Age- and sex-specific differences in the association of serum osteocalcin and cardiometabolic risk factors in type 2 diabetes

Abstract

Abstract Background: Serum osteocalcin levels are closely related to metabolic syndrome and cardiovascular disease. This study aimed to investigate the association between serum osteocalcin levels and cardiometabolic risk factors in patients with type 2 diabetes (T2D) according to age and sex. Methods: This cross-sectional study included 1500 patients with T2D (991 men and 509 women) aged ≥18 years old. The age- and sex-specific disparities in glycemic and lipid control, as well as cardiometabolic risk factors were evaluated. Results: The levels of serum osteocalcin were significantly higher in women aged ＞50 years old compared with women aged ≤50 years old (15.6 ± 6.5 ng/mL vs. 11.3 ± 4.5 ng/mL, p < 0.0001). However, this was lower in men aged ＞50 years old than men aged ≤50 years old (12.2 ± 4.2 ng/mL vs. 12.9 ± 4.3 ng/mL, p = 0.0081). We performed correlation analyses between serum osteocalcin and cardiometabolic parameters. Serum osteocalcin concentrations had a negative association with FBG and HbA1c levels in women and men aged ≤50 years old, but not in men aged ＞50 years old. Serum osteocalcin were negatively related to TG and positively related to HDL-C and LDL-C only in men aged ≤50 years old. In binary logistic regression analysis, serum osteocalcin levels were associated with multiple cardiovascular risk factors, as follows: being overweight/obese (odds ratio [OR], 0.944; 95% confidence interval [CI], 0.9–0.991, p = 0.02) in men aged ＞50 years old; high HbA1C and high FBG in women and men aged ≤50 years old, but not in men aged ＞50 years old; and high TG (OR, 0.905; 95% CI 0.865–0.947, p < 0.0001), metabolic syndrome (OR, 0.914; 95% CI 0.874-0.956, p < 0.0001), and low high-density lipoprotein cholesterol (OR, 0.933; 95% CI, 0.893-0.975, p = 0.002) only in men aged ≤50 years old, after adjustment for confounding factors. Conclusions: Serum osteocalcinlevel has significant relationships with cardiometabolic risk factors and several age- and sex-related differences in patients with T2D. Decreased serum osteocalcin levels are associated with a worse cardiometabolic risk profile.