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Mi Y, Wen O, Lei Z, Ge L, Xing L, Xi H. Insulin resistance and osteocalcin associate with the incidence and severity of postoperative delirium in elderly patients undergoing joint replacement. Geriatr Gerontol Int 2024; 24:421-429. [PMID: 38438300 DOI: 10.1111/ggi.14848] [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: 09/03/2023] [Revised: 01/30/2024] [Accepted: 02/14/2024] [Indexed: 03/06/2024]
Abstract
AIM While insulin sensitivity plays an important role in maintaining glucose metabolic homeostasis and cognitive function, its impact on postoperative delirium (POD) remains unclear. This study aimed to investigate the association between POD and indicators of insulin sensitivity, including insulin resistance and osteocalcin. METHODS A total of 120 elderly patients undergoing joint replacement were recruited and divided into delirium and non-delirium groups. Plasma and cerebrospinal fluid (CSF) samples were collected for the analysis of biomarkers, including insulin, uncarboxylated osteocalcin (ucOC), total osteocalcin (tOC), and glucose. Insulin resistance was assessed through the homeostatic model assessment of insulin resistance (HOMA-IR). MAIN RESULTS Out of the total, 28 patients (23.3%) experienced POD within 5 days after surgery. Patients with delirium exhibited higher levels of preoperative HOMA-IR and ucOC in CSF and plasma, and of tOC in CSF (P = 0.028, P < 0.001, P = 0.005, P = 0.019). After adjusting for variables, including age, Mini-Mental State Examination score, surgical site and preoperative fracture, only preoperative ucOC in CSF and HOMA-IR were significantly linked to the incidence of delirium (OR = 5.940, P = 0.008; OR = 1.208, P = 0.046, respectively), both of which also correlated with the severity of delirium (P = 0.007, P < 0.001). Receiver operating curve analysis indicated that preoperative HOMA-IR and ucOC in CSF might partly predict POD (area under the curve [AUC] = 0.697, 95% confidence interval [CI] = 0.501-0.775, AUC = 0.745, 95% CI = 0.659-0.860). CONCLUSIONS We observed that preoperative elevated HOMA-IR and ucOC in CSF were associated with the incidence and severity of POD. While these preliminary results need confirmation, they suggest a potential involvement of insulin resistance and osteocalcin in the pathological mechanism of POD. Geriatr Gerontol Int 2024; 24: 421-429.
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Affiliation(s)
- Yang Mi
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Ouyang Wen
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Zhou Lei
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Long Ge
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Liu Xing
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - He Xi
- Department of Anesthesiology, The Third Xiangya Hospital of Central South University, Changsha, China
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Bajpai AK, Gu Q, Jiao Y, Starlard-Davenport A, Gu W, Quarles LD, Xiao Z, Lu L. Systems genetics and bioinformatics analyses using ESR1-correlated genes identify potential candidates underlying female bone development. Genomics 2024; 116:110769. [PMID: 38141931 PMCID: PMC10811775 DOI: 10.1016/j.ygeno.2023.110769] [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: 07/22/2023] [Revised: 11/14/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
Estrogen receptor α (ESR1) is involved in E2 signaling and plays a major role in postmenopausal bone loss. However, the molecular network underlying ESR1 has not been explored. We used systems genetics and bioinformatics to identify important genes associated with Esr1 in postmenopausal bone loss. We identified ~2300 Esr1-coexpressed genes in female BXD bone femur, functional analysis of which revealed 'osteoblast signaling' as the most enriched pathway. PPI network led to the identification of 25 'female bone candidates'. The gene-regulatory analysis revealed RUNX2 as a key TF. ANKRD1 and RUNX2 were significantly different between osteoporosis patients and healthy controls. Sp7, Col1a1 and Pth1r correlated with multiple femur bone phenotypes in BXD mice. miR-3121-3p targeted Csf1, Ankrd1, Sp7 and Runx2. β-estradiol treatment markedly increased the expression of these candidates in mouse osteoblast. Our study revealed that Esr1-correlated genes Ankrd1, Runx2, Csf1 and Sp7 may play important roles in female bone development.
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Affiliation(s)
- Akhilesh K Bajpai
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Qingqing Gu
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA; Department of Cardiology, Affiliated Hospital of Nantong University, Jiangsu 226001, China
| | - Yan Jiao
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Athena Starlard-Davenport
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Weikuan Gu
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Leigh Darryl Quarles
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Zhousheng Xiao
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Lu Lu
- Department of Genetics, Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA.
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Hou B, Qiu J. Correlation analysis of bone metabolism indices and glycosylated hemoglobin in middle-aged and older adult patients with type 2 diabetes mellitus. Medicine (Baltimore) 2023; 102:e35115. [PMID: 37713851 PMCID: PMC10508373 DOI: 10.1097/md.0000000000035115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/16/2023] [Indexed: 09/17/2023] Open
Abstract
This study aimed to evaluate the association between bone metabolism indices and glycated hemoglobin (HbA1c) levels in middle-aged and older adult patients with type 2 diabetes mellitus (T2DM). We retrospectively analyzed 372 T2DM patients aged > 45 years who had attended the Endocrinology Department at our hospital (males, n = 192; postmenopausal females, n = 180). We collected data concerning patient characteristics, HbA1c levels, and bone metabolism indices (25-hydroxyvitamin D [25(OH)D], β-isomerized C-terminal telopeptides, N-terminal osteocalcin [N-MID], procollagen type 1 N-terminal propeptide [P1NP], bone-specific alkaline phosphatase [BAP], calcium [Ca], and phosphorus [P]). Study patients were divided into 3 groups according to their HbA1c levels: Group A, HbA1c < 7.5%; Group B, HbA1c 7.5 to 8.9%; and Group C, HbA1c ≥ 9.0%. Pearson correlation was used to determine the correlation between HbA1c levels and the bone metabolism indices. Multiple linear regression analysis was performed to identify factors influencing HbA1c in T2DM patients. Among the 3 groups, no differences were observed in 25(OH)D, β-CTx, Ca, or P indices among the 3 groups, whereas a statistically significant difference in N-MID was observed. Pearson correlation analysis showed an inverse correlation between HbA1c levels and N-MID and no correlation with other bone metabolism indices. Multiple linear regression analysis showed that N-MID was a factor influencing HbA1c levels after adjusting for age and body mass index (BMI). Serum N-MID levels negatively correlated with HbA1c levels in middle-aged and older adult men with T2DM. Therefore, high serum N-MID levels may contribute to blood glucose control in T2DM patients.
