scholarly journals Could osteoprotegerin serve as a marker of metabolic syndrome?

2013 ◽  
Vol 26 (3) ◽  
pp. 309-312

There has been a dramatic increase in the worldwide prevalence of obesity, which is associated with the development of several chronic diseases such as metabolic syndrome, type 2 diabetes and cardiovascular diseases. Osteoprotegerin is a glycoprotein mainly secreted by bone but produced also by heart muscle and blood vessels. It inhibits the recruitment, proliferation, and activation of osteoclasts. The role of osteoprotegerin in the pathogenesis of metabolic syndrome, type 2 diabetes and cardiovascular diseases is still discussed. The study was carried out on 62 patients with metabolic syndrome aged 35-83 (34F and 28M). Type 2 diabetes was diagnosed in 76% of subjects and 62% of them suffered from coronary artery disease as a macrovascular complication. Determinations of biochemical parameters and anthropometric measurements were performed in the studied group. The relationships between serum osteoprotegerin concentrations and components of metabolic syndrome and total cholesterol, LDL-cholesterol, HbA1C, BMI, levels of calcium and phosphate in the blood and 24-hour urinary calcium have been analysed. Diabetics had higher osteoprotegerin concentrations than patients without diabetes (5.570 pmol/l vs 4.690 pmol/l). Osteoprotegerin levels in patients with diabetes and coronary artery disease were significantly higher (6.640pmol/l) than in those without macrovascular complications (5.295 pmol/l) (Z=1.986; p=0.047). Furthermore, the associations between osteoprotegerin and calcium and phosphate levels in the blood and 24-hour urinary calcium have been shown. A lower calcium level in the blood was negative but a lower phosphate level was positive correlated with OPG serum concentration (respectively: 6.825 pmol/l vs 5.195 pmol/l, Z=2.656, p=0.008; 4.250pmol/l vs 5.640 pmol/l, Z=2.718, p=0.007). What’s more, the inverse correlations between OPG concentrations and 24-hour urinary calcium and diastolic blood pressure have been observed. No associations between osteoprotegerin and waist circumference, BMI, cholesterol levels and HbA1C, were found. In summary, osteoprotegerin is not a use ful marker of all components of metabolic syndrome. It is level depends on the presence of hypertension, type 2 diabetes and coronary artery disease. This glycoprotein may serve a a marker of calcium and phosphate homeostasis. We concluded that the relationship between osteoprotegerin concentrations and calcification of atherosclerotic plaques in patients with metabolic syndrome and type 2 diabetes should be analysed in further investigations.

2021 ◽  
Vol 18 (3) ◽  
pp. 147916412110201
Author(s):  
Katarzyna Szmigielska ◽  
Anna Jegier

The study evaluated the influence of cardiac rehabilitation (CR) on heart rate variability (HRV) in men with coronary artery disease (CAD) with and without diabetes. Method: The study population included 141 male CAD patients prospectively and consecutively admitted to an outpatient comprehensive CR program. Twenty-seven patients with type-2 diabetes were compared with 114 males without diabetes. The participants performed a 45-min cycle ergometer interval training alternating 4-min workload and a 2-min active restitution three times a week for 8 weeks. The training intensity was adjusted so that the patient’s heart rate achieved the training heart rate calculated according to the Karvonen formula. At the baseline and after 8 weeks, all the patients underwent the HRV assessment. Results: HRV indices in the patients with diabetes were significantly lower as compared to the patients without diabetes in SDNN, TP, LF parameters, both at the baseline and after 8 weeks of CR. After 8 weeks of CR, a significant improvement of TP, SDNN, pNN50% and HF occurred in the patients without diabetes, whereas in the patients with diabetes only HF component improved significantly. Conclusions: As regards HRV indices, CR seems to be less effective in patients with CAD and type-2 diabetes.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Katerina V. Kiburg ◽  
Andrew I. MacIsaac ◽  
Georgia E. McCluskey ◽  
Vijaya Sundararajan ◽  
Richard J. MacIsaac

