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Wang L, Niu X. Immunoregulatory Roles of Osteopontin in Diseases. Nutrients 2024; 16:312. [PMID: 38276550 PMCID: PMC10819284 DOI: 10.3390/nu16020312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/07/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Osteopontin (OPN) is a multifunctional protein that plays a pivotal role in the immune system. It is involved in various biological processes, including cell adhesion, migration and survival. The study of the immunomodulatory effects of OPN is of paramount importance due to its potential therapeutic applications. A comprehensive understanding of how OPN regulates the immune response could pave the way for the development of novel treatments for a multitude of diseases, including autoimmune disorders, infectious diseases and cancer. Therefore, in the following paper, we provide a systematic overview of OPN and its immunoregulatory roles in various diseases, laying the foundation for the development of OPN-based therapies in the future.
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Affiliation(s)
- Lebei Wang
- Department of Immunology and Microbiology, Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
- College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Xiaoyin Niu
- Department of Immunology and Microbiology, Shanghai Institute of Immunology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;
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Lecis D, Prandi FR, Barone L, Belli M, Sergi D, Longo S, Muscoli S, Romeo F, Federici M, Lerakis S, Barillà F. Beyond the Cardiovascular Effects of Glucagon-like Peptide-1 Receptor Agonists: Body Slimming and Plaque Stabilization. Are New Statins Born? Biomolecules 2023; 13:1695. [PMID: 38136567 PMCID: PMC10741698 DOI: 10.3390/biom13121695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
Atherosclerosis is a chronic inflammatory disease characterized by lipid and inflammatory cell deposits in the inner layer of large- and medium-sized elastic and muscular arteries. Diabetes mellitus (DM) significantly increases the risk of cardiovascular diseases and the overall and cardiovascular mortality, and it is a pro-atherogenic factor that induces atherosclerosis development and/or accelerates its progression through a multifactorial process. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are a new class of drugs, belonging to the armamentarium to fight type 2 DM, that have shown robust reductions in atherosclerotic events and all-cause mortality in all studies. Preclinical studies have shown that GLP-1RAs play a role in the immunomodulation of atherosclerosis, affecting multiple pathways involved in plaque development and progression. In this review, we wanted to explore the translational power of such preclinical studies by analyzing the most recent clinical trials investigating the atheroprotective effect of GLP-1RAs.
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Affiliation(s)
- Dalgisio Lecis
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (F.R.P.); (L.B.); (M.B.); (D.S.); (S.M.); (F.B.)
| | - Francesca Romana Prandi
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (F.R.P.); (L.B.); (M.B.); (D.S.); (S.M.); (F.B.)
- Division of Cardiology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA;
| | - Lucy Barone
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (F.R.P.); (L.B.); (M.B.); (D.S.); (S.M.); (F.B.)
| | - Martina Belli
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (F.R.P.); (L.B.); (M.B.); (D.S.); (S.M.); (F.B.)
- Cardiovascular Imaging Unit, San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Domenico Sergi
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (F.R.P.); (L.B.); (M.B.); (D.S.); (S.M.); (F.B.)
| | - Susanna Longo
- Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (S.L.); (M.F.)
| | - Saverio Muscoli
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (F.R.P.); (L.B.); (M.B.); (D.S.); (S.M.); (F.B.)
| | - Francesco Romeo
- Faculty of Medicine, UniCamillus-Saint Camillus International University of Health and Medical Sciences, 00131 Rome, Italy;
| | - Massimo Federici
- Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (S.L.); (M.F.)
| | - Stamatios Lerakis
- Division of Cardiology, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA;
| | - Francesco Barillà
- Division of Cardiology, Department of Systems Medicine, Tor Vergata University, 00133 Rome, Italy; (F.R.P.); (L.B.); (M.B.); (D.S.); (S.M.); (F.B.)
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Si SC, Yang W, Luo HY, Ma YX, Zhao H, Liu J. Association of bone turnover biomarkers with severe intracranial and extracranial artery stenosis in type 2 diabetes mellitus patients. World J Diabetes 2023; 14:594-605. [PMID: 37273245 PMCID: PMC10236991 DOI: 10.4239/wjd.v14.i5.594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/20/2023] [Accepted: 04/12/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Intracranial and extracranial artery stenosis is associated with cerebral infarction. Vascular calcification and atherosclerosis are the main causes of stenosis and major risk factors for cardiovascular and cerebrovascular events in patients with type 2 diabetes mellitus (T2DM). Bone turnover biomarkers (BTMs) are associated with vascular calcification, atherosclerosis, glucose, and lipid metabolism.
AIM To investigate the association of circulating BTM levels with severe intracranial and extracranial artery stenosis in patients with T2DM.
METHODS For this cross-sectional study including 257 T2DM patients, levels of the BTMs serum osteocalcin (OC), C-terminal cross-linked telopeptide of type I collagen (CTX), and procollagen type I N-peptide were measured by electrical chemiluminescent immunoassay, and artery stenosis was assessed by color Doppler and transcranial Doppler. Patients were grouped according to the existence and location (intracranial vs. extracranial) of artery stenosis. Correlations between BTM levels, previous stroke, stenosis location, and glucose and lipid metabolism were analyzed.
