Serum osteoprotegerin in relation to metabolic status, severity, and estimated risk of subsequent coronary heart disease

Background: Osteoprotegerin (OPG), a key factor in bone remodeling and vascular calcification, has been suggested to be associated with cardiovascular events. This study sought to assess the relationship between plasma OPG, anthropometric, metabolic status, severity and extent of coronary artery calcification, and the two-year recurrence risk of coronary event in patients with coronary heart disease (CHD).

Methods: A total of 155 consecutive patients with symptoms suggestive of CHD were enrolled in this cross-sectional study. Blood samples were taken for laboratory tests. Coronary angiography and cardiac CT scan were performed to assess the severity and extent of involved vessels. Two-year risk of subsequent CHD was estimated based on the computational Framingham risk prediction model.

Results: OPG level was in direct linear association with age (β = 0.38, p < 0.001), waist to hip ratio (β = 0.17, p < 0.05), hs-CRP (β = 0.17, p < 0.05), systolic and diastolic blood pressure (β = 0.17, p < 0.05; β = 0.23, p < 0.01), and HbA1c (β = 0.17, p < 0.05). After age-sex adjustment, only HbA1c (β = 0.15, p < 0.05) was a significant indicator of serum OPG. OPG showed significant linear association with the coronary calcium score (CCS), and the number of involved vessels even after adjustment for age, sex, diabetes, blood pressure, and markers of bone-calcium metabolism (β = 0.27, P < 0.05; β = 29, P < 0.01). There is a significant positive association between two-year risk of subsequent CHD and serum OPG in females (β = 0.45, P < 0.01) but not in males.

Conclusion: Increased OPG is independently associated with the severity and extent of CHD. This study also proposes OPG as a potential marker in predicting the risk of subsequent CHD, in females.