A Cut-Point Value of Uncarboxylated to Carboxylated Index is Associated with Glycemic Status Markers in Type 2 Diabetes

Villafán-Bernal, José Rafael; Llamas-Covarrubias, Mara Anaís; Muñoz‐Valle, José Francisco; Rivera-León, Edgar Alfonso; González-Hita, Mercedes; Bastidas-Ramírez, Blanca Estela; Gurrola-Díaz, Carmen M.; Armendáriz‐Borunda, Juan; Sánchez‐Enríquez, Sergio

doi:10.2310/jim.0000000000000015

Cited by 20 publications

(12 citation statements)

References 24 publications

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“…Similarly, to our results, Villafan-Bernal et al used the ucOC/OC index to predict the probability of having T2D in a cohort of T2D patients and healthy subjects. Patients with ucOC/OC index below 0.31 had 12.6-fold increased probability of developing T2D than patients with higher index 51 . These findings strengthen our above-mentioned results, suggesting that serum levels of ucOC could be a potential biomarker to estimate cardiovascular and T2D risk in MetS patients.…”

Section: Discussionmentioning

confidence: 89%

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Riquelme-Gallego

García-Molina

Cano-Ibáñez

et al. 2020

Sci Rep

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Undercarboxylated osteocalcin (ucoc) could be a biomarker of glucose disturbances and cardiovascular risk. our study aimed to determine the association between serum levels of ucoc and cardiovascular risk in metabolic syndrome (MetS) patients and to analyse its potential role as estimator of type 2 diabetes (T2D) risk in this population. This cross-sectional study included 235 patients with MetS, 53.2% women, aged 55-75 years. Circulating ucOC levels were measured by ELISA. Cardiovascular risk was determined as Z-score of the diagnostic criteria for MetS (CV-ZS). Linear regression model was performed to analyse the association between circulating ucoc and cV-ZS. A receiver operating curve (ROC) was performed to analyse the usefulness of ucOC as T2D risk estimator. Patients above the CV-ZS median showed significant lower ucOC levels. We found an inverse association between ucOC levels and CV-ZS in MetS patients without T2D. Patients with ucOC levels below the 25 th percentile showed worse cardiometabolic profile and higher cardiovascular and T2D risk. The area under the curve performed better when ucOC levels were included along with the classic T2D risk factors. The measurement of circulating ucOC could be a useful tool to identify increased cardiovascular and T2D risk in MetS patients without T2D. Current lifestyle is causing a remarkable increase in overweight up to epidemic numbers globally 1. In Spain, over 60% of the adult population is overweight or obese 2. According to this trend, an increase of 16% in the number of cases is estimated by 2030 associated with a 58% increase in direct healthcare costs 3. A large body of evidence has shown that all-cause mortality, and especially cardiovascular-related mortality, is associated with an increased central adiposity and overweight 4. Visceral obesity in conjunction with other disorders, such as dyslipidaemia, hypertension and fasting hyperglycaemia lead to the metabolic syndrome (MetS), conferring thus a larger risk of developing cardiovascular disease (CVD) 5. An association between osteoporosis, CVD and cardiovascular-related mortality has been reported 6,7. The common risk factors involved in bone fragility and CVD could partially explain this association. Therefore, the

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Section: Discussionmentioning

confidence: 89%

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Riquelme-Gallego

García-Molina

Cano-Ibáñez

et al. 2020

Sci Rep

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“…While cOC has high affinity for calcium ions contained in hydroxyapatite, is actively involved in osteogenesis[4] and enhances osteoclast maturation[5], ucOC functions as a regulatory hormone in glucose metabolism improving insulin sensitivity and secretion, β-cell mass and glucose tolerance[6,7]. Low serum OC levels and the index ucOC/cOC are associated with increased fasting plasma glucose (FPG) and IR in several cross-sectional and prospective studies[8-12] and with risk for developing type 2 diabetes (T2D)[10,13]. On the other hand, bone metabolism, T2D and cardiovascular diseases (CVD) interact with one another through complex mechanisms[14-21].…”

Section: Introductionmentioning

confidence: 99%

Serum levels of undercarboxylated osteocalcin are related to cardiovascular risk factors in patients with type 2 diabetes mellitus and healthy subjects

