Osteocalcin and Chinese visceral adiposity index are associated with the risk of atherosclerotic cardiovascular disease and arterial stiffness in patients with type 2 diabetes mellitus：a case control study

Abstract

Background Current risk assessments for atherosclerotic cardiovascular disease (ASCVD) in patients with type 2 diabetes mellitus (T2DM) are limit. Recent evidence strongly supports a close correlation between serum osteocalcin, the Chinese visceral adiposity index (CVAI), and T2DM, and cardiovascular events. However, their association with ASCVD risk in patients with T2DM remains unknown, and their impact on arterial stiffness also remains unclear. Methods An analysis of 646 T2DM patients aged 18 and older was conducted in this cross-sectional study. The ASCVD risk was assessed using the China-PAR equation, with patients categorized into low- or medium-high-risk groups. Osteocalcin was detected through electrochemical luminescence, whereas arterial stiffness was defined using ankle-brachial index and brachial-ankle pulse wave velocity. Logistic regression analysis was conducted to examine the correlation between serum osteocalcin levels, CVAI, ASCVD risk, and arterial stiffness. Results Osteocalcin levels were significantly lower in men patients with T2DM in the medium-high-risk ASCVD group compared to the low-risk ASCVD group, whereas CVAI levels was significantly higher in women patients with T2DM in the medium-high-risk ASCVD group than the low-risk ASCVD group. Logistic regression analysis identified osteocalcin and CVAI as independent risk factors for both medium-high-risk ASCVD (osteocalcin: men, OR,0.958, 95%CI 0.923, 0.99, women, OR, 0.788, 95%CI 0.645, 0.96, respectively)(CVAI: men, OR,1.010, 95%CI 1.00, 1.02, women, OR,1.084, 95%CI 1.00, 1.17, respectively) and arterial stiffness (osteocalcin: men, OR, 0.958, 95%CI 0.92, 1.00, women, OR, 0.925, 95%CI 0.86, 0.99, respectively)(CVAI: men, OR,1.011, 95%CI 1.003, 1.02, women, OR,1.0217, 95%CI 1.00, 1.03, respectively) in both men and women patients with T2DM. Combining osteocalcin levels and CVAI improved the prediction accuracy of arterial stiffness in men patients with T2DM (difference of AUC (Model 4 vs. Model 1):1.4%). All P-values were < 0.05. Conclusion Osteocalcin levels and CVAI are independent risk factors for ASCVD risk and arterial stiffness in T2DM. Combining osteocalcin and CVAI can enhance the early detection of atherosclerosis through men patients with T2DM.