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Affiliation(s)
- Bo Hou
- Department of Endocrinology, Hubei Jianghan Oilfield General Hospital, Qianjiang, Hubei, China
| | - Jiang Qiu
- Department of Endocrinology, Hubei Jianghan Oilfield General Hospital, Qianjiang, Hubei, China
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Xiong L, Chen QQ, Cheng Y, Lan YS, Yang JB, Wen XQ, Xie X, Kang T, Wu WH, Ou S. The relationship between coronary artery calcification and bone metabolic markers in maintenance hemodialysis patients. BMC Nephrol 2023; 24:238. [PMID: 37582785 PMCID: PMC10428586 DOI: 10.1186/s12882-023-03286-z] [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: 05/02/2023] [Accepted: 07/31/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND To study the influencing factors for coronary artery calcification (CAC) in maintenance hemodialysis (MHD) patients and the relationship between CAC and bone metabolism markers and to attempt to find a reliable marker linking vascular calcification and bone metabolism in MHD patients. METHODS A total of 123 patients were enrolled. CAC was assessed by multislice spiral computed tomography (MSCT), and the CAC score (CACS) was evaluated using the Agaston method. Routine laboratory parameters, including triglycerides (TG), total cholesterol (TC), glucose (Glu), calcium (Ca), phosphorus (P), magnesium (Mg), etc., were measured. Serum markers of bone metabolism, such as alkaline phosphatase(ALP), calcitonin (CT), 25-hydroxy vitamin D [25-(OH)D], intact parathyroid hormone (iPTH), total type I procollagen amino-terminal peptide (tPINP), N-terminal mid-fragment of osteocalcin (N-MID OC), and β-type I collagen crosslinked carboxyl-terminal peptide (β-CTX), were also measured. RESULTS Among 123 MHD patients, 37 patients (30.08%) did not have CAC, and 86 patients (69.92%) had CAC, including 41 patients (47.67%) with mild calcification and 45 patients (52.33%) with moderate to severe calcification. Age, Body Mass Index(BMI), the prevalence of hypertension and diabetes mellitus, TC, Glu, P, and Ca×P in the calcification group were higher than those in the noncalcification group, whereas Mg, iPTH, tPINP, N-MID OC, and β-CTX were lower than those in the noncalcified group (P < 0.05). Compared with the mild calcification group (0 0.05). A logistic regression model was used to evaluate the influencing factors for CAC. The results showed that age, BMI, TC, Glu, P, and Ca×P were risk factors for CAC and its severity in MHD patients, whereas diabetes mellitus, Mg, and N-MID OC were protective factors for CAC in MHD patients. In addition, N-MID OC was a protective factor for the severity of CAC. After adjusting for the corresponding confounding factors, the results of the risk factors were consistent, and N-MID OC was still an independent protective factor for CAC and its severity. CONCLUSIONS Elevated serum P and Ca×P were independent risk factors for CAC in MHD patients, and serum Mg may be an independent protective factor for CAC. CAC was closely related to abnormal bone metabolism and bone metabolic markers in MHD patients. Relatively low bone turnover can promote the occurrence and development of CAC. N-MID OC may be a reliable bone metabolic marker linking vascular calcification and bone metabolism in MHD patients.
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Affiliation(s)
- Lin Xiong
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Qi-Qi Chen
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Yong Cheng
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China;, China
| | - Yong-Shu Lan
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China;, China
| | - Jian-Bo Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China;, China
- Academician (Expert) Workstation of Sichuan Province, Luzhou, Sichuan, China
| | - Xiang-Qiong Wen
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Xin Xie
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Ting Kang
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Wei-Hua Wu
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China
| | - Santao Ou
- Department of Nephrology, The Affiliated Hospital of Southwest Medical University, 25th Taiping Street, Luzhou, 646000, Sichuan, China.
- Sichuan Clinical Research Center for Nephropathy, Luzhou, Sichuan, China.
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Yang Z, Xuan S, Li W, Hu W, Tu P, Duan P. Clinical application of the fracture risk assessment tool in the general population and its correlation with bone turnover markers. Front Pharmacol 2023; 13:1013483. [PMID: 36703751 PMCID: PMC9871251 DOI: 10.3389/fphar.2022.1013483] [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: 08/07/2022] [Accepted: 12/28/2022] [Indexed: 01/12/2023] Open
Abstract
Objective: To compare the risk of osteoporotic fractures between the urban and urban-rural fringe populations in southern China and to explore the effect of bone turnover markers on fracture risk. Methods: Epidemiological investigations were conducted in the urban and urban-rural fringe areas of southern China in June 2018. Residents aged 40 years and over who signed informed consent forms were included. Physical examination and questionnaire collection were completed. Bone turnover markers (BTMs) including osteocalcin (OC) and beta cross-linked C-telopeptide of type 1 collagen (β-CTX) were tested. Bone mineral density (BMD) of the femoral neck and lumbar vertebrae 1-4 were measured using dual energy X-ray absorptiometry. Fracture risk assessment tool (FRAX) values were calculated to show the probability of major osteoporotic fracture (PMOF) and probability of hip fracture (PHF) over the next 10 years. Results: A total of 1,051 participants were included in this study, including 553 in the urban areas and 498 in the urban-rural fringe areas. The average PMOF and PHF were 3.4 (2.3-5.4) % and .6 (.3-1.5) %, respectively. Compared with that in the urban populations, the femoral neck BMD in the urban-rural fringe populations was lower and FRAX values were generally higher, especially for women. FRAX values in various populations were mainly negatively correlated with lumbar and femoral neck BMD and were positively correlated with β-CTX; meanwhile, only PHF was negatively correlated with OC. After adjusting for sex, elevated β-CTX levels significantly increased the risk of high PMOF in various populations and increased the risk of high PHF in the urban-rural fringe populations. In particular, the risks of increased PMOF and PHF could increase by as much as 33 times and 19.5 times, respectively, in the urban-rural fringe areas. Conclusion: The urban-rural fringe populations in Southern China may be at risk of osteoporotic fracture. In addition to being related to BMD, the FRAX value also correlates with some BTMs. Combining FRAX with BMD, and BTMs may better predict the fracture risk.