RESULTS T2DM patients with severe artery stenosis had a higher frequency of previous stroke and levels of all three tested BTMs (all P < 0.05) than patients without. Some differences in OC and CTX levels were observed according to the location of artery stenosis. Significant associations were also observed between BTM levels and some glucose and lipid homeostasis parameters. On multivariate logistic regression analysis, all BTMs were significant predictors of artery stenosis in T2DM patients with and without adjustment for confounding factors (all P < 0.001), and receiver operating characteristic curve analysis demonstrated the ability of BTM levels to predict artery stenosis in T2DM patients.
CONCLUSION BTM levels were found to be independent risk factors for severe intracranial and extracranial artery stenosis and were differentially associated with glucose and lipid metabolism in patients with T2DM. Therefore, BTMs may be promising biomarkers and potential therapeutic targets for artery stenosis.
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Affiliation(s)
- Si-Cong Si
- General Geriatric Department, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Wei Yang
- General Geriatric Department, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Hong-Yu Luo
- General Geriatric Department, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Yi-Xin Ma
- General Geriatric Department, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Huan Zhao
- General Geriatric Department, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
| | - Jia Liu
- General Geriatric Department, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
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Hou Y, Hou X, Nie Q, Xia Q, Hu R, Yang X, Song G, Ren L. Association of Bone Turnover Markers with Type 2 Diabetes Mellitus and Microvascular Complications: A Matched Case-Control Study. Diabetes Metab Syndr Obes 2023; 16:1177-1192. [PMID: 37139349 PMCID: PMC10149773 DOI: 10.2147/dmso.s400285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/12/2023] [Indexed: 05/05/2023] Open
Abstract
Purpose The aim of this study was to evaluate the association of bone turnover markers (BTMs) with type 2 diabetes mellitus (T2DM) and microvascular complications. Methods A total of 166 T2DM patients and 166 non-diabetic controls matched by gender and age were enrolled. T2DM patients were sub-classified into groups based on whether they had diabetic peripheral neuropathy (DPN), diabetic retinopathy (DR), and diabetic kidney disease (DKD). Clinical data including demographic characteristics and blood test results [serum levels of osteocalcin (OC), N-terminal propeptide of type 1 procollagen (P1NP), and β-crosslaps (β-CTX)] were collected. Logistic regression and restrictive cubic spline curves were performed to examine the association of BTMs with the risk of T2DM and microvascular complications. Results After adjusting for family history of diabetes, sex and age, an inverse association was observed between elevated serum OC levels [O, p < 0.001] and increased serum P1NP levels , p < 0.001] with the risk of T2DM. Moreover, there was an inverse linear association of serum OC and P1NP levels with the risk of T2DM. However, β-CTX was not associated with T2DM. Further analysis showed a nonlinear association between OC and the risk of DR, while P1NP and β-CTX were not correlated with DR. Serum concentrations of BTMs were not associated with the risks of DPN and DKD. Conclusion Serum OC and P1NP levels were negatively correlated with T2DM risk. Particularly, serum OC levels were associated with DR risk. Given that BTMs are widely used as markers of bone remodeling, the present finding provides a new perspective for estimating the risk of diabetic microvascular complications.
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Affiliation(s)
- Yilin Hou
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Xiaoyu Hou
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Qian Nie
- Health Examination Center, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Qiuyang Xia
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Rui Hu
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Xiaoyue Yang
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Guangyao Song
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
- Correspondence: Guangyao Song; Luping Ren, Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email ;
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China
- Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China
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Li W, Liu X, Liu L, Zhang L, Li M, Liu R, Li T, Chen E, Liu S. Relationships of Serum Bone Turnover Markers With Metabolic Syndrome Components and Carotid Atherosclerosis in Patients With Type 2 Diabetes Mellitus. Front Cardiovasc Med 2022; 9:824561. [PMID: 35548441 PMCID: PMC9081760 DOI: 10.3389/fcvm.2022.824561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study aimed to investigate the association of serum bone turnover markers (BTMs) with metabolic syndrome components and carotid atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Methods We performed a cross-sectional based study in T2DM populations. Serum BTMs including N-terminal osteocalcin (N-MID), β-cross-linked C-telopeptide of type I collagen (β-CTX), and procollagen type I N-terminal propeptide (PINP) were measured by immunoassay method. Carotid artery intima-media thickness and carotid artery plaque (CAP) were measured by B-mode ultrasound. Results The serum N-MID, PINP, and β-CTX levels significantly lower in the CAP group compared with the non-CAP group. N-MID and PINP levels were inversely associated with fasting blood glucose, HOMA-IR, CRP, eGFR, and triglycerides (all P < 0.05), whereas β-CTX levels were negatively associated with triglycerides (P < 0.05). After multiple adjustment, the odds ratios (ORs) were substantially higher for CAP with decreased N-MID level (OR = 0.958; 95% CI = 0.926–0.991; P = 0.013). However, serum levels of PINP and β-CTX were not associated with the presence of CAP. Multivariate logistic regression analysis further revealed that serum N-MID, PINP, and β-CTX levels were significantly associated with hypertriglyceridemia, whereas serum N-MID and β-CTX levels were associated with overweight/obesity risk. Conclusions These findings indicated that serum N-MID level was an independent risk factor for carotid atherosclerosis, whereas BTM levels were associated with other metabolic syndrome components in a T2DM population.
