High osteoprotegerin predicts all-cause mortality in Type 2 diabetics
MedWire News: Results show that high levels of osteoprotegerin, which forms part of the tumor necrosis factor receptor superfamily, are associated with increased all-cause mortality in patients with Type 2 diabetes.
Previous studies have shown osteoprotegerin to be a strong predictor of cardiovascular disease (CVD) in high-risk patients, such as those with Type 1 diabetes, or who have had prior myocardial infarction or a kidney transplant, but less is known about its effects in patients with Type 2 diabetes.
In this study, Henrik Reinhard (Steno Diabetes Center, Gentofte, Denmark) and colleagues followed-up 283 patients with Type 2 diabetes, aged 53.9 years at baseline, for a median period of 16.8 years to assess links between baseline levels of osteoprotegerin and CVD and all-cause mortality.
The patients were divided into low, medium, and high osteoprotegerin groups depending on their baseline levels, namely, less than 1691 pg/ml, 1691-2219 pg/ml, and above 2219 pg/ml.
Over the study period, 193 patients died. The researchers found that high, compared with low, baseline levels of osteoprotegerin increased the risk for all-cause mortality by a significant 81%. This association was independent of NH2-terminal pro-brain natriuretic peptide, urinary albumin excretion rate, and other cardiovascular risk factors.
Of the 193 deaths, 103 were from cardiovascular causes. Reinhard and team report that high and medium levels of baseline osteoprotegerin versus low levels increased the risk for CVD-related death by 86%. However, after adjustment for possible confounders, this association was no longer significant.
"OPG may be considered an additional marker of the atherosclerosis involved in the pathogenesis of ischemic heart disease, but the possible therapeutic benefit from lowering OPG remains to be shown in intervention studies," comment the authors.
The results of this study are published in the journal Diabetes Care.
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By Helen Albert