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Affiliation(s)
- Zhi Yang
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Shu Xuan
- School of Physical Education, Liaoning Normal University, Dalian, China
| | - Weihong Li
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Wan Hu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Ping Tu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China
| | - Peng Duan
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, China,*Correspondence: Peng Duan,
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Jeziorny K, Zmyslowska-Polakowska E, Wyka K, Pyziak-Skupień A, Borowiec M, Szadkowska A, Zmysłowska A. Identification of bone metabolism disorders in patients with Alström and Bardet-Biedl syndromes based on markers of bone turnover and mandibular atrophy. Bone Rep 2022; 17:101600. [PMID: 35818441 PMCID: PMC9270207 DOI: 10.1016/j.bonr.2022.101600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives Causative variants in genes responsible for Alström syndrome (ALMS) and Bardet-Biedl syndrome (BBS) cause damage to primary cilia associated with correct functioning of cell signaling pathways in many tissues. Despite differences in genetic background, both syndromes affect multiple organs and numerous clinical manifestations are common including obesity, retinal degeneration, insulin resistance, type 2 diabetes and many others. The aim of the study was to evaluate bone metabolism abnormalities and their relation to metabolic disorders based on bone turnover markers and presence of mandibular atrophy in patients with ALMS and BBS syndromes. Material and methods In 18 patients (11 with ALMS and 7 with BBS aged 5–29) and in 42 age-matched (p < 0.05) healthy subjects, the following markers of bone turnover were assessed: serum osteocalcin (OC), osteoprotegerin (OPG), s-RANKL and urinary deoxypyridinoline - DPD. In addition, a severity of alveolar atrophy using dental panoramic radiograms was evaluated. Results Lower serum OC (p = 0.0004) and urinary DPD levels (p = 0.0056) were observed in the study group compared to controls. In ALMS and BBS patients, serum OC and urinary DPD values negatively correlated with the HOMA-IR index, while a positive correlation between the OC and 25-OHD levels and a negative correlation between s-RANKL and fasting glucose concentrations were found. A significant difference in the incidence of low-grade mandibular atrophy between patients with ALMS and BBS and controls (p < 0.0001) was observed. Conclusions The identification of bone metabolism disorders in patients with ALMS and BBS syndromes indicates the necessity to provide them with appropriate diagnosis and treatment of these abnormalities. Bone metabolism disorders in Alstrom and Bardet-Biedl syndromes Markers of bone turnover in Alstrom and Bardet-Biedl syndromes Mandibular atrophy in Alstrom and Bardet-Biedl syndromes
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Current use of bone turnover markers in the management of osteoporosis. Clin Biochem 2022; 109-110:1-10. [PMID: 36096182 DOI: 10.1016/j.clinbiochem.2022.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/21/2022]
Abstract
The adult bone is continuously being remodelled to repair microdamage, preserve bone strength and mechanical competence as well as maintain calcium homeostasis. Bone turnover markers are products of osteoblasts (bone formation markers) and osteoclasts (bone resorption markers) providing a dynamic assessment of remodelling (turnover). Resorption-specific bone turnover markers are typically degradation products of bone collagen molecules (N- [NTX] and C-telopeptide cross-linked type 1 collagen [CTX]), which are released into the circulation and excreted in urine; or enzymatic activities reflecting osteoclastic resorption, tartrate-resistant acid phosphatase [TRACP]. Formation-specific bone turnover markers embrace different osteoblastic activities: type 1 collagen synthesis (Procollagen type I N- propeptide [PINP]), osteoblast enzymes (bone-specific alkaline phosphatase [BALP]), or bone matrix proteins [osteocalcin]. Among individuals not receiving osteoporosis treatment, resorption and formation markers are tightly linked and highly correlated (r= 0.6-0.8). Significant biological variability was reported in the past, but these issues have been greatly improved with automated assays and attention to pre-analytical and analytical factors that are known to influence bone turnover marker levels. Bone turnover markers are not useful in the diagnosis of osteoporosis, the individual prediction of bone loss, fracture, or rare complications, or in the selection of pharmacological treatment. Despite remaining issues with reference intervals and assays harmonization, bone turnover markers have proven to be useful in elucidating the pharmacodynamics and effectiveness of osteoporosis medications in clinical trials. As an alternative to BMD testing, BTMs may be useful to monitor osteoporosis therapies.
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Shen Y, Chen L, Zhou J, Wang C, Gao F, Zhu W, Hu G, Ma X, Xia H, Bao Y. Low total osteocalcin levels are associated with all-cause and cardiovascular mortality among patients with type 2 diabetes: a real-world study. Cardiovasc Diabetol 2022; 21:98. [PMID: 35681236 PMCID: PMC9185881 DOI: 10.1186/s12933-022-01539-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 05/25/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between osteocalcin and mortality has been scantly studied. We aimed to investigate the association between osteocalcin along with its trajectories and mortality based on long-term longitudinal data. METHODS We performed a retrospective cohort study of 9413 type 2 diabetic patients with at least three measurements of total serum osteocalcin within 3 years since their first inpatient diagnosis of type 2 diabetes. Baseline, mean values of osteocalcin levels and their trajectories were used as exposures. A multivariable-adjusted Cox proportional hazards model was used to estimate the association of osteocalcin levels and their trajectories with mortality. RESULTS During a mean follow-up of 5.37 years, 1638 patients died, of whom 588 were due to cardiovascular events. Multivariable-adjusted hazard ratios (HRs) across quintiles of baseline osteocalcin levels were 2.88 (95% confidence interval (CI) 2.42-3.42), 1.65 (95% CI 1.37-1.99), 1.17 (95% CI 0.96-1.42), 1.00, and 1.92 (95% CI 1.60-2.30) for all-cause mortality, and 3.52 (95% CI 2.63-4.71), 2.00 (95% CI 1.46-2.73), 1.03 (95% CI 0.72-1.47), 1.00, 1.67 (95% CI 1.21-2.31) for CVD mortality, respectively. When we used the mean values of osteocalcin as the exposure, U-shaped associations were also found. These U-shaped associations were consistent among patients of different baseline characteristics. Patients with a stable or even increasing trajectory of osteocalcin may have a lower risk of both all-cause and CVD mortality. CONCLUSIONS A U-shape association between baseline osteocalcin and mortality was observed among patients with type 2 diabetes. Patients with lower levels of serum osteocalcin during follow-ups had higher risks for all-cause and cardiovascular mortality.
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Affiliation(s)
- Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.,Chronic Disease Epidemiology, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - Lei Chen
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai, 200336, China
| | - Jian Zhou
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Chunfang Wang
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai, 200336, China
| | - Fei Gao
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Wei Zhu
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Gang Hu
- Chronic Disease Epidemiology, Pennington Biomedical Research Center, Baton Rouge, LA, 70808, USA
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Han Xia
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhongshan Road, Shanghai, 200336, China.
