Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

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, HbA1C, 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. Dhore CR, Cleutjens JP, Lutgens E, Cleutjens KB, Geusens PP, Kitslaar PJ, Tordoir JH, Spronk HM, Vermeer C, Daemen MJ (2001) Differential expression of bone matrix regulatory proteins in human atherosclerotic plaques. Arterioscler Thromb Vasc Biol 21:1998–2003

    Article  CAS  PubMed  Google Scholar 

  2. Budoff MJ, Achenbach S, Blumenthal RS, Carr JJ, Goldin JG, Greenland P, Guerci AD, Lima JAC, Rader DJ, Rubin GD, Shaw LJ, Wiegers SE (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American heart association committee on cardiovascular imaging and intervention, council on cardiovascular radiology and intervention, and committee on cardiac imaging, council on clinical cardiology. Circulation 114:1761–1791

    Article  PubMed  Google Scholar 

  3. LaMonte MJ, FitzGerald SJ, Church TS, Barlow CE, Radford NB, Levine BD, Pippin JJ, Gibbons LW, Blair SN, Nichaman MZ (2005) Coronary artery calcium score and coronary heart disease events in a large cohort of asymptomatic men and women. Am J Epidemiol 162:421–429

    Article  PubMed  Google Scholar 

  4. Greenland P, Labree L, Azen SP, Doherty TM, Detrano RC (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291:210–215

    Article  CAS  PubMed  Google Scholar 

  5. Pletcher MJ, Tice JA, Pignone M, Browner WS (2004) Using the coronary artery calcium score to predict coronary heart disease events. Arch Intern Med 164:1285–1292

    Article  PubMed  Google Scholar 

  6. Elkeles RS, Godsland IF, Feher MD (2008) Coronary calcium measurement improves prediction of cardiovascular events in asymptomatic patients with type 2 diabetes: the PREDICT study. Eur Heart J 29:2244–2251

    Article  CAS  PubMed  Google Scholar 

  7. Stehouwer CDA, Ferreira HI (2008) Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia 51:527–539

    Article  CAS  PubMed  Google Scholar 

  8. Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, Yamamoto Y, Hori S (2003) Brachial-ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res 26:615–622

    Article  PubMed  Google Scholar 

  9. Kim HJ, Nam JS, Park JS, Cho MH, Kim CS, Ahn CW, Kwon HM, Hong BK, Yoon YW, Cha BS, Kim KR, Lee HC (2009) Usefulness of brachial-ankle pulse wave velocity as a predictive marker of multiple coronary artery occlusive disease in Korean type 2 diabetes patients. Diab Res Clin Pract 85:30–34

    Article  Google Scholar 

  10. Alarhabi AY, Mohamed MS, Ibrahim S, Hun TM, Musa KI, Yusof Z (2009) Pulse wave velocity as a marker of severity of coronary artery disease. J Clin Hypertens 11:17–21

    Article  Google Scholar 

  11. Simonet WS, Lacey DL, Dunstan CR, Kelley M, Chang MS, Luthy R, Nguyen HQ, Wooden S, Bennett L, Boone T, Shimamoto G, DeRose M, Elliott R, Colombero A, Tan HL, Trail G, Sullivan J, Davy E, Bucay N, Renshaw-Gegg L, Hughes TM, Hill D, Pattison W, Campbell P, Sander S, Van G, Tarpley J, Derby P, Lee R, Boyle WJ (1997) Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell 89:309–319

    Article  CAS  PubMed  Google Scholar 

  12. Schoppet M, Preissner KT, Hofbauer LC (2002) RANK ligand and osteoprotegerin: paracrine regulators of bone metabolism and vascular function. Arterioscler Thromb Vasc Biol 22:549–553

    Article  CAS  PubMed  Google Scholar 

  13. Kiechl S, Xchett G, Wenning G, Redlich K, Oberhollenzer M, Mayr A, Santer P, Smolen J, Poewe W, Willeit J (2004) Osteoprotegerin is a risk factor for progressive atherosclerosis and cardiovascular disease. Circulation 9:2175–2180

    Article  Google Scholar 

  14. Hofbauer LC, Schoppet M (2001) Osteoprotegerin: a link between osteoporosis and arterial calcification? Lancet 358:257–259

    Article  CAS  PubMed  Google Scholar 

  15. Schoppet M, Sattler AM, Schaefer JR, Herzum M, Maisch B, Hofbauer LC (2003) Increased osteoprotegerin serum levels in men with coronary artery disease. J Clin Endocrinol Metab 88:1024–1028

    Article  CAS  PubMed  Google Scholar 

  16. Jono S, Ikari Y, Shioi A, Mori K, Miki T, Hara K, Nishizawa Y (2002) Serum osteoprotegerin levels are associated with the presence and severity of coronary artery disease. Circulation 106:1192–1194

    Article  CAS  PubMed  Google Scholar 

  17. Anand DV, Lahiri A, Lim E, Hopkins D, Corder R (2006) The relationship between plasma osteoprotegerin levels and coronary artery calcification in uncomplicated type 2 diabetic subjects. J Am Coll Cardiol 47:1850–1857

    Article  CAS  PubMed  Google Scholar 

  18. Elkeles RS, Feher MD, Flather MD, Godsland IF, Nugara F, Richmond W, Rubens MB, Wang D (2004) The association of coronary calcium score and conventional cardiovascular risk factors in type 2 diabetic subjects asymptomatic for coronary heart disease (the PREDICT study). Diabet Med 21:1129–1134