Sánchez‐Enríquez

Ballesteros-Gonzalez

Villafán-Bernal

et al. 2017

WJD

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AIMTo determine a potential relationship between serum undercarboxylated (ucOC) concentration and cardiovascular risk factors in type 2 diabetes (T2D) patients and healthy subjects (HS).METHODSA cross-sectional study was conducted on 140 subjects classified into two groups, 70 with T2D and 70 HS. Medical history and physical examination with anthropometric measurements were obtained from all subjects. Body fat percentage was determined by bioelectrical impendency analysis. Serum ucOC concentration was determined by enzyme immunoassay, while serum levels of insulin and hsCRP were obtained using high sensitivity enzyme-linked immunosorbent assay. Insulin resistance was determined using the homeostasis model assessment-IR. Lipid profile [triglycerides, total cholesterol (TC), high-density lipoproteins (HDL-c), low density lipoproteins (LDL-c), very low-density lipoproteins] was determined by spectrophotometry and standard formulas when applicable.RESULTSThe T2D patient group showed significantly higher values of waist circumference, waist-to-hip ratio, systolic blood pressure (SBP), diastolic blood pressure (DBP), current smoking, and alcohol use when compared to the HS group (P < 0.05). We observed a significantly lower serum ucOC concentration in T2D than in HS (1.5 ± 1.4 vs 2.3 ± 1.8, P < 0.05). In the whole study population, ucOC concentration was inversely correlated with body mass index (BMI) (r = -0.236, P < 0.05), fasting plasma glucose (r = -0.283, P < 0.01) and HDL-c (r = -0.255, P < 0.05); and positively correlated with LDL-c/HDL-c ratio (r = 0.306, P < 0.05) and TC/HDL-c ratio (r = 0.284, P < 0.05). In the T2D group, serum ucOC concentration was inversely correlated with BMI (r = -0.310, P < 0.05) and body-fat percentage (r = -0.311, P < 0.05), and positively correlated with DBP (r = 0.450, P < 0.01). In HS group a positive correlation between serum levels of ucOC and SBP (r = 0.277, P < 0.05) was observed.CONCLUSIONSerum ucOC is a potential marker for cardiovascular risk in Mexicans because it is related to adiposity parameters, blood pressure and lipid profile.

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“…The assessment of OC in humans included both the carboxylated (cOC) and uncarboxylated forms (ucOC), whereas ucOC appeared associated to higher HOMA-B% levels, and thus to β-cell function, while cOC was associated to lower HOMA-IR values, more representative of insulin resistance [ 55 ]. Interestingly, some data suggested that values lower than a ucOC/cOC index cutoff, corresponding to 0.3, can be associated with markers of poor metabolic control in T2D [ 56 ].…”

Section: Vitamin D and Biomarkers Of Bone Turnovermentioning

confidence: 99%

Nontraditional Cardiovascular Biomarkers and Risk Factors: Rationale and Future Perspectives

et al. 2018

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The primary prevention of cardiovascular (CV) disease depends on the capacity to identify subjects at higher risk long before the occurrence of CV clinical manifestations. Traditional risk factors do not cover fully prediction of individual risk. Moreover, there is an area of gray for patients at intermediate CV risk, which offers wide margins of improvement. These observations highlight the need for new additive tools for a more accurate risk stratification. An increasing number of candidate biomarkers have been identified to predict CV risk and events, although they generally give only a moderate increase when added to currently available predictive scores. The approach utilizing a relative small number of biomarkers in multiple combinations, but only weakly related to each other or unrelated, thus belonging to independent-pathways, and so able to catch the multidimensional characteristic of atherosclerosis, appears promising. We discuss vitamin D and bone turnover biomarkers, hepatitis C virus, and psycho-emotional factors that may reflect alternative pathways over those generally considered for atherosclerosis (e.g., aspects directly related to inflammation and thrombosis). These new biomarkers could facilitate a more accurate assessment of CV risk stratification if incorporated in the current risk assessment algorithms.

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A Cut-Point Value of Uncarboxylated to Carboxylated Index is Associated with Glycemic Status Markers in Type 2 Diabetes

Abstract: A value of ucOC/cOC index less than 0.3 is associated with markers of poor metabolic control in patients with T2D.

Cited by 20 publications

References 24 publications

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Circulating Undercarboxylated Osteocalcin as Estimator of Cardiovascular and Type 2 Diabetes Risk in Metabolic Syndrome Patients

Serum levels of undercarboxylated osteocalcin are related to cardiovascular risk factors in patients with type 2 diabetes mellitus and healthy subjects

Nontraditional Cardiovascular Biomarkers and Risk Factors: Rationale and Future Perspectives

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