title: Osteoprotegerin is a Better Serum Biomarker of Coronary Artery Calcification than Osteocalcin in Type 2 Diabetes.
abstract: OBJECTIVE
  Coronary artery calcification (CAC) is a prominent feature of atherosclerosis and is associated with cardiovascular events. In vitro studies have suggested that osteoprotegerin (OPG) and osteocalcin (OC) exert anticalcification potential in the vessel wall. The objective of this study was to investigate the association of CAC and serum bone biomarkers in persons with type 2 diabetes.
  
  
  METHODS
  We examined 50 individuals with type 2 diabetes. CAC imaging was performed by multidetector computed tomography. CAC scores ≥10, expressed in Agatston units, were considered abnormal. OC, undercarboxylated OC (ucOC), and OPG levels were determined by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Abnormal CAC scores were found for 64% of the study cohort. OPG levels were significantly elevated (5.5 ± 2.0 pmol/L vs. 4.2 ± 1.7 pmol/L; P = .026) for those with abnormal CAC scores. No univariate differences were found for OC or ucOC. Logistic regression analyses revealed that an increase in serum OPG level was significantly associated with an increase in CAC score (odds ratio, 3.324; 95% confidence interval, 1.321 to 8.359; P = .011). Longer duration of diabetes was a significant covariate (P = .026), whereas nonsignificant covariates in the final model were age, gender, systolic blood pressure, body mass index, insulin resistance determined by the homeostasis model assessment for insulin resistance, leptin, adiponectin, and glycemic control. The Nagelkerke R2 for the model was 0.66. Neither OC nor ucOC were significantly associated with elevated CAC scores.
  
  
  CONCLUSIONS
  Our results suggest that OPG is a more useful serum biomarker than OC or ucOC for identifying those at increased risk of arterial calcification in type 2 diabetes.
authors.affiliation: Department of Medical Laboratory Sciences, University of Delaware, Newark, Delaware Diabetes and Metabolic Research Center, Christiana Care Health System, Newark, Delaware.
authors.forename: Raelene E
authors.initials: RE
authors.lastname: Maser
authors.affiliation: Diabetes and Metabolic Research Center, Christiana Care Health System, Newark, Delaware Diabetes and Metabolic Diseases Center, Christiana Care Health System, Wilmington, Delaware.
authors.forename: M James
authors.initials: MJ
authors.lastname: Lenhard
authors.affiliation: Department of Radiology, Christiana Care Health System, Newark, Delaware.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Sneider
authors.affiliation: Biostatistics Core Facility, University of Delaware, Newark, Delaware.
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Pohlig
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood*; D053244:Osteoprotegerin / Q000097:blood*; D061205:Vascular Calcification / Q000097:blood*
chemical_list: D015415:Biomarkers; D053244:Osteoprotegerin; D015675:Osteocalcin
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