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Affiliation(s)
- Wei Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaojun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lijun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Zhang
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengdi Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rui Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tianfang Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - En Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
- *Correspondence: En Chen
| | - Shengyun Liu
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Shengyun Liu
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Contenti J, Durand M, Vido S, Declemy S, Raffort J, Carboni J, Bonnet S, Koelsch C, Hassen-Khodja R, Gual P, Mazure NM, Sadaghianloo N. Plasmatic osteopontin and vascular access dysfunction in hemodialysis patients: a cross-sectional, case-control study (The OSMOSIS Study). J Nephrol 2021; 35:527-534. [PMID: 34468976 DOI: 10.1007/s40620-021-01129-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 07/11/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS Despite close follow-up of patients with native arteriovenous fistulas (AVFs), up to 10% experience thrombosis each year. The OSMOSIS Study (Osteopontin as a Marker of Stenosis) tested the hypothesis that the systemic osteopontin level, a pro-inflammatory mediator related to vascular remodelling and intimal hyperplasia, increases in AVF stenosis, and may be used in clinical surveillance. METHODS Our cross-sectional study compared the level of plasmatic osteopontin (pOPN) between patients with a well-functioning AVF (control group) and patients who required revision of their AVF due to stenosis (stenosis group). Blood samples were collected before dialysis (control group) or before intervention (stenosis group) from the AVF arm, and from the opposite arm as a within-subject control. pOPN level was measured by enzyme-linked immunosorbent assay. RESULTS A total of 76 patients were included in the study. Baseline characteristics were similar between the groups (mean age, 70 years; men, 63%; AVF duration, 39 months), apart from prevalence of type 2 diabetes (T2D) (control group, 33%; stenosis group, 57%; p = 0.04). pOPN levels were similar between the AVF arm and the contralateral arm (551 ± 42 ng/mL vs. 521 ± 41 ng/mL, respectively, p = 0.11, paired t-test). Patients in the stenosis group displayed a higher pOPN level than patients in the control group (650.2 ± 59.8 ng/mL vs. 460.5 ± 61.2, respectively, p = 0.03; two-way ANOVA). T2D was not identified as an associated factor in a multivariate analysis (p = 0.50). CONCLUSIONS The level of pOPN in hemodialysis patients was associated with the presence of AVF stenosis requiring intervention. Thus, its potential as a diagnostic biomarker should be assessed in a vascular access surveillance program.
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Affiliation(s)
- Julie Contenti
- Department of Emergency Medicine, Centre Hospitalier Universitaire de Nice, Nice, France.,Centre Méditerranéen de Médecine Moléculaire, INSERM U1065, Université Côte d'Azur, Nice, France
| | - Matthieu Durand
- Department of Urology and Andrology and Renal Transplantation, Centre Hospitalier Universiatire de Nice, Nice, France.,Institute of Research on Cancer and Aging of Nice, INSERM U1081-CNRS, UMR 7284, Université Côte d'Azur, Nice, France
| | - Sandor Vido
- Department of Nephrology and Hemodialysis, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Serge Declemy
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur 1, 30 Ave de la voie Romaine, 06000, Nice, France
| | - Juliette Raffort
- Clinical Chemistry Laboratory (J.R), Centre Hospitalier Universitaire de Nice, Nice, France
| | - Joseph Carboni
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur 1, 30 Ave de la voie Romaine, 06000, Nice, France
| | - Sophie Bonnet
- Department of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur 1, 30 Ave de la voie Romaine, 06000, Nice, France.,Department of Clinical Research and Innovation, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Christophe Koelsch
- Department of Anesthesiology, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Réda Hassen-Khodja
- Centre Méditerranéen de Médecine Moléculaire, INSERM U1065, Université Côte d'Azur, Nice, France.,Department of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur 1, 30 Ave de la voie Romaine, 06000, Nice, France
| | - Philippe Gual
- Centre Méditerranéen de Médecine Moléculaire, INSERM U1065, Université Côte d'Azur, Nice, France
| | - Nathalie M Mazure
- Centre Méditerranéen de Médecine Moléculaire, INSERM U1065, Université Côte d'Azur, Nice, France
| | - Nirvana Sadaghianloo
- Centre Méditerranéen de Médecine Moléculaire, INSERM U1065, Université Côte d'Azur, Nice, France. .,Department of Vascular Surgery, Centre Hospitalier Universitaire de Nice, Hôpital Pasteur 1, 30 Ave de la voie Romaine, 06000, Nice, France.
