title: Baseline osteocalcin levels and incident diabetes in a 3-year prospective study of high-risk individuals.
abstract: OBJECTIVE
  Experimental evidence suggests that osteocalcin is a key messenger that affects both adipocytes and insulin-producing β cells. Epidemiological cross-sectional studies have shown a negative association between plasma levels of osteocalcin and glucose. For this reason, the hypothesis that lower baseline osteocalcin plasma levels are associated with diabetes was prospectively tested.
  
  
  METHODS
  The study population consisted of individuals at high risk for type 2 diabetes who were screened for participation in the Greek arm of a European type 2 diabetes prevention study (the DE-PLAN study). All participants were free of diabetes at baseline and underwent a second evaluation 3 years later. Diabetes status was defined according to an oral glucose tolerance test.
  
  
  RESULTS
  A total of 307 subjects were included in the present analysis. The population, including 154 men (50.3%), was middle-aged (54.4 ± 10.2 years) and overweight (BMI: 29.5 ± 4.9 kg/m(2)). At baseline, mean total plasma osteocalcin was lower in those with impaired fasting glucose and/or impaired glucose tolerance compared with those with normal glucose tolerance (6.0 ± 3.1 ng/mL vs. 7.3 ± 4.0 ng/mL, respectively; P = 0.01). After 3 years, 36 subjects had developed diabetes. In the prospective evaluation, there was no association between baseline osteocalcin levels and diabetes (OR: 1.04 per 1 ng/mL, 95% CI: 0.93-1.15; P = 0.49) on multivariable logistic regression analysis, nor was there any correlation with changes in plasma glucose after 3 years (r = 0.09, P = 0.38).
  
  
  CONCLUSIONS
  Our prospective results show that lower levels of circulating osteocalcin do not predict future diabetes development and, in contrast to most cross-sectional published data so far, suggest that this molecule may not be playing a major role in glucose homoeostasis in humans.
authors: First Department of Propaedeutic Medicine & Diabetes Center, Athens University Medical School, Laiko General Hospital, 17 Ag. Thoma str, 11527 Athens, Greece. Electronic address: s.liatis@yahoo.com.
authors: S
authors: S
authors: Liatis
authors: First Department of Propaedeutic Medicine & Diabetes Center, Athens University Medical School, Laiko General Hospital, 17 Ag. Thoma str, 11527 Athens, Greece.
authors: P P
authors: PP
authors: Sfikakis
authors: First Department of Propaedeutic Medicine & Diabetes Center, Athens University Medical School, Laiko General Hospital, 17 Ag. Thoma str, 11527 Athens, Greece.
authors: A
authors: A
authors: Tsiakou
authors: First Department of Propaedeutic Medicine & Diabetes Center, Athens University Medical School, Laiko General Hospital, 17 Ag. Thoma str, 11527 Athens, Greece.
authors: C
authors: C
authors: Stathi
authors: Department of Clinical Therapeutics, Athens University Medical School, Athens, Greece.
authors: E
authors: E
authors: Terpos
authors: First Department of Propaedeutic Medicine & Diabetes Center, Athens University Medical School, Laiko General Hospital, 17 Ag. Thoma str, 11527 Athens, Greece.
authors: N
authors: N
authors: Katsilambros
authors: First Department of Propaedeutic Medicine & Diabetes Center, Athens University Medical School, Laiko General Hospital, 17 Ag. Thoma str, 11527 Athens, Greece.
authors: K
authors: K
authors: Makrilakis
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000517:prevention & control; D004032:Diet; D015444:Exercise; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood* / Q000378:metabolism; D011236:Prediabetic State / Q000097:blood* / Q000453:epidemiology / Q000378:metabolism; D011446:Prospective Studies; D012307:Risk Factors; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D015675:Osteocalcin
keywords: Bone density; Osteocalcin; Type 2 diabetes