    Article  CAS  PubMed  Google Scholar 

  19. Brown ER, Kronmal RA, Bluemke DA, Guerci AD, Carr JJ, Goldin J, Detrano R (2008) Coronary calcium coverage score: determination, correlates, and predictive accuracy in the multi-ethnic study of atherosclerosis. Radiology 247:669–678

    Article  PubMed  Google Scholar 

  20. Schurgin S, Rich S, Mazzone T (2001) Increased prevalence of significant coronary artery calcification in patients with diabetes. Diabetes Care 24:335–338

    Article  CAS  PubMed  Google Scholar 

  21. Sung JD, Lim SJ, Choe YH, Choi YH, Lee MK, Lee SH, Hong KY, Park JE (2008) Comparison of the coronary calcium score with the estimated coronary risk. Coron Artery Dis 19:475–479

    Article  PubMed  Google Scholar 

  22. Kronmal RA, McClelland RL, Detrano R, Shea S, Lima JA, Cushman M, Bild DE, Burke GL (2007) Risk factors for the progression of coronary artery calcification in asymptomatic subjects. Results from the multi-ethnic study of atherosclerosis (MESA). Circulation 115:2722–2730

    Article  PubMed  Google Scholar 

  23. Shoji T, Emoto M, Shinohara K, Kakiya R, Tsujimoto Y, Kishimoto H, Ishimura E, Tabata T, Nishizawa Y (2001) Diabetes mellitus, aortic stiffness, and cardiovascular mortality in end-stage renal disease. J Am Soc Nephrol 12:2117–2124

    CAS  PubMed  Google Scholar 

  24. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG (2002) Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function. Circulation 106:2085–2090

    Article  PubMed  Google Scholar 

  25. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y (2002) Validity, reproducibility and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 25:359–364

    Article  PubMed  Google Scholar 

  26. Tsuchiya M, Inoue S, Suzuki E, Mitsunami K, Egawa K, Morikawa S, Nishio Y, Inubushi T, Maegawa H, Kashiwagi A (2004) Stiffness and impaired blood flow in lower-leg arteries are associated with severity of coronary artery calcification among asymptomatic type 2 diabetic patients. Diabetes Care 27:2409–2415

    Article  PubMed  Google Scholar 

  27. Kim SM, Lee J, Ryu OH, Lee KW, Kim HY, Seo JA, Kim SG, Kim NH, Baik SH, Choi DS, Choi KM (2005) Serum osteoprotegerin levels are associated with inflammation and pulse wave velocity. Clin Endocrinol 63:594–598

    Article  CAS  Google Scholar 

  28. Hecht HS, Superko HR, Smith LK, Mccolgan BP (2001) Relation of coronary artery calcium identified by electron beam tomography to serum lipoprotein levels and implications for treatment. Am J Cardiol 87:406–412

    Article  CAS  PubMed  Google Scholar 

  29. Superko HR, Hecht HS (2001) Metabolic disorders contribute to subclinical coronary atherosclerosis in patients with coronary calcification. Am J Cardiol 88:260–264

    Article  CAS  PubMed  Google Scholar 

  30. Callister TQ, Raggi P, Cooil B, Lippolis NJ, Russo DJ (1998) Effect of HMG-CoA reductase inhibitors on coronary artery disease as assessed by electron-beam computed tomography. N Engl J Med 339:1972–1978

    Article  CAS  PubMed  Google Scholar 

  31. Wagenknecht LE, Bowden DW, Carr JJ, Langefeld CD, Freedman BI, Rich SS (2001) Familial aggregation of coronary artery calcium in families with type 2 diabetes. Diabetes 50:861–866

    Article  CAS  PubMed  Google Scholar 

  32. Redberg RF, Rifai N, Gee L, Ridker PM (2000) Lack of association of C-reactive protein and coronary calcium by electron beam computed tomography in postmenopausal women: implications for coronary artery disease screening. J Am Coll Cardiol 36:39–43

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank M. Y. Lee for statistical assistance and Y. M. Bae and M. J. Choi for helpful assistance.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Division of Endocrinology and Metabolism, Soonchunhyang University School of Medicine, Bucheon, Republic of Korea

    Chan-Hee Jung, Jung-Hwa Jung, Ji-Oh Mok & Chul-Hee Kim

  2. Department of Internal Medicine, Division of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, # 108 Pyung-Dong, Jongro-Ku, Seoul, 110-746, Korea

    Won-Young Lee, Se-Yeon Kim, Eun-Jung Rhee, Cheol-Young Park, Ki-Won Oh, Sung-Woo Park & Sun-Woo Kim

Authors
  1. Chan-Hee Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Won-Young Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Se-Yeon Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jung-Hwa Jung
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Eun-Jung Rhee
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cheol-Young Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ji-Oh Mok
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ki-Won Oh
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Chul-Hee Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Sung-Woo Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Sun-Woo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Won-Young Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jung, CH., Lee, WY., Kim, SY. et al. The relationship between coronary artery calcification score, plasma osteoprotegerin level and arterial stiffness in asymptomatic type 2 DM. Acta Diabetol 47 (Suppl 1), 145–152 (2010). https://doi.org/10.1007/s00592-009-0154-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-009-0154-z

Keywords

Search

Navigation