Serum Osteocalcin Level in Type 2 Diabetes and its Relation to the Severity of Coronary Heart Disease, Insulin Resistance and High Sensitive-CRP.
Introduction: Among macrovascular diabetes complications, CAD has been associated with
diabetes in numerous studies beginning with the Framingham study. More recent studies have
shown that the risk of myocardial infarction (MI) in people with diabetes is equivalent to the risk
in non-diabetic patients with a history of previous MI. Osteocalcin is the most abundant noncollagenic
protein of the bone matrix. It has have been reported to be inversely associated with
measures of insulin resistance Recent cross sectional and prospective studies suggest it to be an
established surrogate of atherosclerosis and related cardiovascular risk.
Aim of the work: The objective of the study was to investigate the link between serum osteocalcin
and hs-CRP in the different degrees of severity of atherosclerotic CAD in patients with and
Patients and method: This cross-sectional study was, conducted on 160 male subjects divided into
four groups: Group A: 40 CAD patients with T2DM. Group B: 40 CAD patients without T2DM.
Group C: 40 T2DM patients without CAD. Group D: 40 healthy control subjects matched for
age, sex and socioeconomic status. They were subjected to: complete history taking, thorough
clinical examination, Lab investigations (routine, serum insulin, osteocalcin, hs-CRP), ECG,
Groups A and B subjected to Cardiac catheterization and coronary angiography. Angiographic
analysis was done using the SYNTAX score (SS).
Results: there was a statistically significant decrease in serum osteocalcin level in diabetic than
non-diabetic subjects; also there was a statistically significant negative correlation between
serum osteocalcin and fasting plasma glucose and HbA1c. While there was no difference in
serum osteocalcin level between CAD and non CAD subjects and no difference between 3 syntax
group of severity of CAD patients. Hs-CRP was statistically significantly higher in CAD than
non CAD patients, smokers than non-smokers, syntax group 3 than group 2, and there was a
statistically significant positive correlation with the duration of CAD. There was no difference in
serum hs-CRP level between diabetic and non-diabetic subjects.
Conclusion: Serum osteocalcin level may be considered as an indicator to the severity of
glycemic control. While serum hs-CRP level is demonstrated to be an indicator to the degree of
atherosclerosis and smoking as both represent a state of chronic inflammation.
Author(s): Nagwa Amr Lacine, Magy Abd El-Monem Shalash, Eman Youssef Moursy, Mohamed Ahmed Sadaka, Gihane
Ibrahim Khalil, Asmaa kamal Eldine Elshobaky