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Del Toro R, Cavallari I, Tramontana F, Park K, Strollo R, Valente L, De Pascalis M, Grigioni F, Pozzilli P, Buzzetti R, Napoli N, Maddaloni E. Association of bone biomarkers with advanced atherosclerotic disease in people with overweight/obesity. Endocrine 2021; 73:339-346. [PMID: 33948786 DOI: 10.1007/s12020-021-02736-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/19/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND A growing body of evidence suggests a potential link between bone metabolism and cardiovascular disease. Aim of this study was to investigate the relationship between levels of circulating bone turnover biomarkers and advanced atherosclerosis. METHODS Klotho (KL), sclerostin (SOST), osteopontin (OPN) and osteoprotegerin (OPG) were measured in patients undergoing elective coronary angiography and carotid Doppler ultrasound. The primary outcome was the difference in bone biomarkers levels between participants with and without advanced atherosclerosis, defined as the presence of a critical coronary (≥70%) and/or carotid (≥50%) stenosis. RESULTS A total of 80 subjects (32.5% females) with a mean age of 68 ± 10 years were included. Advanced atherosclerosis was detected in 55 (68.8%) patients. Subjects with advanced atherosclerosis showed higher serum levels of OPG (p = 0.0015) and SOST (p = 0.017) and similar levels of KL (p = 0.62) and OPN (p = 0.06) compared to patients without. After adjustment for age and sex, only elevated levels of OPG remained significantly associated with advanced atherosclerosis (p = 0.011). CONCLUSIONS Higher serum levels of OPG are independently associated with advanced atherosclerosis confirming a common bond between bone metabolism and vascular disease. Further investigations on the role of selected bone biomarkers in the pathogenesis of cardiovascular disease are needed.
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Affiliation(s)
- Rossella Del Toro
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
| | - Ilaria Cavallari
- Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy
| | - Flavia Tramontana
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Kyoungmin Park
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
| | - Rocky Strollo
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Luciana Valente
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Mariangela De Pascalis
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Francesco Grigioni
- Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Rome, Italy
| | - Paolo Pozzilli
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Raffaella Buzzetti
- Experimental Medicine Department, Sapienza University of Rome, Rome, Italy
| | - Nicola Napoli
- Endocrinology and Diabetes Unit, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Ernesto Maddaloni
- Experimental Medicine Department, Sapienza University of Rome, Rome, Italy
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Zhang Y, Zhou C, Li J, Zhang Y, Xie D, Liang M, Wang B, Song Y, Wang X, Huo Y, Hou FF, Xu X, Qin X. Serum alkaline phosphatase levels and the risk of new-onset diabetes in hypertensive adults. Cardiovasc Diabetol 2020; 19:186. [PMID: 33099298 PMCID: PMC7585682 DOI: 10.1186/s12933-020-01161-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 10/17/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The association between alkaline phosphatase (ALP) and incident diabetes remains uncertain. Our study aimed to investigate the prospective relation of serum ALP with the risk of new-onset diabetes, and explore possible effect modifiers, in hypertensive adults. METHODS A total 14,393 hypertensive patients with available ALP measurements and without diabetes and liver disease at baseline were included from the China Stroke Primary Prevention Trial (CSPPT). The primary outcome was new-onset diabetes, defined as physician-diagnosed diabetes or use of glucose-lowering drugs during follow-up, or fasting glucose ≥ 7.0 mmol/L at the exit visit. The secondary study outcome was new-onset impaired fasting glucose (IFG), defined as FG < 6.1 mmol/L at baseline and ≥ 6.1 but < 7.0 mmol/L at the exit visit. RESULTS Over a median of 4.5 years follow-up, 1549 (10.8%) participants developed diabetes. Overall, there was a positive relation of serum ALP and the risk of new-onset diabetes (per SD increment, adjusted OR, 1.07; 95% CI: 1.01, 1.14) and new-onset IFG (per SD increment, adjusted OR, 1.07; 95% CI: 1.02, 1.14). Moreover, a stronger positive association between baseline ALP (per SD increment) with new-onset diabetes was found in participants with total homocysteine (tHcy) < 10 μmol/L (adjusted OR, 1.24; 95% CI: 1.10, 1.40 vs. ≥ 10 μmol/L: adjusted OR, 1.03; 95% CI: 0.96, 1.10; P-interaction = 0.007) or FG ≥ 5.9 mmol/L (adjusted OR, 1.16; 95% CI: 1.07, 1.27 vs. < 5.9 mmol/L: adjusted OR, 1.00; 95% CI: 0.93, 1.08; P-interaction = 0.009) CONCLUSIONS: In this non-diabetic, hypertensive population, higher serum ALP was significantly associated with the increased risk of new-onset diabetes, especially in those with lower tHcy or higher FG levels. Clinical Trial Registration-URL Trial registration: NCT00794885 (clinicaltrials.gov). Retrospectively registered November 20, 2008.