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
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Shahrour HE, Al Fahom S, Al-Massarani G, AlSaadi AR, Magni P. Osteocalcin-expressing endothelial progenitor cells and serum osteocalcin forms are independent biomarkers of coronary atherosclerotic disease severity in male and female patients. J Endocrinol Invest 2022; 45:1173-1180. [PMID: 35089541 PMCID: PMC9098612 DOI: 10.1007/s40618-022-01744-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/14/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Osteocalcin (OC), an osteoblast-derived regulator of metabolic processes, and circulating early endothelial progenitor cells (EPC, CD34 - /CD133 + /KDR +) expressing OC (OC +) are potential candidates linking bone metabolism and the vasculature and might be involved in vascular atherosclerotic calcification. This study aimed at assessing the association of circulating levels of different OC forms and of EPCs count with disease severity in patients with documented coronary atherosclerosis (CAD). METHODS Patients (n = 59) undergoing coronary angiography were divided, according to stenosis severity, into (1) early coronary atherosclerosis (ECA) (n = 22), and (2) late coronary atherosclerosis (LCA) (n = 37). Total OC (TOC), carboxylated OC (cOC), undercarboxylated OC (unOC) were quantified by ELISA. EPC OC + count was assessed by flow cytometry. RESULTS EPC OC + counts showed significant differences between ECA and LCA groups. unOC and unOC/TOC ratio were inversely correlated with EPC OC + count. A significant decrease in TOC and unOC plasma levels was associated with higher cardiovascular risk factors (CVRFs) number. EPC OC + count was correlated with LDL-C, total cholesterol, and triglycerides, with a greater significance in the LCA group. No association between the different forms of circulating OC (TOC, ucOC, cOC) and severity of CAD was found. CONCLUSION This study showed a significant association between EPCs (CD34 - /CD133 + /KDR + /OC +), CAD severity and CVRFs, suggesting an active role for EPC OC + in the development of CAD. An inverse correlation between TOC, ucOC, and number of CVRFs was observed, suggesting that OC, regardless of its carboxylation status, may be developed as a further cardiovascular risk biomarker.
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Affiliation(s)
- H E Shahrour
- Department of Biochemistry and Microbiology, Faculty of Pharmacy, Damascus University, Damascus, Syria
| | - S Al Fahom
- Department of Biochemistry and Microbiology, Faculty of Pharmacy, Damascus University, Damascus, Syria
| | - G Al-Massarani
- Department Radiation Medicine, Pharmacological Studies Division, Atomic Energy Commission of Syria (AECS), Damascus, Syria
| | - A R AlSaadi
- Department of Internal Medicine, Cardiovascular Disease Section, Faculty of Medicine, Damascus University, Damascus, Syria
| | - P Magni
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università Degli Studi di Milano, Milan, Italy.
- IRCCS MultiMedica, Sesto S. Giovanni, Milan, Italy.
- DISFeB-UNIMI, via Balzaretti 9, 20133, Milan, Italy.
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Osteocalcin Alleviates Lipopolysaccharide-Induced Acute Inflammation via Activation of GPR37 in Macrophages. Biomedicines 2022; 10:biomedicines10051006. [PMID: 35625743 PMCID: PMC9138386 DOI: 10.3390/biomedicines10051006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/24/2022] [Accepted: 04/24/2022] [Indexed: 11/16/2022] Open
Abstract
The G protein-coupled receptor 37 (GPR37) has been reported to be expressed in macrophages and the activation of GPR37 by its ligand/agonist, and it can regulate macrophage-associated functions and inflammatory responses. Since our previous work identified that osteocalcin (OCN) acts as an endogenous ligand for GPR37 and can elicit various intracellular signals by interacting with GPR37, we thus hypothesized that OCN may also play a functional role in macrophage through the activation of GPR37. To verify the hypothesis, we conducted a series of in vivo and in vitro studies in lipopolysaccharide (LPS)-challenged mice and primary cultured macrophages. Our results reveal that the OCN gene deletion (OCN−/−) and wild type (WT) mice showed comparable death rates and inflammatory cytokines productions in response to a lethal dose of LPS exposure. However, the detrimental effects caused by LPS were significantly ameliorated by exogenous OCN treatments in both WT and OCN−/− mice. Notably, the protective effects of OCN were absent in GPR37−/− mice. In coordination with the in vivo results, our in vitro studies further illustrated that OCN triggered intracellular responses via GPR37 in peritoneal macrophages by regulating the release of inflammatory factors and macrophage phagocytic function. Finally, we exhibited that the adoptive transfer of OCN-treated macrophages from WT mice significantly inhibits the release of pro-inflammatory cytokines in GPR37−/− mice exposed to LPS. Taken together, these findings suggest a protective role of OCN against LPS-caused acute inflammation, by the activation of GPR37 in macrophages, and provide a potential application of the activation of the OCN/GPR37 regulatory axis as a therapeutic strategy for inflammatory diseases.
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Ye X, Yu R, Jiang F, Hou X, Wei L, Bao Y, Jia W. Osteocalcin and Risks of Incident Diabetes and Diabetic Kidney Disease: A 4.6-Year Prospective Cohort Study. Diabetes Care 2022; 45:830-836. [PMID: 35090006 PMCID: PMC9016737 DOI: 10.2337/dc21-2113] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/06/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We aimed to examine the relationship between osteocalcin (OC) and the risk of incident diabetes and the risk of incident diabetic kidney disease (DKD). RESEARCH DESIGN AND METHODS We followed 5,396 participants without diabetes (nondiabetes subcohort) and 1,174 participants with diabetes and normal kidney function (diabetes subcohort) at baseline. Logistic regression and modified Poisson regression models were used to estimate the relative risk (RR) of baseline OC levels with incident diabetes and DKD. RESULTS During a mean 4.6-year follow-up period, 296 cases of incident diabetes and 184 cases of incident DKD were identified. In the nondiabetes subcohort, higher OC levels were linearly associated with a decreased risk of diabetes (RR for 1-unit increase of loge-transformed OC 0.51 [95% CI 0.35-0.76]; RR for highest vs. lowest quartile 0.65 [95% CI 0.44-0.95]; P for trend < 0.05). In the diabetes subcohort, OC levels were linearly inversely associated with incident DKD (RR for 1-unit increase of loge-transformed OC 0.49 [95% CI 0.33-0.74]; RR for highest vs. lowest quartile 0.56 [95% CI 0.38-0.83]; P for trend < 0.05), even independent of baseline estimated glomerular filtration rate and urinary albumin-to-creatinine ratio. No significant interactions between OC and various subgroups on incident diabetes or DKD were observed. CONCLUSIONS Lower OC levels were associated with an increased risk of incident diabetes and DKD.
