The Relationship of Osteoprotegerin, Matrix Gla Protein, and HbA1C in Controlled and Uncontrolled Type 2 Diabetes Mellitus Patients

Dwi Yuniati Daulay, Marsetio Donosepoetro, Sutomo Kasiman

Abstract


BACKGROUND: Many studies have reported that diabetes mellitus correlates with vascular calcification event that increases progressively in uncontrolled diabetes. Osteoprotegerin (OPG) is known to act as a promoter in vascular calcification, contrary to Matrix Gla Protein (MGP), which is an inhibitor in vascular calcification. The aim of this study was to observe the progress of vascular calcification in uncontrolled diabetes patients by assessing biochemical markers OPG as promoter and MGP as inhibitor in vascular calcification.

METHODS: This was an observational study with cross sectional design on adult male patients with type 2 diabetes mellitus, defined by DM Consensus Criteria Indonesia, 2006.

RESULTS: The results of this study showed that there was a positive significant correlation between OPG and HbA1c (r=0.261, p=0.030), in contrast with MGP that showed no significant correlation with HbA1c. OPG also correlated significantly with Fasting Plasma Glucose (r=0.261, p=0.014). In uncontrolled diabetes group there was positive significant correlation between OPG and HbA1c (r=0.397, p=0.014). There was no significant difference found in the levels of OPG in controlled and uncontrolled diabetes groups (p=0.567), but OPG/MGP index showed higher difference (p=0.259). The OPG/MGP index also had positive significant correlation with HbA1c (r=0.285, p=0.018) and Fasting Plasma Glucose (r=0.313, p=0.009).

CONCLUSIONS: This study suggested progress to vascular calcification in uncontrolled type 2 diabetes mellitus. The use of vascular calcification biomarkers are recommended to predict/detect vascular calcification event in type 2 diabetes mellitus patients.

KEYWORDS: type 2 diabetes mellitus, vascular calcification, OPG, MGP, HbA1c


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References


PB PERKENI. Consensus on management and prevention of type 2 diabetes mellitus in Indonesia. Jakarta: PB PERKENI; 2006.

Goldstein BJ, Muller-Wieland D. Type 2 diabetes - principle and practice. 2nd Ed. London: Informa Healthcare; 2008, NLMID.

Johnstone MT, Veves A. Diabetes and cardiovascular disease. 2nd Ed. New Jersey: Humana Press; 2005, NLMID.

Danilevicius CF, Lopes JB, Pereira RMR. Bone metabolism and vascular calcification. Braz J Med Biol Res. 2007; 40: 435-42, CrossRef.

Abedin M, Tintut Y, Demer LL. Vascular calcification: mechanism and clinical ramifications. Arterioscler Thromb Vasc Biol. 2004; 24: 1161-70, CrossRef.

Doherty TM, Fitzpatrick LA, Inoue D, Qiao JH, Fishbein MC, Detrano RC, et al. Molecular, endocrine, and genetic mechanisms of arterial calcification. End Rev. 2004; 25: 629-72, CrossRef.

Meigs JB, Larson MG, D’Agoetino RB, Levy D, Clouse ME, Nathan DM, et al. Coronary artery calcification in type 2 diabetes and insulin resistance. Diabetes Care. 2002; 25: 1313-9, CrossRef.

Olesen P, Nguyen K, Wogensen L, Ledet T, Rasmussen LM. Calcification of human vascular smooth muscle cells: associations with osteoprotegerin expression and acceleration by high-dose insulin. Am J Physiol. 2006; 292: H1058-64, CrossRef.

Secchiero P, Corallini F, Pandolfi A, Consoli A, Candido R, Fabris B, et al. An increased osteoprotegerin serum release characterizes the early onset of diabetes mellitus and may contribute to endothelial cell dysfunction. Am Journal Pathol. 2006; 169: 2236-44, CrossRef.

Browner WS, Lui L, Cummings SR. Associations of serum osteoprotegerin levels with diabetes, stroke, bone density, fractures, and mortality in elderly women. J Clin Endocrinol Metab. 2001; 86: 631-7, CrossRef.

Hayden MR, Tyagi SC, Kolb L, Sowers JR, Khanna R. Vascular ossification-calcification in metabolic syndrome, type 2 diabetes mellitus, chronic kidney disease, and calciphylaxis-calcific uremic arteriolopathy: the emerging role of sodium thiosulfate. Cardiovasc Diabetol. 2001; 4: 4, PMID.

Rasmussen LM, Tarnow L, Hansen TK, Parving H, Flyvbjerg A. Plasma osteoprotegerin levels are associated with glycaemic status, systolic blood pressure, kidney function and cardiovascular morbidity in type 1 diabetic patients. Euro J Endocrinol. 2006; 154: 75-8, CrossRef.

Johnson RC, Leopold JA, Loscalzo J. Vascular calcification: pathobiological mechanisms and clinical implications. Circ Res. 2006; 99: 1044-59, CrossRef.

Tyson KL, Reynolds JL, McNair R, Zhang Q, Weissberg PL, Shanahan CM. Osteo/chondrocytic transcription factors and their target genes exhibit distinct patterns of expression in human arterial calcification. Arterioscler Thromb Vasc Biol. 2006; 23: 489-94, CrossRef.




DOI: https://doi.org/10.18585/inabj.v2i2.118

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