Endocrine Abstracts

Introduction: It’s known that type 2 diabetes is an independent risk factor for cardiovascular disease. Osteoprotegerin (OPG), a glycoprotein secreted mainly by osteoblasts, is also produced by heart muscle and vessels. Its role in the pathogenesis of atherosclerosis and future cardiovascular events is still discussed.

Material and methods: The study was conducted in 113 patients (48 F, 65 M) with type 2 diabetes mellitus (DM2) and coronary heart disease (CHD), aged mean 68.22±9.56. The studied group was divided into subgroups: 61 subjects with acute coronary syndrome (ACS) and 52 subjects with stable angina (SA). Among patients with ACS two groups were separated: with myocardial infarction (MI) and with unstable angina (UA). The control group was composed of 46 well-balanced patients (33 F, 13 M) without DM2 and CHD. Determinations of serum OPG levels with the use of MicroVue OPG-EIA (an assay sensitivity of 0.4 pmol/l) were performed. Statistica 10.0 StatSoft was used for data analysis. OPG concentrations were shown as medians.

Results: Patients with DM2 and ACS as well as subjects with DM2 and SA had significantly higher OPG levels than patients in control group (6.5 pmol/l and 5.64 pmol/l vs 3.48 pmol/l) (H=62.258; P=0.000) (P<0.001). The tendency of higher OPG concentrations in subjects with ACS compared to patients with SA was observed (P>0.05). Higher OPG levels were noted in patients with MI (7.36 pmol/l) than in those with UA (4.72 pmol/l) (P<0.05). Patients with complications in the course of ACS such as: cardiac arrhythmias, pulmonary oedema, cardiac tamponade had statistically significantly higher OPG concentrations (8.40 pmol/l) compared to subjects with uncomplicated course of ACS (5.86 pmol/l) (P<0.05). Higher OPG levels were also found in patients with transmural MI – with Q-wave MI (8.37 pmol/l) than in patients with subendocardial MI – with non-Q wave MI (6.44 pmol/l) (P<0.05).

Conclusions: OPG may be a marker of cardiovascular disease and ischemia’s severity in diabetic patients.