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Low total osteocalcin levels are associated with the risk of cardiovascular events among women with hyperglycaemia: a 7.6-year prospective study

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Abstract

Purpose

To investigate the association between circulating osteocalcin and incident cardiovascular diseases in a community-based cohort, and further assess whether the association differs by different glycemic stages.

Methods

This cohort study included 1428 participants (626 men and 802 women) aged 50–80 years, without baseline cardiovascular diseases, and with osteocalcin data available. Circulating total osteocalcin levels were measured by electrochemiluminescence immunoassay. Multivariate Cox proportional hazards models were used to assess the relationship between osteocalcin levels and different glycemic stages with cardiovascular events.

Results

At baseline, 437 participants were normoglycaemia and 991 participants were hyperglycaemia. Median circulating osteocalcin levels were 16.43 (13.34–20.19) and 21.66 (17.95–26.11) ng/mL in men and women, respectively. During a mean follow-up of 7.6 years, 144 cases of cardiovascular diseases occurred (10.1%). The risk of incident cardiovascular diseases linearly increased with a decrease in baseline osteocalcin quartiles (quartile 1 versus quartile 4: hazard ratio 2.44, 95% confidence interval 1.07–5.55) in women, while not in men (Pinteraction on sex = 0.028). Subgroup analyses showed that the association was more predominant in participants with baseline hyperglycaemia. Besides, the joint effect of baseline decreased osteocalcin levels and hyperglycaemia resulted in higher risks of future cardiovascular diseases.

Conclusions

Low baseline osteocalcin levels were associated with high risks of cardiovascular diseases in middle-aged and elderly women, which were more predominant among those with baseline hyperglycaemia.

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Data availability

The dataset analyzed during the current study is available from the corresponding author upon reasonable request.

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Funding

This work was partly funded by the Shanghai Research Center for Endocrine and Metabolic Diseases (2022ZZ01002), Shanghai Municipal Science and Technology Commission Medical Guide Project (19411964300), Shanghai Pujiang Program (21PJ1411800), and Shanghai Municipal Key Clinical Specialty. The funders of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the manuscript.

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Author notes

  1. These authors contributed equally: Tingting Hu, Yun Shen

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China

    Tingting Hu, Yun Shen, Yiting Xu, Yufei Wang, Yuqian Bao & Xiaojing Ma

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  1. Tingting Hu
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  2. Yun Shen
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Contributions

Y.Q.B. and X.J.M. conceived the study. T.T.H. and Y.S. analyzed the data and wrote the manuscript. Y.T.X. and Y.F.W. collected the data. Y.S. and Y.Q.B. obtained funding. All authors contributed to the conception and design of the work, interpretation of the data, reviewed and provided edits and comments on the manuscript, approved the final version of the manuscript, and agree to be accountable for all aspects of the work. Y.Q.B. and X.J.M. are the guarantors of this work and, as such, had full access to all the data in the study.

Corresponding authors

Correspondence to Yuqian Bao or Xiaojing Ma.

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The authors declare no competing interests.

Ethics approval

The current study was carried out in accordance with the principles of the Declaration of Helsinki and approved by the institutional review board at the Ethics Committee of Shanghai Sixth People’s Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, approved number 2019-067.

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Informed consent was obtained from all individual participants included in the study.

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Hu, T., Shen, Y., Xu, Y. et al. Low total osteocalcin levels are associated with the risk of cardiovascular events among women with hyperglycaemia: a 7.6-year prospective study. Endocrine 82, 47–56 (2023). https://doi.org/10.1007/s12020-023-03428-1

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  • DOI: https://doi.org/10.1007/s12020-023-03428-1

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