22 septembre, 2005 21:41
Epidemiology
Osteoprotegerin tied to silent coronary disease in diabetics
Last Updated: 2005-09-22 12:24:55 -0400 (Reuters Health)
By David Douglas
NEW YORK (Reuters Health) - Findings from a small study indicate that elevated serum osteoprotegerin is associated with asymptomatic coronary artery disease (CAD) in patients with type 2 diabetes, French researchers report in the September issue of Diabetes Care.
In fact, lead investigator Dr. Antoine Avignon told Reuters Health, "The association between CAD and osteoprotegerin in asymptomatic diabetic patients was better than for any other risk factors, even high-sensitivity C-reactive protein."
Even though it's known that "diabetic patients as a group have a very high cardiovascular risk," he added, "it remains that it would be very interesting to have a marker that could help us to select the patients with the highest risk."
As part of that effort, Dr. Avignon of Lapeyronie Hospital, Montpellier, and colleagues sought to determine the relationship between osteoprotegerin, an inhibitor of osteoclastogenesis that has been implicated in atherosclerosis, and CAD in 20 diabetic patients.
All had silent myocardial ischemia and significant cardiac disease and they were matched with a like number of controls without silent ischemia or CAD.
The percentage of subjects with osteoprotegerin above median levels was 70% in the CAD group and 25% in controls.
Moreover, 50% of CAD subjects had nephropathy versus 5% of controls, and LDL and HDL cholesterol levels were significantly higher in CAD patients than controls. There were no other variables associated with CAD.
Both nephropathy (odds ratio, 21.94) and osteoprotegerin levels above the median (odds ratio, 8.31) were significant independent predictors of CAD.
"Thus," concluded Dr. Avignon, "if these results are confirmed by a bigger study, osteoprotegerin could prove to be a very important risk marker for CAD in diabetic patients."
Diabetes Care 2005;28:2176-2180.
