Abstract
BackgroundAn increased osteoprotegerin (OPG) level has been reported in both type-2 diabetes mellitus (T2DM) and cardiovascular diease (CVD) that are linked to sympathovagal imbalance (SVI). We explored the link of osteoprotegerin with cardiovagal modulation in T2DM.MethodsWe assessed fasting serum OPG, high-sensitive C-reactive protein (hsCRP), glucose, insulin and lipid profile in patients having T2DM receiving oral antidiabetic drugs (OAD) (n = 42) compared with age, gender and body composition-matched healthy participants without diabetes (n = 42). Rate pressure product (RPP), spectral indices of heart rate variability (HRV) and body composition were recorded in both the groups. Association of HOMA-IR and OPG with various parameters were assessed.ResultsOsteoprotegerin, HOMA-IR, hsCRP, coronary lipid risk factor were significantly increased, markers of cardiovagal modulation (TP, SDNN, RMSSD) were considerably decreased, ratio of low-frequency to high-frequency (LH-HF ratio), the indicator of SVI, and RPP, the marker of myocardial work stress were significantly higher in patients with diabetes, suggesting an overall elevated CVD risks in them. HOMA-IR was correlated with RMSSD, lipid risk factors and OPG. Rise in OPG was correlated with decreased cardiovagal modulation in patients with diabetes. There was significant contribution of OPG in decreasing TP, suggesting impaired cardiovagal modulation.ConclusionT2DM patients receiving OAD had higher cardiometabolic risks compared to age, gender and body composition-matched healthy individuals. Increased level of OPG is linked to decreased cardiovagal modulation in T2DM patients.
Highlights
An increased osteoprotegerin (OPG) level has been reported in both type-2 diabetes mellitus (T2DM) and cardiovascular diease (CVD) that are linked to sympathovagal imbalance (SVI)
There was significant increase in basal heart rate, SBP, DBP and Rate pressure product (RPP) in patients with diabetes compared to participants without diabetes (Table 1)
FSG, insulin and HOMA-insulin resistance (IR) were significantly increased in diabetes group compared to control group (Table 2)
Summary
An increased osteoprotegerin (OPG) level has been reported in both type-2 diabetes mellitus (T2DM) and cardiovascular diease (CVD) that are linked to sympathovagal imbalance (SVI). Though in physiological concentration it mainly prevents arterial calcification, higher plasma levels of OPG has been reported to contribute to the progression of vascular dysfunction and inflammation and elevated OPG is proposed as a marker of progressive atherosclerosis and CVD [6]. Though, elevated circulating levels of OPG have been reported in T2DM, in the presence of microvascular complications [7] and peripheral neuropathy [8,9,10], the role of OPG in autonomic neuropathy in diabetes has not been adequately studied. A recent report did not demonstrate the association of OPG and osteopontin with cardiovascular autonomic function in T2DM patients [11]. In the present study we have assessed the link of OPG with autonomic dysfunctions in T2DM patients
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