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Affiliation(s)
| | | | | | - Xuhong Hou
- Corresponding authors: Xuhong Hou, , and Weiping Jia,
| | | | | | - Weiping Jia
- Corresponding authors: Xuhong Hou, , and Weiping Jia,
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Zhang L, Yuan Y, Wu W, Sun Z, Lei L, Fan J, Gao B, Zou J. Medium-Intensity Treadmill Exercise Exerts Beneficial Effects on Bone Modeling Through Bone Marrow Mesenchymal Stromal Cells. Front Cell Dev Biol 2020; 8:600639. [PMID: 33330492 PMCID: PMC7732523 DOI: 10.3389/fcell.2020.600639] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 10/28/2020] [Indexed: 01/04/2023] Open
Abstract
As a type of multipotential cells, bone marrow mesenchymal stromal cells (BMMSCs) can differentiate into chondrocytes, osteoblasts, and adipocytes under different loading condition or specific microenvironment. Previous studies have shown that BMMSCs and their lineage-differentiated progeny (for example, osteoblasts), and osteocytes are mechanosensitive in bone. The appropriate physical activity and exercise could help attenuate bone loss, effectively stimulate bone formation, increase bone mineral density (BMD), prevent the progression of osteoporosis, and reduce the risk of bone fractures. Bone morphogenetic protein (BMP) is originally discovered as a protein with heterotopic bone-inducing activity in the bone matrix that exerts a critical role in multiple stages of bone metabolism. In the present study, the medium-intensity treadmill exercise enhanced bone formation and increased osteocalcin (OCN) and osteopontin (OPN) mRNA expression as well as activation of the BMP-Smad signaling pathway in vivo. In order to investigate the effect of a BMP-Smad signaling pathway, we injected mice with activated enzyme inhibitors (LDN-193189HCL) and subjected the mice to treadmill exercise intervention. LDN-193189HCL attenuated the BMD and bone mass mediated by medium-intensity exercise and BMP-Smad signaling pathway.
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Affiliation(s)
- Lingli Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yu Yuan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Wei Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Zhongguang Sun
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Le Lei
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jing Fan
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Bo Gao
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jun Zou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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Tacey A, Sim M, Smith C, Woessner MN, Byrnes E, Lewis JR, Brennan-Speranza T, Hodgson JM, Blekkenhorst LC, Levinger I. Association between Circulating Osteocalcin and Cardiometabolic Risk Factors following a 4-Week Leafy Green Vitamin K-Rich Diet. ANNALS OF NUTRITION AND METABOLISM 2020; 76:361-367. [DOI: 10.1159/000511660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/17/2020] [Indexed: 11/19/2022]
Abstract
<b><i>Background:</i></b> Evidence suggests that lower serum undercarboxylated osteocalcin (ucOC) may be negatively associated with cardiometabolic health. We investigated whether individuals with a suppression of ucOC following an increase in dietary vitamin K1 exhibit a relative worsening of cardiometabolic risk factors. <b><i>Materials and Methods:</i></b> Men (<i>n</i> = 20) and women (<i>n</i> = 10) aged 62 ± 10 years participated in a randomized, controlled, crossover study. The primary analysis involved using data obtained from participants following a high vitamin K1 diet (HK; 4-week intervention of increased leafy green vegetable intake). High and low responders were defined based on the median percent reduction (30%) in ucOC following the HK diet. Blood pressure (resting and 24 h), arterial stiffness, plasma glucose, lipid concentrations, and serum OC forms were assessed. <b><i>Results:</i></b> Following the HK diet, ucOC and ucOC/tOC were suppressed more (<i>p</i> < 0.01) in high responders (41 and 29%) versus low responders (12 and 10%). The reduction in ucOC and ucOC/tOC was not associated with changes in blood pressure, arterial stiffness, plasma glucose, or lipid concentrations in the high responders (<i>p</i> > 0.05). <b><i>Discussion/Conclusion:</i></b> Suppression of ucOC via consumption of leafy green vegetables has no negative effects on cardiometabolic health, perhaps, in part, because of cross-talk mechanisms.
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Lin L, Chiu LT, Lee MC, Hsu BG. Serum Osteocalcin Level is Negatively Associated with Vascular Reactivity Index by Digital Thermal Monitoring in Kidney Transplant Recipients. ACTA ACUST UNITED AC 2020; 56:medicina56080400. [PMID: 32784817 PMCID: PMC7466333 DOI: 10.3390/medicina56080400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Osteocalcin is the most abundant noncollagenous protein in bone matrix, which is considered a marker of bone formation. Previous studies indicate that circulating osteocalcin can be expressed by osteoblasts and even by osteoblast-like cells in vessel walls, and it is often associated with arterial stiffness. Our study aims to examine the potential association between osteocalcin levels and endothelial function among kidney transplant (KT) recipients. MATERIALS AND METHODS Fasting blood samples were obtained from 68 KT recipients. To measure the endothelial function and vascular reactivity index (VRI), a digital thermal monitoring test (VENDYS) was used. A commercial enzyme-linked immunosorbent assay kit was also utilized to measure serum total osteocalcin levels. In this study, a VRI of less than 1.0 indicated poor vascular reactivity; a VRI of 1.0-2.0 indicated intermediate vascular reactivity; and a VRI of 2.0 or higher indicated good vascular reactivity. RESULTS Our findings show that 8 KT recipients (11.8%) had poor vascular reactivity (VRI < 1.0), 26 (38.2%) had intermediate vascular reactivity (1.0 ≤ VRI < 2.0), and 34 (50%) had good vascular reactivity. Increased serum osteocalcin levels (p < 0.001) were found to be associated with poor vascular reactivity. Advanced age (r = -0.361, p = 0.002), serum alkaline phosphate level (r = -0.254, p = 0.037), and log-transformed osteocalcin levels (r = - 0.432, p < 0.001) were identified to be negatively correlated with VRI in KT recipients. Multivariable forward stepwise linear regression analysis revealed that the serum level of osteocalcin (β = -0.391, adjusted R2 change = 0.174; p < 0.001) and advanced age (β = -0.308, adjusted R2 change = 0.084; p = 0.005) were significantly and independently associated with VRI in KT recipients. CONCLUSIONS Higher serum osteocalcin level was associated with lower VRI and poorer endothelial dysfunction among KT recipients.
