title: Association of plasma osteoprotegerin levels with the severity of lower extremity arterial disease in patients with type 2 diabetes.
abstract: BACKGROUND
  Osteoprotegerin (OPG) is a member of the tumor necrosis factor receptor superfamily and suggested as a marker of atherosclerosis. However, little is known about the association between plasma OPG levels and lower extremity arterial disease. We investigated whether plasma OPG levels were associated with the presence and severity of lower extremity arterial disease in patients with type 2 diabetes.
  
  
  METHODS
  This was a study of 712 patients with type 2 diabetes aged 40 years or older. Plasma OPG was measured using ELISA. The lower extremity arterial disease was diagnosed by high-frequency color Doppler ultrasonic.
  
  
  RESULTS
  Of 712 patients, 505 (70.9 %) had lower extremity arterial stenosis. OPG levels were significantly increased in patients with lower extremity arterial stenosis [1.89 (1.48-2.41) vs. 2.39 (1.82-3.33) ng/mL, p < 0.001]. Plasma OPG levels increased gradually with increasing severity of lower extremity arterial stenosis (p < 0.001 for trend), after adjustment for traditional cardiovascular risk factors such as age, gender, smoking, total cholesterol, high-density lipoprotein (HDL) cholesterol, C-reactive protein (CRP), body mass index (BMI), systolic blood pressure(SBP). The risk of lower extremity arterial disease was increased (OR = 1.17, 95 % CI 1.09 -1.28, p < 0.001) with each standard deviation (SD) higher level of OPG in patients with type 2 diabetes after adjustment for traditional CVD risk factors.
  
  
  CONCLUSIONS
  Plasma OPG levels were significantly associated with the presence and severity of lower extremity arterial disease. Our results suggest that OPG is an important plasma biomarker of lower extremity arterial disease in type 2 diabetes.
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. niuyixin198@163.com.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Niu
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. zhangweiwei@hotmail.com.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. yangzhen1020@hotmail.com.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. lixiaoyong@163.com.
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Endocrinology, Huashan Hospital Affiliated to Fudan University, Shanghai, China. wenjie12@hotmail.com.
authors.forename: Jie
authors.initials: J
authors.lastname: Wen
authors.affiliation: Department of Endocrinology, Clinical Geriatric Medicine, Henan Provincial People's Hospital, Zhengzhou, China. wangsj@163.com.
authors.forename: Suijun
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. zhanghongmei@hotmail.com.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology, Huashan Hospital Affiliated to Fudan University, Shanghai, China. wang2014@163.com.
authors.forename: Xuanchun
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Geriatrics, Huashan Hospital Affiliated to Fudan University, Shanghai, China. zhouhouguang@126.com.
authors.forename: Houguang
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. fangwenjun@126.com.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Fang
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. qinlixinhua@126.com.
authors.forename: Li
authors.initials: L
authors.lastname: Qin
authors.affiliation: Department of Endocrinology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, China. suqingxinhua@163.com.
authors.forename: Qing
authors.initials: Q
authors.lastname: Su
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000097:blood / Q000000981:diagnostic imaging; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D011446:Prospective Studies; D012720:Severity of Illness Index; D018615:Ultrasonography, Doppler, Color
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human; D002097:C-Reactive Protein