Serum osteoprotegerin levels in patients with acute atherothrombotic stroke and lacunar infarct

Güldiken, Babürhan; Güldiken, Sibel; Turgut, Burhan; Turgut, Nilda; Demir, Muzaffer; Çelik, Yahya; Arikan, Ender; Tuğrul, Armağan

doi:10.1016/j.thromres.2006.12.004

Cited by 40 publications

(45 citation statements)

References 24 publications

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“…This observation supports other studies using OPG in high-risk patients [5]. It is also important to underscore that the two other studies that were mentioned by Dr Wiwanitkit have another focus and purpose compared with our study [6,7]. Thus, while we described OPG levels during the early phase of ischaemic stroke in relation to long-term mortality [1], Guldiken et al [6] measured OPG levels in 51 patients with acute ischaemic stroke in relation to stroke subtypes with no evaluation of its potential prognostic impact.…”

supporting

confidence: 92%

“…It is also important to underscore that the two other studies that were mentioned by Dr Wiwanitkit have another focus and purpose compared with our study [6,7]. Thus, while we described OPG levels during the early phase of ischaemic stroke in relation to long-term mortality [1], Guldiken et al [6] measured OPG levels in 51 patients with acute ischaemic stroke in relation to stroke subtypes with no evaluation of its potential prognostic impact. Moreover, in contrast to our study in patients with acute ischaemic stroke, Nybo et al [7] conducted a nested case-control study in a healthy cohort and found no association between OPG and forthcoming stroke.…”

mentioning

confidence: 75%

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Osteoprotegerin and acute ischaemic stroke: reply

Jensen

Aukrust²,

Januzzi

2010

Journal of Internal Medicine

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We thank Dr Wiwanitkit for the comments on our manuscript [1]. There is growing evidence of osteoprotegerin (OPG) as an independent predictor of cardiovascular mortality in high risk populations [2]. However, the knowledge of OPG in the setting of ischaemic stroke is sparse. Non-stroke cardiovascular disease, especially coronary artery disease, is the main cause of long-term mortality in patients surviving cerebrovascular diseases [3]. Because stroke risk prediction based on conventional risk factors is of limited value, a search for predictive markers is of interest.Troponins have been measured with great interest in patients suffering acute ischaemic stroke and it seems that currently available data demonstrate no threshold below which elevations of troponins are harmless and without negative prognostic implications [4]. When we adjusted for elevated levels of troponin in our study, OPG remained an independent predictor of long-term mortality [1]. This observation supports other studies using OPG in high-risk patients [5]. It is also important to underscore that the two other studies that were mentioned by Dr Wiwanitkit have another focus and purpose compared with our study [6,7]. Thus, while we described OPG levels during the early phase of ischaemic stroke in relation to long-term mortality [1], Guldiken et al.[6] measured OPG levels in 51 patients with acute ischaemic stroke in relation to stroke subtypes with no evaluation of its potential prognostic impact. Moreover, in contrast to our study in patients with acute ischaemic stroke, Nybo et al.[7] conducted a nested case-control study in a healthy cohort and found no association between OPG and forthcoming stroke.Nevertheless, we agree with Dr Wiwanitkit that further studies are needed to clarify the role of OPG in ischaemic stroke patients. Conflict of interest statementNo conflict of interest was declared.

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supporting

confidence: 92%

mentioning

confidence: 75%

Osteoprotegerin and acute ischaemic stroke: reply

Jensen

Aukrust²,

Januzzi

2010

Journal of Internal Medicine

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“…However, increased circulating OPG levels have also been found in association with the presence and severity of coronary artery disease (36)(37)(38), peripheral artery disease (39), and stroke (40), suggesting that OPG may serve as a biomarker of established atherosclerosis in humans (41,42). The apparent paradox of increased levels of a cardiovascular protective molecule in subjects with established atherosclerotic disease may result from a local compensatory response to atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Serum osteoprotegerin concentrations are decreased in women with the polycystic ovary syndrome

Escobar-Morreale

Botella-Carretero

Martínez‐García

et al. 2008

European Journal of Endocrinology

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Objective: Osteoprotegerin (OPG), an inhibitor of osteoclastic bone resorption, has a variety of functions including anti-inflammatory effects and a possible cardiovascular protective role. Both low-grade chronic inflammation and cardiovascular risk are increased in women with the polycystic ovary syndrome (PCOS). We aimed to study serum OPG concentrations in PCOS patients. Design: Case-control study including 40 PCOS patients matched with 40 non-hyperandrogenic women for age and body mass index. Methods: Basal serum sampling and standard oral glucose tolerance test, and measurement of serum OPG concentrations by commercial ELISA. Results: Serum OPG concentrations were lower in women with PCOS compared with those of controls (304G120 vs 363G105 pg/ml respectively; FZ7.641, PZ0.007) independently of obesity. No differences were observed in serum receptor activator of nuclear factor-kB ligand (RANKL) levels and in the RANKL/OPG molar ratio. A multivariate linear regression model (R 2 Z0.208, FZ6.579, PZ0.001) showed that PCOS (bZK0.281, PZ0.008), obesity (bZK0.245, PZ0.022) and age (bZ0.296, PZ0.006) were predictive of serum OPG concentrations. Conclusions: Serum OPG concentrations are reduced in PCOS patients independently of obesity. Considering the anti-inflammatory effects of OPG, its reduced serum concentrations might contribute to the proinflammatory state and cardiovascular risk of PCOS patients.European Journal of Endocrinology 159 225-232

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“…Osteoprotegerin may be related to inflammatory endothelial processes resulting in calcification, 36,37 which leads to cardiovascular disorders and may also affect the brain. 13,15 In this way, OPG could affect the blood-brain barrier and induce neurotoxic effects, resulting in the smaller brain volumes that have been associated with OPG 38 as well as with severe mental disorders.…”

Section: Discussionmentioning

confidence: 99%

Osteoprotegerin levels in patients with severe mental disorders

Hope

Melle²,

Aukrust³

et al. 2010

jpn

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Background: Severe mental disorders are associated with elevated levels of inflammatory markers. In the present study, we investigated whether osteoprotegerin (OPG), a member of the tumour necrosis factor receptor family involved in calcification and inflammation, is elevated in patients with severe mental disorders. Methods: We measured the plasma levels of OPG in patients with severe mental disorders (n = 312; 125 with bipolar disorder and 187 with schizophrenia) and healthy volunteers (n = 239). Results: The mean plasma levels of OPG were significantly higher in patients than in controls (t 531 = 2.6, p = 0.01), with the same pattern in bipolar disorder and schizophrenia. The increase was significant after adjustment for possible confounding variables, including age, sex, ethnic background, alcohol consumption, liver and kidney function, diabetes, cardiovascular disease, autoimmune diseases and levels of cholesterol, glucose and C-reactive protein. Limitations: Owing to the cross-sectional design, it is difficult to determine causality. Conclusion: Our results indicate that elevated OPG levels are associated with severe mental disorders and suggest that mechanisms related to calcification and inflammation may play a role in disease development.

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Serum osteoprotegerin levels in patients with acute atherothrombotic stroke and lacunar infarct

Cited by 40 publications

References 24 publications

Osteoprotegerin and acute ischaemic stroke: reply

Osteoprotegerin and acute ischaemic stroke: reply

Serum osteoprotegerin concentrations are decreased in women with the polycystic ovary syndrome

Osteoprotegerin levels in patients with severe mental disorders

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