Serum osteoprotegerin level in relation to ankle-brachial index among type 2 diabetic patients with subclinical hypothyroidism

Abstract

Background Osteoprotegerin (OPG) acts as an important regulatory molecule in vascular disease. The presence of diabetes mellitus greatly increases the risk of peripheral artery disease (PAD), and also both subclinical and overt hypothyroidism have been clearly linked with dyslipidemia, which is a known risk factor for peripheral arterial disease. Aim We aimed to evaluate the relation between serum OPG and PAD among type 2 diabetic patients with subclinical hypothyroidism (SCH). Patients and methods A total of 60 participants were enrolled in the study who were divided into three groups: group 1 included 20 type 2 diabetic patients with normal thyroid function, group 2 included 20 type 2 diabetic patients with SCH, and group 3 included 20 healthy participants. They were subjected to complete history taking, complete clinical examination, routine laboratory investigations, serum OPG level, neck ultrasound, and Doppler study for ankle-brachial index (ABI). Results We found that OPG levels were statistically elevated in type 2 diabetic patients with SCH group compared with type 2 diabetic patients with euthyroidism (P=0.040). Also there was lower ABI in type 2 diabetic patients with SCH compared with those with euthyroidism, showing an increased incidence of PAD in group 2 than group 1 and nondiabetic patients, with statistically significant results in between groups. Conclusions Our results found that diabetic patients with SCH revealed an independent association between thyroid-stimulating hormone and serum level of OPG. Likewise, we found a statistically significant difference between OPG level and ABI among type 2 diabetic patients. Therefore, OPG can act as a marker of PAD among diabetic patients with SCH.