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.

Reference:

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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