Abstract
Undercarboxylated osteocalcin (ucOC) could be a biomarker of glucose disturbances and cardiovascular risk. Our study aimed to determine the association between serum levels of ucOC and cardiovascular risk in metabolic syndrome (MetS) patients and to analyse its potential role as estimator of type 2 diabetes (T2D) risk in this population. This cross-sectional study included 235 patients with MetS, 53.2% women, aged 55–75 years. Circulating ucOC levels were measured by ELISA. Cardiovascular risk was determined as Z-score of the diagnostic criteria for MetS (CV-ZS). Linear regression model was performed to analyse the association between circulating ucOC and CV-ZS. A receiver operating curve (ROC) was performed to analyse the usefulness of ucOC as T2D risk estimator. Patients above the CV-ZS median showed significant lower ucOC levels. We found an inverse association between ucOC levels and CV-ZS in MetS patients without T2D. Patients with ucOC levels below the 25th percentile showed worse cardiometabolic profile and higher cardiovascular and T2D risk. The area under the curve performed better when ucOC levels were included along with the classic T2D risk factors. The measurement of circulating ucOC could be a useful tool to identify increased cardiovascular and T2D risk in MetS patients without T2D.
Highlights
Bone-related proteins, such as osteocalcin (OC), are of special interest for the study of CVD
Considering cardiovascular risk scores estimated by Framingham and REGICOR, we found significant differences between groups according to P50 of cardiovascular risk Z-score (CV-ZS), finding a significant positive correlation between CV-ZS and Framingham and REGICOR scores (Fig. 1)
Our results show that undercarboxylated fraction (ucOC) serum levels are independently associated with cardiovascular risk determined as Z-score in metabolic syndrome (MetS) patients without prevalent type 2 diabetes (T2D)
Summary
Bone-related proteins, such as osteocalcin (OC), are of special interest for the study of CVD. UcOC can act directly on pancreatic beta cells and on adipocytes, regulating insulin secretion and insulin sensitivity These findings have assigned a new role to the bone as an endocrine organ with extra-skeletal functions[14]. Despite the large evidence about OC as a metabolic regulator[18,19,20], the involvement of ucOC in cardiovascular risk in MetS patients remains unclear. This occurs because most of the studies in this regard have analysed the relationship between ucOC and individual cardiovascular parameters. No studies evaluating the role of ucOC serum levels as a potential biomarker of cardiovascular risk determined as a global score are available. The aims of the present study were: 1. To determine the serum levels of ucOC in adults with MetS in order to analyse the association between ucOC and cardiovascular risk scores
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