Background: The role of osteoprotegerin (OPG) as a marker of cardiovascular disease (CVD) in Type 2 diabetes (T2DM) is not well established. Moreover, the relationship between OPG, osteoporosis, and vertebral fractures in T2DM remains to be elucidated. Aim: To determine the role of serum OPG in the prediction of CVD and bone disease in T2DM males. Subjects and methods: Cross-sectional study with 68 males, 43 with T2DM and 25 subjects without diabetes. We measured: serum OPG by inmunoassay, the presence of CVD (coronary heart disease, cerebrovascular and peripheral artery disease), surrogate markers of CVD intima-media thickness (IMT) and aortic calcification and bone disease (bone mineral density and prevalent vertebral fractures). Results: OPG serum levels (in pmol/l) were significantly higher in T2DM males with abnormal IMT (5.12±1.59 vs 3.76±1.98), carotid plaque (5.46±1.67 vs 4.20±1.81), aortic calcification (5.91±1.39 vs 4.07±1.76), hypertension (5.11±1.86 vs 3.81±1.47), and peripheral artery disease (6.24±1.64 vs 4.21±1.63, p<0.05 for all comparisons). In the logistic regression analysis (after adjustment for age and main cardiovascular risk factors), serum OPG (per 1 pmol/l increase in OPG) was associated with increased risk of abnormal IMT odds ratio (OR) 1.84, confidence interval (CI) 1.21-2.79, p=0.004), carotid plaque (OR 1.71, CI 1.13-2.58, p=0.012), aortic calcification (OR 2.21, CI 1.27-3.84, p=0.05) and peripheral artery disease (OR 4.02, CI 1.65-9.8 p=0.002). However, OPG were not related to bone mass or vertebral fractures. Conclusions: Our results suggest that in T2DM males OPG serum concentrations constitute a marker of CVD, but not a marker of bone disease.
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