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Affiliation(s)
- Yuanyuan Zhang
- Division of Nephrology, Nanfang Hospital, Southern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Chun Zhou
- Division of Nephrology, Nanfang Hospital, Southern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Jianping Li
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Yan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Di Xie
- Division of Nephrology, Nanfang Hospital, Southern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Min Liang
- Division of Nephrology, Nanfang Hospital, Southern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Binyan Wang
- Institute of Biomedicine, Anhui Medical University, Hefei, 230032, China
| | - Yun Song
- Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Xiaobin Wang
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe Street, E4132, Baltimore, MD, 21205-2179, USA
| | - Yong Huo
- Department of Cardiology, Peking University First Hospital, Beijing, 100034, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China
| | - Xiping Xu
- Division of Nephrology, Nanfang Hospital, Southern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.
| | - Xianhui Qin
- Division of Nephrology, Nanfang Hospital, Southern Medical UniversityNational Clinical Research Center for Kidney DiseaseState Key Laboratory of Organ Failure ResearchGuangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, 510515, China.
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9
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Alexandre-Heymann L, Barral M, Dohan A, Larger E. Patients with type 2 diabetes present with multiple anomalies of the pancreatic arterial tree on abdominal computed tomography: comparison between patients with type 2 diabetes and a matched control group. Cardiovasc Diabetol 2020; 19:122. [PMID: 32758235 PMCID: PMC7410152 DOI: 10.1186/s12933-020-01098-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/25/2020] [Indexed: 02/07/2023] Open
Abstract
Background Studies suggest that cardio-vascular risk factors could foster the development of type 2 diabetes (T2D). This could partly be mediated by pancreatic atherosclerosis resulting in pancreatic ischemia. We hypothesized that patients with T2D present with more severe atherosclerosis of pancreas-bound arteries than control patients without T2D. Methods We performed a retrospective study comparing the abdominal computed tomography of patients with T2D and of control subjects matched for gender and for age. We performed a multivariate logistic regression with adjustment for age, gender, BMI and the presence or absence of hypertension. Results Forty-eight patients with T2D and 48 control subjects were included. A calcification score of the splenic artery was defined (from 0: no calcification to 3: continuous linear calcifications). Seventeen percent of the patients with T2D presented with a high calcification score (i.e. 2 or 3), versus only 2% of the control subjects (p = 0.04). The mean number of pancreas-bound branches among the greater pancreatic artery, dorsal pancreatic artery and inferior pancreatic artery (from 0 to 3) was lower in patients with T2D than in control subjects (1.1 vs 1.7, p = 0.003). The mean number of visible intrapancreatic arterial subdivisions (from 0 to 2) was lower in patients with T2D than in control subjects (0.7 vs 1.3, p = 0.0017). All these differences hold true using multivariate logistic regression. None of these differences correlated with the duration of diabetes. The relationship between pancreas volume and BMI seen in control subjects was not confirmed in patients with T2D. Conversely, in patients with T2D but not in control subjects, the splenic artery diameter correlated with the pancreas volume. Conclusions Patients with T2D present with more calcifications of the splenic artery and with a less dense pancreatic arterial tree than control subjects.
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Affiliation(s)
- Laure Alexandre-Heymann
- Service de Diabétologie, Hôpital Cochin, 123 Boulevard de Port Royal, 75014, Paris, France. .,Département Hospitalo Universitaire, INSERM U1016, Université Paris Descartes, Paris, France.
| | | | - Anthony Dohan
- Département Hospitalo Universitaire, INSERM U1016, Université Paris Descartes, Paris, France.,Service de Radiologie A, Hôpital Cochin, Paris, France.,Université de Paris, Paris, France
| | - Etienne Larger
- Service de Diabétologie, Hôpital Cochin, 123 Boulevard de Port Royal, 75014, Paris, France.,Département Hospitalo Universitaire, INSERM U1016, Université Paris Descartes, Paris, France.,Université de Paris, Paris, France
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10
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Gateva A, Tsakova A, Hristova J, Kamenov Z. Fibroblast growth factor 23 and 25(OH)D levels are related to abdominal obesity and cardiovascular risk in patients with polycystic ovarian syndrome. Gynecol Endocrinol 2020; 36:402-405. [PMID: 31709849 DOI: 10.1080/09513590.2019.1689550] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Fibroblast growth factor 23 (FGF23) and Klotho are extensively studied in relation to bone metabolism and progression of chronic kidney disease. There is very limited information about their role in polycystic ovarian syndrome (PCOS). The aim of the present study was to investigate some bone markers in women with PCOS in relation to obesity and cardiovascular risk. In the study were included 80 patients, divided into three age-matched groups -Non-obese PCOS (n = 40); Obese PCOS (n = 20) and Obese control group (n = 20). Bone marker levels were measured by an enzyme-linked immunosorbent assay. Obese PCOS patients had higher levels of FGF23 and sRANKL, lower levels of 25(OH)D and higher prevalence of vitamin D deficiency compared to non-obese subjects. Patients with abdominal obesity (waist circumference >80 cm) independently of PCOS status had significantly higher levels of FGF23 (112.5 ± 86.5 vs. 73.4 ± 37.9 pg/ml; p = .023) and lower of 25(OH)D (35.8 ± 21.4 vs 47.8 ± 26.5 nmol/l; p = .034). Patients with PCOS at risk of cardiovascular diseases according to AE-PCOS consensus also had increased levels of FGF23 (111.6 ± 84.5 vs. 66.5 ± 35.1 pg/ml; p = .031) and decreased levels of 25(OH)D (31.9 ± 16.8 vs. 47.1 vs 28.4 nmol/l; p = .017) compared to those not at risk. There was no correlation between bone markers and blood glucose levels, insulin resistance or hormonal levels.
