Does osteoprotegerin relate to micro- and macrovascular complications in long-term type 1 diabetes?

Abstract

Purpose. Markers of micro- and macrovascular disease are needed in type 1 diabetes in order to identify patients at risk of severe complications. Osteoprotegerin (OPG) is expressed in vascular myocytes, and increasing levels have been reported in type 1 diabetes. Consequently, we investigated OPG as a non-invasive marker of micro- and macrovascular complications in long-term type 1 diabetic patients. Methods. This was a cross-sectional study of 200 type 1 diabetic patients with long diabetes duration from a population-based cohort from Fyn County, Denmark. Patients were examined in 2007–2008, and OPG was measured and correlated to diabetes-associated complications: retinopathy, nephropathy, neuropathy and macrovascular disease. Results. Median age and duration of diabetes was 58.7 years (range 37.7–84.4 years) and 43 years (range 34–70 years), respectively. Median level of OPG was 1257 pg/ml (range 379–5706 pg/ml). In univariate analyses, OPG was related to age, duration of diabetes, female gender, nephropathy and inversely to diastolic blood pressure. In an age- and sex-adjusted model, higher levels of OPG were associated with a higher risk of nephropathy (OR 2.54, 95% confidence interval 1.09–5.90 for third vs. first tertile). Statistical significance was, however, lost in a multivariate model, and proliferative diabetic retinopathy, neuropathy and macrovascular disease was not associated with OPG in either model. Conclusions. Some associations of OPG and nephropathy were found in a long-term type 1 diabetic cohort. Prospective studies are needed in order to determine whether OPG can be used to predict nephropathy.

Key Words::

• Type 1 diabetes
• osteoprotegerin
• microvascular complications
• macrovascular complications
• nephropathy

Acknowledgments

This work was supported by grants from the Velux Foundation, The Danish Eye Health Society, Sehested Hansen’s Foundation, Danish Diabetes Association, Synoptik Foundation, The A.P. Møller Foundation for the Advancement of Medical Science and Institute of Clinical Research at University of Southern Denmark.

Declaration of interest: Nothing to declare.