title: Osteoprotegerin is independently associated with metabolic syndrome and microvascular complications in type 2 diabetes mellitus.
abstract: OBJECTIVE
  Osteoprotegerin (OPG) is a glycoprotein from tumour necrosis factor receptor superfamily, responsible for osteoclastogenesis inhibition and associated with arterial calcification and stiffness. We describe the association between metabolic syndrome (MS) and OPG in type 2 diabetes mellitus patients.
  
  
  METHODS
  We consecutively enrolled 1220 patients from our institution's Diabetes Centre from August 2011. Anthropometric data such as fasting blood/urine were obtained, and OPG was measured by enzyme-linked immunosorbent assay (ELISA).
  
  
  RESULTS
  Mean (standard deviation (SD)) of age and diabetes duration was 57.4 (10.9) years and 11.2 (8.9) years, respectively. Prevalence of MS was 64.3% (95% confidence interval (CI): 61.3%-67.2%) and associated with significantly higher OPG (5.44 vs 4.47 pmol/L) and microvascular complications. The presence of microvascular complications was associated with higher OPG: nephropathy (5.54 (2.20) vs 4.65 (1.70) pmol/L, p < 0.0001), neuropathy (6.33 (2.64) vs 5.06 (1.91) pmol/L, p < 0.0001) and retinopathy (6.08 (2.47) vs 5.00 (1.95) pmol/L, p < 0.0001). After adjusting for age, gender, ethnicity, glucose and microvascular complications, OPG remained an independent predictor of MS: (odds ratio (OR) = 1.102 (95% CI: 1.015-1.196), p = 0.021).
  
  
  CONCLUSIONS
  Higher OPG levels were associated with risk of MS and microvascular complications. Studies are needed to test whether OPG could be a useful biomarker identifying patients at risk of vascular complications and whether further exploration of this pathway may lead novel therapeutic options.
authors.affiliation: Diabetes Centre, Khoo Teck Puat Hospital, Singapore Division of Endocrinology, Khoo Teck Puat Hospital, Singapore subramaniam.tavintharan@alexandrahealth.com.sg.
authors.forename: S
authors.initials: S
authors.lastname: Tavintharan
authors.affiliation: Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
authors.forename: Li Ting Sharon
authors.initials: LT
authors.lastname: Pek
authors.affiliation: Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
authors.forename: Jian Jun
authors.initials: JJ
authors.lastname: Liu
authors.affiliation: Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
authors.forename: Xiao Wei
authors.initials: XW
authors.lastname: Ng
authors.affiliation: Division of Nephrology, Department of Medicine, Khoo Teck Puat Hospital, Singapore.
authors.forename: Lee Ying
authors.initials: LY
authors.lastname: Yeoh
authors.affiliation: Diabetes Centre, Khoo Teck Puat Hospital, Singapore Division of Endocrinology, Khoo Teck Puat Hospital, Singapore.
authors.forename: Lim
authors.initials: L
authors.lastname: Su Chi
authors.affiliation: Diabetes Centre, Khoo Teck Puat Hospital, Singapore Division of Endocrinology, Khoo Teck Puat Hospital, Singapore.
authors.forename: Sum
authors.initials: S
authors.lastname: Chee Fang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D008833:Microcirculation; D055806:Microvessels / Q000503:physiopathology*; D008875:Middle Aged; D016017:Odds Ratio; D053244:Osteoprotegerin / Q000097:blood*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012846:Singapore; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human
keywords: Metabolic syndrome; biomarkers; diabetes; macrovascular; microvascular