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Affiliation(s)
- Antoaneta Gateva
- Department of Internal Medicine, Medical University-Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital "Alexandrovska", Sofia, Bulgaria
| | - Adelina Tsakova
- Department of Clinical Laboratory and Clinical Immunology, Medical University-Sofia, Sofia, Bulgaria
- Clinical Laboratory and Clinical Pharmacology, University Hospital "Alexandrovska", Sofia, Bulgaria
| | - Julieta Hristova
- Department of Clinical Laboratory and Clinical Immunology, Medical University-Sofia, Sofia, Bulgaria
- Clinical Laboratory and Clinical Pharmacology, University Hospital "Alexandrovska", Sofia, Bulgaria
| | - Zdravko Kamenov
- Department of Internal Medicine, Medical University-Sofia, Sofia, Bulgaria
- Clinic of Endocrinology, University Hospital "Alexandrovska", Sofia, Bulgaria
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11
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Abstract
Over the last decades, the association between vascular calcification (VC) and all-cause/cardiovascular mortality, especially in patients with high atherogenic status, such as those with diabetes and/or chronic kidney disease, has been repeatedly highlighted. For over a century, VC has been noted as a passive, degenerative, aging process without any treatment options. However, during the past decades, studies confirmed that mineralization of the arteries is an active, complex process, similar to bone genesis and formation. The main purpose of this review is to provide an update of the existing biomarkers of VC in serum and develop the various pathogenetic mechanisms underlying the calcification process, including the pivotal roles of matrix Gla protein, osteoprotegerin, bone morphogenetic proteins, fetuin-a, fibroblast growth-factor-23, osteocalcin, osteopontin, osteonectin, sclerostin, pyrophosphate, Smads, fibrillin-1 and carbonic anhydrase II.
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12
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Eleftheriadou I, Tsilingiris D, Tentolouris A, Mourouzis I, Grigoropoulou P, Kapelios C, Pantos C, Makrilakis K, Tentolouris N. Association of Circulating Osteopontin Levels With Lower Extremity Arterial Disease in Subjects With Type 2 Diabetes Mellitus: A Cross-Sectional Observational Study. INT J LOW EXTR WOUND 2020; 19:180-189. [DOI: 10.1177/1534734619898097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Osteopontin (OPN) is involved in the atherosclerotic and inflammatory process. In this article, we examined the relationship between circulating OPN levels with lower extremity arterial disease (LEAD) in individuals with type 2 diabetes mellitus (T2DM). Seventy individuals with T2DM and 66 individuals without T2DM were recruited. Diagnosis of LEAD was based on the absence of triphasic waveform on the pedal arteries. Plasma OPN levels were determined by Luminex Multiplex immunoassay. LEAD was present in 34 (48.6%) patients with T2DM. In the diabetes cohort, individuals with LEAD had higher plasma OPN concentrations than those without LEAD (geometric mean [95% confidence intervals]; 43.4 [37.5-50.4] vs 26.1 [22.9-29.8] ng/mL, respectively, P < .001). Multivariable analysis showed that presence of LEAD independently associated with higher OPN levels in subjects with T2DM, with marginal statistical significance ( P = .049). In both cohorts, plasma OPN concentrations were negatively associated with ankle-brachial index values ( P < .05). In the total sample, there was a gradual increase of OPN levels across subgroups with triphasic, biphasic, and monophasic/blunted waveforms ( P < .001). In conclusion, plasma OPN levels are associated with the presence and severity of LEAD in subjects with T2DM. Further studies are needed to investigate the role of OPN in the pathogenesis and progression of LEAD.
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Affiliation(s)
- Ioanna Eleftheriadou
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Dimitrios Tsilingiris
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Anastasios Tentolouris
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Iordanis Mourouzis
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Pinelopi Grigoropoulou
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Christos Kapelios
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Constantinos Pantos
- Department of Pharmacology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Makrilakis
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
| | - Nikolaos Tentolouris
- Diabetes Center, First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece
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13
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Ahmed S, Sobh R. Predictive Value of Osteoprotegerin for Detecting Coronary Artery Calcification in Type 2 Diabetes Mellitus Patients in Correlation with Extent of Calcification Detected by Multidetector Computed Tomography. Endocr Metab Immune Disord Drug Targets 2019; 19:845-851. [DOI: 10.2174/1871530319666190211122858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/25/2019] [Accepted: 01/26/2019] [Indexed: 12/28/2022]
Abstract
Background:Osteoprotegerin (OPG) is a tumor necrosis factor receptor super-family member. It specifically acts on bone by increasing bone mineral density and bone volume. Recent studies have evidenced its close relation to the development of atherosclerosis and plaque destabilization. Elevated OPG level has also been associated with the degree of coronary calcification in the general population and it has been considered to be a marker of coronary atherosclerosis.Objective:The aim of this study was to determine the relation between OPG levels and Coronary Artery Calcification score (CACs) in Type 2 diabetic patients in comparison to healthy controls.Methods:Our study included 45 type 2 diabetic patients (mean age 51.7 years; 51.1% male) without evidence of previous CVD and 45 healthy age and sex matched subjects as control. All participants were subjected to full history, full examination and lab investigations. Serum OPG concentration was measured by an enzyme-linked immunosorbent assay (ELISA) and CAC imaging was performed using non contrast Multi detector CT of the heart.Results:Significant CAC (<10 Agatston units) was seen in 23 patients (51.11 %).:OPG was significantly high in diabetic patients in comparison to controls with mean 12.9±5.7 pmol/l in cases, and 8.6±0.5 pmol/l in controls (P value < 0.001).:The Coronary Artery Calcification Score (CACS) was positively correlated with age and duration of diabetes. The OPG was positively correlated with age, fasting blood sugar and duration of diabetes. The CACS showed a significantly positive correlation with OPG.Conclusion:Findings suggested that increasing in serum OPG was consistent with CAC and could be used for the early diagnosis of subclinical atherosclerosis.
