The indicator of osteogenesis is a potential marker of the risk of cardiovascular diseases in patients with type 2 diabetes mellitus

Abstract

Background. An increase in mortality due to cardiovascular diseases in patients with diabetes mellitus necessitates the search for effective prevention and treatment strategies. Osteocalcin, a proven marker of bone metabolism playing a key role in the pathogenesis of cardiovascular diseases, is considered one of the potential therapeutic targets. The purpose of the study was to reveal possible relationships between the osteocalcin level and severe cardiovascular diseases in patients with type 2 diabetes (T2DM). Materials and methods. Sixty-three patients with T2DM were examined, 40 (63.49 %) men and 23 (36.51 %) women, average age 58.11 ± 1.25 years. Blood osteocalcin, glycated hemoglobin were evaluated, and body mass index was calculated. Two groups were formed: group 1 (n = 30) with a history of cardiovascular diseases, group 2 (n = 33) without the specified conditions in the past. Later, depending on the amount of osteocalcin, the patients of group 2 were further divided into subgroups 2.1 and 2.2, in order to determine the probability of a difference between them in the parameters of the echocardiographic study, which was performed for all patients of group 2. Statistical processing of the results was carried out using the IBM SPSS Statistics 20 program (IBM Corp., USA). The difference was considered significant at p < 0.05. Results. Group 1 patients with a history of cardiovascular diseases (acute myocardial infarction, acute cerebrovascular accident, stenting of coronary or peripheral arteries on the background of T2DM) had lower values of serum osteocalcin compared to the group 2 without specified complications (1.0 [1.0–2.2] vs. 2.4 [1.0–3.5], p = 0.016). Echocardiography revealed that among patients without clinical signs of cardiovascular diseases, low serum osteocalcin values were associated with the occurrence of diastolic dysfunction in the form of delayed relaxation, left ventricular hypertrophy and atherosclerotic lesions of the aortic walls, which were not observed among participants with type 2 diabetes with higher values of the marker (1.0 ng/ml [1.0–2.3] vs. 3.6 ng/ml [3.2–4.4], p < 0.001). Conclusions. The relationship between the osteocalcin level and cardiovascular diseases in patients with T2DM indicates a high potential for the use of serum osteocalcin, namely its low values, as a marker of severe cardiovascular conditions in the future.