Osteoprotegerin and coronary artery disease in type 2 diabetic patients with microalbuminuria

• Published in: Cardiovascular diabetology 2011-07, Vol.10 (1), p.70-70
• Main Authors: Reinhard, Henrik, Nybo, Mads, Hansen, Peter R, Wiinberg, Niels, Kjær, Andreas, Petersen, Claus L, Winther, Kaj, Parving, Hans-Henrik, Rasmussen, Lars M, Rossing, Peter, Jacobsen, Peter K
• Format: Article
• Language: English
• Subjects: Adult; Aged; Albuminuria - complications; Albuminuria - epidemiology; Biomarkers - blood; Calcium - metabolism; Comorbidity; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - epidemiology; Coronary Vessels - metabolism; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Female; Humans; Male; Middle Aged; Natriuretic Peptide, Brain - blood; Original Investigation; Osteoprotegerin - blood; Peptide Fragments - blood; Predictive Value of Tests; Retrospective Studies; Risk Factors
• ISSN: 1475-2840; 1475-2840
• DOI: 10.1186/1475-2840-10-70

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. 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. 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. Elevated P-OPG is an independent predictor of the presence of CAD in asymptomatic type 2 diabetic patients with microalbuminuria.