Original investigation
Osteoprotegerin and coronary artery disease in type 2 diabetic patients with microalbuminuria
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* Corresponding author: Henrik Reinhard hnri@steno.dk
1 Steno Diabetes Center, Gentofte, Denmark
2 Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
3 Department of Cardiology, Gentofte University Hospital, Gentofte, Denmark
4 Department of Clinical Physiology and Nuclear Medicine, Frederiksberg University Hospital Frederiksberg, Denmark
5 Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, University Hospital of Copenhagen, Copenhagen, Denmark
6 Department of Clinical Biochemistry, Frederiksberg University Hospital, Frederiksberg, Denmark
7 Department of Medical Endocrinology, University Hospital of Copenhagen, Copenhagen, Denmark
8 Faculty of Health Science, Aarhus University, Aarhus, Denmark
9 The Heart Centre, University Hospital of Copenhagen, Copenhagen, Denmark
Cardiovascular Diabetology 2011, 10:70 doi:10.1186/1475-2840-10-70
Published: 29 July 2011Abstract
Objective
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.
Methods
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.
Results
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.
Conclusions
Elevated P-OPG is an independent predictor of the presence of CAD in asymptomatic type 2 diabetic patients with microalbuminuria.