The relationship between coronary artery calcification score, plasma osteoprotegerin level and arterial stiffness in asymptomatic type 2 DM

Abstract

Because T2DM increases the risk of coronary atherosclerosis and CAD and new noninvasive techniques to assess CVD risk have gained considerable popularity, it is important to know how these tools relate to each other. The aim of this study was to evaluate the relationship between the extent of coronary artery calcification measured by MDCT, plasma OPG levels, baPWV and the established cardiovascular risk factors in Korean patients with T2DM. From November 2006 to December 2007, 110 asymptomatic Korean patients with T2DM without prior evidence of CAD were assessed (mean age 57.2 years). CAC imaging was performed using a 40-slice MDCT. Serum OPG levels were measured by an enzyme-linked immunosorbent assay (Oscotec, Korea) from the serum samples of each subject. We measured the baPWV as an index of arterial stiffness. In addition, we measured fasting glucose, HbA(1)C, hsCRP and lipid profiles. A total of 74 patients (67.3%) had minimal or insignificant CAC (<10). The CACS, OPG and baPWV showed significant positive correlations with each other. The CACS was significantly associated with the baPWV, smoking and use of a statin. The baPWV was significantly associated with age, duration of DM, total cholesterol and CACS by multiple linear regression models of the dependent variables of CACS or baPWV. CAC and baPWV were significant predictors of each other (r = 0.359, P = 0.014 and r = 0.361, P = 0.004). The results of this study showed that CAC, baPWV and serum OPG levels were significantly correlated with each other in asymptomatic Korean patients with T2DM. Furthermore, our results suggest that arterial stiffness, as determined by baPWV, may predict the extent of coronary calcification by MDCT.

Aortic Pulse Wave Velocity Is Associated With Measures of Subclinical Target Organ Damage

“…We previously showed that aPWV is independently associated with CAC in a community-based cohort (19), whereas the association of arterial stiffness with CAC has also been explored in different cohorts including the elderly (22), postmenopausal women (23), and patients with diabetes (24) and renal disease (25), confirming a positive association. The present report is the first to demonstrate an independent association of aPWV with CAC in a cohort consisting mainly of treated hypertensive individuals without a history of myocardial infarction or stroke.…”

Non-alcoholic fatty liver disease - the heart of the matter

“…Coronary artery disease in asymptomatic people can be detected by computed tomography. Several studies have found a connection between coronary artery calcification and NAFLD [23][24][25][26][27] , but 2 studies did not find a significant association [28,29] . Patients with NAFLD have a higher prevalence of CAD independent of other risk factors, including glycemic control and MS components [10,26] .…”

Coronary artery calcification and cardiovascular risk: the role of RANKL/OPG signalling

“…On the other hand, other calcification mediators have been also investigated. Serum OPG predicted mortality in chronic renal disease patients [66] and CAC serum was significantly correlated with OPG levels in asymptomatic Korean patients with type 2 diabetes mellitus [67]. However, studies addressing the possible correlation between CAC and inflammatory mediators of plaque calcification are still lacking.…”