Association of serum osteoprotegerin with coronary artery calcification scores in patients with asymptomatic type 2 diabetes

무증상 제2형 당뇨병 환자에서 관상동맥석회 점수와 혈청 osteoprotegerin농도의 상관 관계

  • Cho, Eun-Hee (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Lee, Dong-Gyu (Department of Internal Medicine, Kangwon National University School of Medicine) ;
  • Kim, Sang-Wook (Department of Internal Medicine, Kangwon National University School of Medicine)
  • 조은희 (강원대학교 의학전문대학원 내과학교실) ;
  • 이동규 (강원대학교 의학전문대학원 내과학교실) ;
  • 김상욱 (강원대학교 의학전문대학원 내과학교실)
  • Received : 2010.05.03
  • Accepted : 2010.06.10
  • Published : 2010.08.01

Abstract

Background/Aims: Osteoprotegerin (OPG), a member of the tumor necrosis factor (TNF) receptor superfamily, is involved in bone metabolism and vascular calcification. However, the relationship between serum OPG levels and coronary calcification is not well elucidated. The present study investigated whether serum OPG levels are associated with coronary artery calcification scores (CACs) in patients with type 2 diabetes. Methods: A total of 140 type 2 diabetic outpatients without previous evidence of clinical cardiovascular disease were recruited. CACs were obtained using multi-slice spiral computed tomography and categorized as minimal (0), mild (1-99), moderate (100-399), or severe (${\geq}$ 400). Serum OPG levels were measured by enzyme-linked immunosorbent assay. Results: A total of 94 of 140 (67.1%) patients with type 2 diabetes showed coronary calcification. A Pearson's correlation analysis showed a positive correlation between serum OPG levels and CACs. However, multivariate regression analyses revealed that waist circumference, duration of diabetes, and serum creatinine concentration were significant independent determinants of CACs. Conclusions: The present study demonstrates that coronary calcification is common (67.1%), and serum OPG levels are correlated with CACs but are not an independent determinant of CACs in patients with asymptomatic type 2 diabetes.

목적: 본 연구는 심혈관 증상이 없는 제2형 당뇨병 환자에서 불현성 관상동맥 죽상경화증의 유병률을 알아보고, 혈청 OPG 농도와 관상동맥석회 점수와의 상관관계를 분석하여 혈청 OPG가 관상동맥질환의 혈청 표지자로 이용될 수 있을지 알아보았다. 방법: 심혈관 증상이 없는 제2형 당뇨병 환자 140명을 대상으로 MSCT를 이용하여 관상동맥석회 점수를 정량하고 혈청 OPG 농도를 측정하여 상관관계를 분석하였다. 결과: 심혈관 증상이 없는 제2형 당뇨병 환자에서 관상동맥 석회화는 67.1%에서 관찰되었다. 상관분석에서, 관상동맥 석회화 점수와 혈중 OPG농도는 양의 상관관계를 보였으나, 다변량 회귀분석에서는 허리둘레(p=0.003), 당뇨병의 유병기간(p=0.005), 혈청 creatinine 농도(p=0.011)가 관상동맥 석회화의 유의한 독립변수로 나타났으며, 혈청 OPG 농도(p=0.082)는 제외되었다. 결론: 심혈관 증상이 없는 제2형 당뇨병 환자에서 관상동맥 석회화는 흔하게 관찰되며, 혈청 OPG 농도는 관상동맥석회 점수에 비례하여 증가하나, 관상동맥석회 점수의 독립적인 위험인자가 아니므로, 관상동맥 석회화를 반영하는 혈청지표로 이용될 수는 없을 것으로 생각된다.

Keywords

References

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