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Affiliation(s)
- Lin Lin
- Division of Gastroenterology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan;
| | - Liang-Te Chiu
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan;
| | - Ming-Che Lee
- Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Correspondence: (M.-C.L.); (B.-G.H.)
| | - Bang-Gee Hsu
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 97004, Taiwan
- Correspondence: (M.-C.L.); (B.-G.H.)
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Interaction among skeleton, body fat and cardiovascular diseases mediated by osteocalcin. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.obmed.2020.100184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Seidu S, Kunutsor SK, Khunti K. Association of circulating osteocalcin with cardiovascular disease and intermediate cardiovascular phenotypes: systematic review and meta-analysis. SCAND CARDIOVASC J 2019; 53:286-295. [DOI: 10.1080/14017431.2019.1655166] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Samuel Seidu
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Setor K Kunutsor
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
- Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK
| | - Kamlesh Khunti
- Leicester Diabetes Centre, Leicester General Hospital, Leicester, UK
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
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Bicuspid aortic valve, atherosclerosis and changes of lipid metabolism: Are there pathological molecular links? J Mol Cell Cardiol 2019; 129:231-235. [DOI: 10.1016/j.yjmcc.2019.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/03/2019] [Accepted: 03/07/2019] [Indexed: 12/19/2022]
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Diaz-Franco MC, Franco-Diaz de Leon R, Villafan-Bernal JR. Osteocalcin‑GPRC6A: An update of its clinical and biological multi‑organic interactions (Review). Mol Med Rep 2018; 19:15-22. [PMID: 30431093 PMCID: PMC6297736 DOI: 10.3892/mmr.2018.9627] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 09/26/2018] [Indexed: 12/14/2022] Open
Abstract
Osteocalcin is no longer regarded as a molecule exclusive to bone remodeling and osteogenesis, but as a hormone with manifold functions. The discovery of the interaction of osteocalcin with the G protein‑coupled receptor family C group 6‑member A (GPRC6A) receptor has accompanied the characterization of several roles that this peptide serves in body regulation and homeostasis. These roles include the modulation of memory in the brain, fertility in the testis, fat accumulation in the liver, incretins release in the intestine and adaptation to exercise in muscle, in addition to the well‑known effects on β‑cell proliferation, insulin release and adiponectin secretion. The aim of the present review was to provide a practical update of the multi‑organ effects that osteocalcin exerts through its interaction with GPRC6A and the clinical implications of this.
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Šeda O, Šedová L, Včelák J, Vaňková M, Liška F, Bendlová B. ZBTB16 and metabolic syndrome: a network perspective. Physiol Res 2018; 66:S357-S365. [PMID: 28948820 DOI: 10.33549/physiolres.933730] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Metabolic syndrome is a prevalent, complex condition. The search for genetic determinants of the syndrome is currently undergoing a paradigm enhancement by adding systems genetics approaches to association studies. We summarize the current evidence on relations between an emergent new candidate, zinc finger and BTB domain containing 16 (ZBTB16) transcription factor and the major components constituting the metabolic syndrome. Information stemming from studies on experimental models with altered Zbtb16 expression clearly shows its effect on adipogenesis, cardiac hypertrophy and fibrosis, lipid levels and insulin sensitivity. Based on current evidence, we provide a network view of relations between ZBTB16 and hallmarks of metabolic syndrome in order to elucidate the potential functional links involving the ZBTB16 node. Many of the identified genes interconnecting ZBTB16 with all or most metabolic syndrome components are linked to immune function, inflammation or oxidative stress. In summary, ZBTB16 represents a promising pleiotropic candidate node for metabolic syndrome.
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Affiliation(s)
- O Šeda
- Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University, Prague, Czech Republic, Institute of Endocrinology, Prague, Czech Republic.
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Csiky B, Sági B, Peti A, Lakatos O, Prémusz V, Sulyok E. The Impact of Osteocalcin, Osteoprotegerin and Osteopontin on Arterial Stiffness in Chronic Renal Failure Patients on Hemodialysis. Kidney Blood Press Res 2017; 42:1312-1321. [PMID: 29258085 DOI: 10.1159/000486114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/07/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This cross-sectional study was designed to assess the relationship between vascular stiffness (VS) and bone-related proteins involved in the development of arteriosclerosis in patients on regular hemodialysis (HD). METHODS 68 consecutive patients in stable clinical condition who received regular HD in the FMC Dialysis Center, Pécs were included. VS parameters (carotid-femoral pulse wave velocity - PWV, aortic augmentation index - AIx) were determined by applanation tonometry (SphygmoCor, AtCor Medical, Sidney) and the routine latoratory test were completed with measurements of osteocalcin (OC), osteopontin (OP) and osteoprotegerin (OPG) by using commercially available ELISA kits. 35 heathcare workers served as controls. RESULTS In patients on regular HD PWV markedly increased and there was several-fold elevation in the interrelated bone-specific proteins (OC, OP, OPG). PWV was found to be independently associated only with OC (β:-0.25, p<0.029) and age (r=0.411,p<0.000), but risk factors for arterial calcification had significant impact on OC (systolic blood pressure, hsCRP, BMI), OPG (age, BMI) and OP (LDL-cholesterol). CONCLUSION Except for OC, our results failed to document direct association of vascular lesion with OP and OPG, therefore their high circulating levels may be an epiphenomenon or they may have counter-regulatory role to attenuate the uremic calcification process.