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Affiliation(s)
- Sahar Ahmed
- Department of Internal Medicine, Kasr Ainy Cairo University, Cairo, Egypt
| | - Rasha Sobh
- Department of Internal Medicine, Kasr Ainy Cairo University, Cairo, Egypt
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14
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Chen HG, Sheng LT, Zhang YB, Cao AL, Lai YW, Kunutsor SK, Jiang L, Pan A. Association of vitamin K with cardiovascular events and all-cause mortality: a systematic review and meta-analysis. Eur J Nutr 2019; 58:2191-2205. [DOI: 10.1007/s00394-019-01998-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 05/12/2019] [Indexed: 12/19/2022]
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15
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Barchetta I, Ceccarelli V, Cimini FA, Bertoccini L, Fraioli A, Alessandri C, Lenzi A, Baroni MG, Cavallo MG. Impaired bone matrix glycoprotein pattern is associated with increased cardio-metabolic risk profile in patients with type 2 diabetes mellitus. J Endocrinol Invest 2019; 42:513-520. [PMID: 30132286 DOI: 10.1007/s40618-018-0941-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Osteopontin (OPN), osteoprotegerin (OPG) and osteocalcin (OC) are matrix glycoproteins which mediate bone mineralization; moreover, their effects on glucose/insulin homeostasis have recently been demonstrated. Higher circulating OPN and OPG levels have been associated with the presence of insulin resistance, atherosclerosis and coronary heart disease. No data are available on contextual changes of these markers in type 2 diabetes mellitus (T2DM). Therefore, aims of this study were to evaluate serum OPN, OPG and OC levels in T2DM patients and their clinical correlates. METHODS We recruited 83 consecutive T2DM patients referring to our diabetes outpatient clinics at Sapienza, University of Rome, and 71 non-diabetic sex and age-comparable subjects as a control group. Study population underwent metabolic characterization and carotid ultrasound for intima-media thickness measurement. Plasma OPN, OPG and OC were measured by MILLIPLEX Multiplex Assays Luminex. RESULTS T2DM patients had significantly higher circulating OPN and OPG levels than controls (14.3 ± 13.6 vs 10.6 ± 13.7 ng/ml p < 0.001, 0.70 ± 0.60 vs 0.54 ± 4.1 ng/ml, p = 0.02) while OC levels were similar in the two cohorts (6.35 ± 5.8 vs 7.80 ± 7.0 ng/ml, p = n.s). OPN and OPG positively correlated with greater systolic blood pressure (SBP) values, HOMA-IR and HOMA-β, and with the presence of dyslipidemia and carotid atherosclerosis. The association between greater OPN and OPG levels and SBP was independent from possible confounders (both p = 0.01). CONCLUSIONS Circulating OPN and OPG levels are increased in T2DM patients and identify a particularly unfavourable metabolic profile, mostly expressed by higher SBP. Bone peptides may represent novel markers of vascular stress and accelerated atherosclerosis in diabetes, constituting a possible tool for cardiovascular risk stratification in diabetes.
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Affiliation(s)
- I Barchetta
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - V Ceccarelli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - F A Cimini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - L Bertoccini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - A Fraioli
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - C Alessandri
- Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy
| | - A Lenzi
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - M G Baroni
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy
| | - M G Cavallo
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome, Italy.
