Endocrine Abstracts

Introduction: It’s known that type 2 diabetes increases the risk of cardiovascular disease. Silent myocardial ischemia occurs frequently in diabetics and may result in more severe coronary artery disease. Osteoprotegerin (OPG) is a glycoprotein secreted mainly by osteoblasts but it’s also produced by heart muscle. Its role in the pathogenesis of type 2 diabetes, atherosclerosis and future cardiovascular events is still discussed.

Material and methods: The study was conducted in 36 patients (12 F and 24 M) with type 2 diabetes and acute coronary syndrome aged mean 70.22±7.62. In the studied group, the average concentration of OPG was 7.283±3.516 pmol/l. The group was divided into subgroups: 26 subjects with myocardial infarction (MI) – 13 patients with ST elevation (STEMI-MI) and 13 patients with non-ST elevation (NSTEMI-MI) as well as ten subjects with unstable angina (UA). Determinations of serum osteoprotegerin levels with the use of MicroVueTM OPG-EIA (an assay sensitivity of 0.4 pmol/l) were performed. For statistical analysis, Statistica 8.0 StatSoft was used (Mann–Whitney U test and Spearman’s test were applied).

Results: Patients with MI had increased OPG concentrations compared to subjects with UA (8.244±3.639 vs 4.782±1.292 pmol/l; Z=2.807; P<0.05). In the group of patients with MI, subjects with NSTEMI-MI had higher OPG levels than patients with STEMI-MI (9.702±4.069 vs 6.786±2.534 pmol/l; Z=2.105; P<0.05). What’s more, the positive statistically significant (P=0.003; 0.004; 0.006 respectively) correlations between OPG concentration and troponin, CK-MB and myoglobin levels, measured few hours after MI, have been observed. No statistically signicant difference between patients with MI and Q waves and without Q waves have been noted.

Conclusions: OPG concentration is increased in diabetics with MI and subjects with NSTEMI-MI. It correlates positively with severity of myocardial ischemia as well. OPG may be a risk factor for the progression of atherosclerosis and onset of cardiovascular disease and predict cardiovascular events in diabetic patients.