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Affiliation(s)
- Botond Csiky
- FMC Dialysis Center Pécs, Pécs, Hungary.,Nephrological Center and 2nd Department of Medicine, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - Balázs Sági
- FMC Dialysis Center Pécs, Pécs, Hungary.,Nephrological Center and 2nd Department of Medicine, Faculty of Medicine, University of Pécs, Pécs, Hungary
| | - Attila Peti
- Department of Laboratory Medicine, Siófok Hospital, Pécs, Hungary
| | - Orsolya Lakatos
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Viktória Prémusz
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Endre Sulyok
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
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Vassalle C, Sabatino L, Cecco PD, Maltinti M, Ndreu R, Maffei S, Pingitore A. Relationship between Bone Health Biomarkers and Cardiovascular Risk in a General Adult Population. Diseases 2017; 5:diseases5040024. [PMID: 29064392 PMCID: PMC5750535 DOI: 10.3390/diseases5040024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 10/21/2017] [Indexed: 12/26/2022] Open
Abstract
Purpose/Introduction: Osteoporosis (OP) and cardiovascular (CV) disease emerge as closely related conditions, showing common risk factors and/or pathophysiological mechanisms. The aim of this study was to evaluate the association between bone health markers (BHM) and individual CV risk factors and overall CV risk (FRAMINGHAM-FRS, and PROCAM scores) in a general adult population. METHODS In 103 subjects (21 males; age: 56 ± 12 years), vitamin D (25(OH)D), osteocalcin (OC), bone alkaline phospatase (BALP), procollagen I aminoterminal propeptide (P1NP), CTx-telopeptide, as well clinical history and life style were evaluated. RESULTS Aging (p < 0.001) and glycemia (p < 0.05) emerged as independent 25(OH)D predictors. Aging (p < 0.001), male sex (p < 0.05), and obesity (p < 0.05) represented independent OC determinants. Aging (p < 0.05) was the only independent BALP determinant. After multivariate adjustment, low 25(OH)D (<20 ng/mL) (Odds ratio OR (95% confidence intervals CI)) (5 (1.4-18) p < 0.05) and elevated OC (>75th percentile-16.6 ng/mL) (6.7 (1.9-23.8) p < 0.01) were found to be significant FRS predictors, while subjects with elevated OC and/or BALP (>75th percentile-9.8 μg/L) showed a higher CV risk as estimated by PROCAM (3.6 (1.2-10.7) p < 0.05). CTx and P1NP did not significantly correlate with CV risk factors or scores. CONCLUSION As we go further into bone and CV physiology, it is evident that a close relationship exists between these diseases. Further studies are needed to investigate mechanisms by which bone turnover markers are related to metabolic risk and could modulate CV risk. This knowledge may help to develop possible multiple-purpose strategies for both CV disease and OP prevention and treatment.
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Affiliation(s)
- Cristina Vassalle
- Fondazione CNR-Regione Toscana G Monasterio and Istituto di Fisiologia Clinica, CNR via Moruzzi 1, I-56124 Pisa, Italy.
| | - Laura Sabatino
- Fondazione CNR-Regione Toscana G Monasterio and Istituto di Fisiologia Clinica, CNR via Moruzzi 1, I-56124 Pisa, Italy.
| | - Pietro Di Cecco
- Fondazione CNR-Regione Toscana G Monasterio and Istituto di Fisiologia Clinica, CNR via Moruzzi 1, I-56124 Pisa, Italy.
| | - Maristella Maltinti
- Fondazione CNR-Regione Toscana G Monasterio and Istituto di Fisiologia Clinica, CNR via Moruzzi 1, I-56124 Pisa, Italy.
| | - Rudina Ndreu
- Fondazione CNR-Regione Toscana G Monasterio and Istituto di Fisiologia Clinica, CNR via Moruzzi 1, I-56124 Pisa, Italy.
| | - Silvia Maffei
- Fondazione CNR-Regione Toscana G Monasterio and Istituto di Fisiologia Clinica, CNR via Moruzzi 1, I-56124 Pisa, Italy.
| | - Alessandro Pingitore
- Fondazione CNR-Regione Toscana G Monasterio and Istituto di Fisiologia Clinica, CNR via Moruzzi 1, I-56124 Pisa, Italy.
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Xifra G, Moreno-Navarrete JM, Moreno M, Ricart W, Fernández-Real JM. Obesity status influences the relationship among serum osteocalcin, iron stores and insulin sensitivity. Clin Nutr 2017; 37:2091-2096. [PMID: 29050649 DOI: 10.1016/j.clnu.2017.10.001] [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: 06/02/2017] [Revised: 09/15/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND & AIMS Increased iron stores significantly influence the clinical course of several chronic metabolic diseases. Recent studies have shown that iron overload decreases osteocalcin. We aimed to explore the relationship among osteocalcin, iron stores and insulin sensitivity. METHODS Extensive clinical and laboratory measurements, including serum ferritin, cross-linked C-telopeptide of type I collagen (CTX) and osteocalcin (OC) concentrations, were analyzed in 250 adult consecutive Caucasian men. Insulin sensitivity was evaluated through frequently sampled intravenous glucose tolerance tests with minimal model analysis. RESULTS Circulating serum ferritin were negatively associated with serum OC and CTX (p = 0.004 and p = 0.045 respectively). In all subjects as a whole, BMI and ferritin contributed to explain 5.2% of OC variance after controlling for age and smoking status. However, the association between OC and insulin sensitivity remained significant only in lean subjects (BMI < 25 kg/m2, r = 0.468; p = 0.006) whereas the link between serum ferritin concentration and OC and CTX were significant only in overweight/obese subjects (BMI ≥ 25 kg/m2, r = -0.229; p = 0.002 and r = -0.196; p = 0.008, respectively). CONCLUSIONS The association of circulating osteocalcin with parameters of insulin sensitivity and iron stores were dependent on obesity status. Increased iron stores could contribute to the detrimental metabolic effects of overweight and obesity on bone.
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Affiliation(s)
- Gemma Xifra
- Department of Diabetes, Endocrinology and Nutrition (UDEN), Institut d'Investigació Biomédica de Girona (IdIBGi), CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBERobn, CB06/03/0010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain
| | - José María Moreno-Navarrete
- Department of Diabetes, Endocrinology and Nutrition (UDEN), Institut d'Investigació Biomédica de Girona (IdIBGi), CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBERobn, CB06/03/0010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain
| | - María Moreno
- Department of Diabetes, Endocrinology and Nutrition (UDEN), Institut d'Investigació Biomédica de Girona (IdIBGi), CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBERobn, CB06/03/0010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain
| | - Wifredo Ricart
- Department of Diabetes, Endocrinology and Nutrition (UDEN), Institut d'Investigació Biomédica de Girona (IdIBGi), CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBERobn, CB06/03/0010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain
| | - José Manuel Fernández-Real
- Department of Diabetes, Endocrinology and Nutrition (UDEN), Institut d'Investigació Biomédica de Girona (IdIBGi), CIBER de la Fisiopatología de la Obesidad y la Nutrición (CIBERobn, CB06/03/0010) and Instituto de Salud Carlos III (ISCIII), Girona, Spain.