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16
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Knudsen LB, Lau J. The Discovery and Development of Liraglutide and Semaglutide. Front Endocrinol (Lausanne) 2019; 10:155. [PMID: 31031702 PMCID: PMC6474072 DOI: 10.3389/fendo.2019.00155] [Citation(s) in RCA: 357] [Impact Index Per Article: 71.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/21/2019] [Indexed: 12/12/2022] Open
Abstract
The discovery of glucagon-like peptide-1 (GLP-1), an incretin hormone with important effects on glycemic control and body weight regulation, led to efforts to extend its half-life and make it therapeutically effective in people with type 2 diabetes (T2D). The development of short- and then long-acting GLP-1 receptor agonists (GLP-1RAs) followed. Our article charts the discovery and development of the long-acting GLP-1 analogs liraglutide and, subsequently, semaglutide. We examine the chemistry employed in designing liraglutide and semaglutide, the human and non-human studies used to investigate their cellular targets and pharmacological effects, and ongoing investigations into new applications and formulations of these drugs. Reversible binding to albumin was used for the systemic protraction of liraglutide and semaglutide, with optimal fatty acid and linker combinations identified to maximize albumin binding while maintaining GLP-1 receptor (GLP-1R) potency. GLP-1RAs mediate their effects via this receptor, which is expressed in the pancreas, gastrointestinal tract, heart, lungs, kidneys, and brain. GLP-1Rs in the pancreas and brain have been shown to account for the respective improvements in glycemic control and body weight that are evident with liraglutide and semaglutide. Both liraglutide and semaglutide also positively affect cardiovascular (CV) outcomes in individuals with T2D, although the precise mechanism is still being explored. Significant weight loss, through an effect to reduce energy intake, led to the approval of liraglutide (3.0 mg) for the treatment of obesity, an indication currently under investigation with semaglutide. Other ongoing investigations with semaglutide include the treatment of non-alcoholic fatty liver disease (NASH) and its use in an oral formulation for the treatment of T2D. In summary, rational design has led to the development of two long-acting GLP-1 analogs, liraglutide and semaglutide, that have made a vast contribution to the management of T2D in terms of improvements in glycemic control, body weight, blood pressure, lipids, beta-cell function, and CV outcomes. Furthermore, the development of an oral formulation for semaglutide may provide individuals with additional benefits in relation to treatment adherence. In addition to T2D, liraglutide is used in the treatment of obesity, while semaglutide is currently under investigation for use in obesity and NASH.
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Affiliation(s)
- Lotte Bjerre Knudsen
- Global Drug Discovery, Novo Nordisk A/S, Måløv, Denmark
- *Correspondence: Lotte Bjerre Knudsen
| | - Jesper Lau
- Global Research Technology, Novo Nordisk A/S, Måløv, Denmark
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17
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The GLP-1 Analogs Liraglutide and Semaglutide Reduce Atherosclerosis in ApoE -/- and LDLr -/- Mice by a Mechanism That Includes Inflammatory Pathways. JACC Basic Transl Sci 2018; 3:844-857. [PMID: 30623143 PMCID: PMC6314963 DOI: 10.1016/j.jacbts.2018.09.004] [Citation(s) in RCA: 202] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/10/2018] [Accepted: 09/14/2018] [Indexed: 02/06/2023]
Abstract
The GLP-1RAs liraglutide and semaglutide reduce cardiovascular risk in type 2 diabetes patients. In ApoE−/− mice and LDLr−/− mice, liraglutide and semaglutide treatment significantly attenuated plaque lesion development, in part independently of body weight and cholesterol lowering. Semaglutide decreased levels of plasma markers of systemic inflammation in an acute inflammation model (lipopolysaccharide), and transcriptomic analysis of aortic atherosclerotic tissue revealed that multiple inflammatory pathways were down-regulated by semaglutide.
The glucagon-like peptide-1 receptor agonists (GLP-1RAs) liraglutide and semaglutide reduce cardiovascular risk in type 2 diabetes patients. The mode of action is suggested to occur through modified atherosclerotic progression. In this study, both of the compounds significantly attenuated plaque lesion development in apolipoprotein E-deficient (ApoE−/−) mice and low-density lipoprotein receptor-deficient (LDLr−/−) mice. This attenuation was partly independent of weight and cholesterol lowering. In aortic tissue, exposure to a Western diet alters expression of genes in pathways relevant to the pathogenesis of atherosclerosis, including leukocyte recruitment, leukocyte rolling, adhesion/extravasation, cholesterol metabolism, lipid-mediated signaling, extracellular matrix protein turnover, and plaque hemorrhage. Treatment with semaglutide significantly reversed these changes. These data suggest GLP-1RAs affect atherosclerosis through an anti-inflammatory mechanism.
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Key Words
- CD163, cluster of differentiation 163 molecule
- GLP, glucagon-like peptide
- GLP-1
- IFN, interferon
- IL, interleukin
- LDL, low-density lipoprotein
- LPS, lipopolysaccharide
- MMP, matrix metalloproteinase
- NASH, nonalcoholic steatohepatitis
- OPN, osteopontin
- RNA, ribonucleic acid
- TIMP, tissue inhibitor of metalloproteinases
- TNF, tumor necrosis factor
- WD, Western diet
- atherosclerosis
- diabetes
- inflammation
- obesity
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Carbone F, Montecucco F. Novel cardiovascular risk biomarkers in carotid atherogenesis. Biomark Med 2018; 12:1065-1067. [PMID: 30227729 DOI: 10.2217/bmm-2018-0198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Affiliation(s)
- Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova 10 Largo Benzi, 16132, Genoa, Italy & Center of Excellence for Biomedical Research (CEBR), University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
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