Abstract Background Although it is known that patients with Type 2 Diabetes Mellitus (T2DM) are at an increased risk of coronary artery disease (CAD), the actual coronary artery burden of atherosclerotic disease in patients with and without T2DM in a real-world setting and its possible modification by preventative therapies has not been extensively documented. Methods Merged coronary angiography and hospital discharge data between 2013 and 2019 were obtained for analysis and a random sub-sample of patient charts were reviewed for medication use. Propensity scores were estimated using logistic regression models and used to match patients, looking at the effect of severity of CAD over time in years in an ordinal logistic regression model. A separate propensity score was estimated and used to inverse probability weight the ordinal logistic regression looking at the effect of medication use on CAD severity in patients with and without T2DM. Results From 3,016 patients in the coronary angiography database, 1421 with T2DM and 1421 without T2DM were matched on propensity score. T2DM patients had more extensive CAD in 2018 compared to 2013 ((adjusted odds ratio) adjOR: 2.06 95% C.I. 1.38, 2.07), but this risk appeared to be attenuated in 2019. In contrast, there was no effect of time on CAD burden in patients without diabetes. In the sub-sample of 760 patients who underwent a chart review of their medication use, there were 367 (48%) with T2DM. For patients with T2DM 69.8% reported taking statins, 64.0% RAS inhibitors and 64.0% anti-platelet drugs. This was significantly higher than patients without diabetes of whom 46.6% reported taking statins, 49.0% RAS inhibitors and 49.9% anti-platelet drugs. As in the full matched sample, patients with diabetes had more extensive CAD (adjOR: 1.32 95% CI: 1.01, 1.74). However, after adjustment for the use of RAS inhibitors, statins and anticoagulants there was no difference in extent of CAD between patients with and without diabetes (adjOR: 1.14 95% CI: 0.85, 1.53). Conclusions Although patients with diabetes have a greater extent of CAD in comparison to those without T2DM, preventative medication use decreases this CAD burden significantly.


2016 ◽  
Vol 94 (5) ◽  
pp. 366-373 ◽  
Author(s):  
Evgeniy D. Bazdyrev ◽  
O. M. Polikutina ◽  
N. A. Kalichenko ◽  
Yu. S. Slepynina ◽  
O. L. Barbarash

Currently, there is no convincing evidence of respiratory failure in patients with diabetes mellitus (DM) and coronary artery disease (CAD). Aim: To evaluate the differences in the main parameters of pulmonary function in patients with isolated type 2 diabetes and diabetic patients with CAD. Materials and methods: Patients with diabetes were allocated to two groups depending to the presence of CAD. The assessment of carbohydrate and lipid metabolism, as well as the measurement of inflammatory markers were performed using standard methods of clinical and biochemical analysis. Respiratory function and diffusion capacity of the lungs (DLCO) were assessed using a body plethysmograph Elite Dl-220v. Results. Main pulmonary functional test parameters were within normal values, except residual volume in diabetic patients. Patients with concomitant CAD demonstrated lower values of the studied parameters compared to non-diabetic ones. A number of volume and flow rate parameters as well as DLCO correlated with systemic inflammation, decompensation of carbohydrate and lipid metabolism, and duration of diabetes. Conclusion. Diabetic patients with CAD suffered from respiratory failure, manifested as decline in pulmonary function and DLCO. Blood glucose levels, inflammation symptoms, dyslipidemia and myocardial dysfunction are among suspected causes contributing to the development and acceleration of this decline.


2013 ◽  
Vol 26 (3) ◽  
pp. 305-308

Metabolic syndrome is a common disorder the prevalence of which is estimated to be about 20% in Polish adult population. Abdominal obesity and insulin resistance are important pathogenetic factors. Metabolic syndrome plays a role as a risk factor for type 2 diabetes and cardiovascular disease. Fetuin-A is a multifunctional plasma glycoprotein. It is a physiological inhibitor of insulin receptor tyrosine kinase and thus associated with insulin resistance, metabolic syndrome and an increased risk for type 2 diabetes. The study was conducted in 62 patients with metabolic syndrome (34F and 28M) aged 35-83. In 47 persons type 2 diabetes was a component of metabolic syndrome, 62% of diabetics had coronary artery disease as a macrovascular complication. Determinations of biochemical parameters and anthropometric measurements were performed in the studied group. We analysed a relationship between serum fetuin-A concentration and components of metabolic syndrome and total cholesterol, LDL-cholesterol, HbA1C, BMI as well. Diabetics had lower fetuin-A concentrations than patients without diabetes (0.550 g/l vs 0.600 g/l). Fetuin-A levels in patients with diabetes and coronary artery disease were significantly lower (0.535 g/l) than in those without macrovascular complications (0.590 g/l) (Z=1.969; p=0.048). Furthermore the correlation between fetuin-A serum concentration and fasting plasma glucose, LDL-cholesterol and triglycerides levels were observed. Patients with higher fasting glucose had lower fetuin-A levels. However, fetuin-A concentration was positive correlated with LDL-cholesterol and triglycerides levels. No association between fetuin-A and waist circumference, blood pressure, HDL-cholesterol, HbA1C and BMI were found. In summary, serum fetuin-A level has a correlation with some components of metabolic syndrome. We concluded that fetuin-A could be used not only as a marker, but also plays some role in pathogenesis of metabolic syndrome, type 2 diabetes and higher risk of cardiovascular disease.


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