Diabetes patients with low osteocalcin levels at increased risk of mortality: BMC

China: A new study published in Cardiovascular Diabetology shows that in type 2 diabetes patients, there was a relationship between baseline osteocalcin and death. Patients with lower serum osteocalcin during follow-ups were found to have a higher risk for all-cause and cardiovascular mortality.

The relationship between osteocalcin and mortality has received little attention. As a result, Yun Shen and colleagues designed this study to look at the relationship between osteocalcin, its trajectories, and mortality using long-term longitudinal data.

A retrospective cohort analysis of 9413 type 2 diabetic patients having at least three total blood osteocalcin readings within three years of their first hospital diagnosis of type 2 diabetes was done. As exposures, baseline, mean osteocalcin levels, and their trajectories were employed. The relationship between osteocalcin levels and their trajectories with death was estimated using a multivariable-adjusted Cox proportional hazards model.

The key findings of this study were as follows:

1. During a 5.37-year average follow-up, 1638 patients died, 588 of them died as a result of cardiovascular events.

2. The multivariable-adjusted hazard ratios (HRs) for all-cause mortality were 2.88, 1.65, 1.17, 1.00, and 1.92, respectively, and 3.52, 2.00, 1.03, 1.00, and 1.67 for cardiovascular disease (CVD) mortality.

3. Researchers discovered U-shaped relationships when they utilized the mean values of osteocalcin as the exposure.

4. These U-shaped relationships were seen in patients with a variety of baseline characteristics.

5. Patients with a steady or even growing osteocalcin trajectory may have a decreased risk of all-cause and CVD death.

In conclusion, the study, which used data from the Shanghai Clinical Center for Diabetes, discovered a U-shaped relationship between blood osteocalcin levels and the chances of all-cause and CVD mortality in type 2 diabetes patients. Secondary trajectory analyses confirmed that individuals with lower blood osteocalcin levels had a greater risk of all-cause and CVD death. Further interventional studies to target the therapy impact of osteocalcin are difficult to conduct.


Shen, Y., Chen, L., Zhou, J., Wang, C., Gao, F., Zhu, W., Hu, G., Ma, X., Xia, H., & Bao, Y. (2022). Low total osteocalcin levels are associated with all-cause and cardiovascular mortality among patients with type 2 diabetes: a real-world study. In Cardiovascular Diabetology (Vol. 21, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12933-022-01539-z

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