG.
  
  
  RESULTS
  Significant CAD was demonstrated in 70 of the high risk patients and of these 23 patients had >70% coronary artery stenosis at CAG. Among high risk patients, increased P-OPG was an independent predictor of significant CAD (adjusted odds ratio [CI] 3.11 [1.01-19.54] and 3.03 [1.00-9.18] for second and third tertile vs.first tertile P-OPG, respectively) and remained so after adjustments for NT-proBNP and CCS. High P-OPG was also associated with presence of >70% coronary artery stenosis(adjusted odds ratio 14.20 [1.35-148.92] for third vs. first tertile P-OPG), and 91% of patients with low (first tertile) P-OPG did not have >70% coronary artery stenosis.
  
  
  CONCLUSIONS
  Elevated P-OPG is an independent predictor of the presence of CAD in asymptomatic type 2 diabetic patients with microalbuminuria.
authors.affiliation: Steno Diabetes Center, Gentofte, Denmark. hnri@steno.dk
authors.forename: Henrik
authors.initials: H
authors.lastname: Reinhard
authors.forename: Mads
authors.initials: M
authors.lastname: Nybo
authors.forename: Peter R
authors.initials: PR
authors.lastname: Hansen
authors.forename: Niels
authors.initials: N
authors.lastname: Wiinberg
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjær
authors.forename: Claus L
authors.initials: CL
authors.lastname: Petersen
authors.forename: Kaj
authors.initials: K
authors.lastname: Winther
authors.forename: Hans-Henrik
authors.initials: HH
authors.lastname: Parving
authors.forename: Lars M
authors.initials: LM
authors.lastname: Rasmussen
authors.forename: Peter
authors.initials: P
authors.lastname: Rossing
authors.forename: Peter K
authors.initials: PK
authors.lastname: Jacobsen
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications* / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000378:metabolism; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003331:Coronary Vessels / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D053244:Osteoprotegerin / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002118:Calcium