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Vitamin D Deficiency Is Associated with Increased Osteocalcin Levels in Acute Aortic Dissection: A Pilot Study on Elderly Patients. Mediators Inflamm 2017; 2017:6412531. [PMID: 28751822 PMCID: PMC5511647 DOI: 10.1155/2017/6412531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 06/06/2017] [Indexed: 02/08/2023] Open
Abstract
An imbalance between degradation and reconstruction of the aortic wall is one of the leading causes of acute aortic dissection (AAD). Vitamin D seems an intriguing molecule to explore in the field of AAD since it improves endothelial function and protects smooth muscle cells from inflammation-induced remodeling, calcification, and loss of function, all events which are strongly related to the aging process. We quantified 25-hydroxy vitamin D, calcium, parathormone, bone alkaline phosphatase, and osteocalcin levels in 24 elderly AAD patients to identify a potential pathological implication of these molecules in AAD. Median 25-hydroxy vitamin D (10.75 ng/mL, 25th–75th percentiles: 6.86–19.23 ng/mL) and calcium levels (8.70 mg/dL, 25th–75th percentiles: 7.30–8.80 mg/dL) suggested hypovitaminosis D and a moderate hypocalcemia. Thirty-eight percent of AAD patients had severe (<10 ng/mL), 38% moderate (10–20 ng/mL), and 24% mild 25-hydroxy vitamin D deficiency (20–30 ng/mL). A significant inverse correlation was observed between 25OHD and osteocalcin levels. All the other molecules were unchanged. A condition of hypovitaminosis D associated to an increase in osteocalcin levels is present in AAD patients. The identification of these molecules as new factors involved in AAD may be helpful to identify individuals at high risk as well to study preventing strategies.
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Huang YJ, Huang TW, Chao TY, Sun YS, Chen SJ, Chu DM, Chen WL, Wu LW. Elevated serum tartrate-resistant acid phosphatase isoform 5a levels in metabolic syndrome. Oncotarget 2017; 8:78144-78152. [PMID: 29100456 PMCID: PMC5652845 DOI: 10.18632/oncotarget.17839] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 04/12/2017] [Indexed: 12/17/2022] Open
Abstract
Background Tartrate-resistant phosphatase isoform 5a is expressed in tumor-associated macrophages and is a biomarker of chronic inflammation. Herein, we correlated serum tartrate-resistant phosphatase isoform 5a levels with metabolic syndrome status and made comparisons with traditional markers of inflammation, including c-reactive protein and interleukin-6. Methods One hundred healthy volunteers were randomly selected, and cut-off points for metabolic syndrome related inflammatory biomarkers were determined using receiver operating characteristic curves. Linear and logistic regression models were subsequently used to correlate inflammatory markers with the risk of metabolic syndrome. Results Twenty-two participants met the criteria for metabolic syndrome, and serum tartrate-resistant phosphatase isoform 5a levels of >5.8 μg/L were associated with metabolic syndrome (c-statistics, 0.730; p = 0.001; 95% confidence interval, 0.618-0.842). In addition, 1 μg/L increases in tartrate-resistant phosphatase isoform 5a levels were indicative of a 1.860 fold increase in the risk of metabolic syndrome (p = 0.012). Conclusions Elevated serum tartrate-resistant phosphatase isoform 5a levels are associated with the risk of metabolic syndrome, with a cut-off level of 5.8 μg/L.
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Affiliation(s)
- Yi-Jhih Huang
- Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C)
| | - Tsai-Wang Huang
- Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C)
| | - Tsu-Yi Chao
- Division of Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C).,Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan, Republic of China (R.O.C)
| | - Yu-Shan Sun
- Division of Family Medicine, Tri-Service General Hospital Penghu Branch, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C)
| | - Shyi-Jou Chen
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C)
| | - Der-Ming Chu
- Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C)
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China (R.O.C).,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China (R.O.C).,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C)
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China (R.O.C).,Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, Taipei, Taiwan, Republic of China (R.O.C).,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China (R.O.C)
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25
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Verheyen N, Fahrleitner-Pammer A, Belyavskiy E, Gruebler MR, Dimai HP, Amrein K, Ablasser K, Martensen J, Catena C, Pieske-Kraigher E, Colantonio C, Voelkl J, Lang F, Alesutan I, Meinitzer A, März W, Brussee H, Pieske B, Pilz S, Tomaschitz A. Relationship between bone turnover and left ventricular function in primary hyperparathyroidism: The EPATH trial. PLoS One 2017; 12:e0173799. [PMID: 28406904 PMCID: PMC5390970 DOI: 10.1371/journal.pone.0173799] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 02/26/2017] [Indexed: 02/07/2023] Open
Abstract
Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the "Eplerenone in Primary Hyperparathyroidism" (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e', diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone-specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035) and e' (β = 0.188, P = 0.042), respectively. OC (β = 0.192, P = 0.039) and BALP (β = 0.198, P = 0.030) were each independently related with e'. CTX showed no correlations with LVEF or e'. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies.
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Affiliation(s)
- Nicolas Verheyen
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Astrid Fahrleitner-Pammer
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - Evgeny Belyavskiy
- Medizinische Klinik mit Schwerpunkt Kardiologie, Campus Virchow-Klinikum, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Martin R Gruebler
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria.,Swiss Cardiovascular Center Bern, Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Hans Peter Dimai
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - Karin Amrein
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - Klemens Ablasser
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Johann Martensen
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Cristiana Catena
- Hypertension Unit, Internal Medicine, Department of Experimental and Clinical Medical Sciences, University of Udine, Udine, Italy
| | - Elisabeth Pieske-Kraigher
- Medizinische Klinik mit Schwerpunkt Kardiologie, Campus Virchow-Klinikum, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | | | - Jakob Voelkl
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - Florian Lang
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - Ioana Alesutan
- Department of Physiology, University of Tübingen, Tübingen, Germany
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Synlab Academy, Synlab Services LLC, Mannheim, Germany.,Medical Clinic V (Nephrology, Hypertensiology, Endocrinology), Medical Faculty Mannheim, Ruperto Carola University Heidelberg, Mannheim, Germany
| | - Helmut Brussee
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Burkert Pieske
- Department of Cardiology, Medical University of Graz, Graz, Austria.,Medizinische Klinik mit Schwerpunkt Kardiologie, Campus Virchow-Klinikum, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria.,Department of Health Sciences and the EMGO+ Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - Andreas Tomaschitz
- Department of Cardiology, Medical University of Graz, Graz, Austria.,Medical Clinic V (Nephrology, Hypertensiology, Endocrinology), Medical Faculty Mannheim, Ruperto Carola University Heidelberg, Mannheim, Germany.,Specialist Clinic for Rehabilitation Bad Gleichenberg, Bad Gleichenberg, Austria
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