Circulating osteopontin as a marker of early coronary vascular calcification in type two diabetes mellitus patients with known asymptomatic coronary artery disease.

OBJECTIVE: To evaluate the interrelation between circulating osteopontin (OPN) and coronary atherosclerosis and calcification in type 2 diabetes mellitus patients (T2DM). DESIGN AND METHODS: 126 subjects (46 patients with T2DM) with previously documented asymptomatic coronary artery disease (CAD) were enrolled in the study. CAD was determined by contrast multispiral CT-angiography. OPN plasma levels were measured by ELISA.
RESULTS: Analysis of the results showed that in a patient cohort the mean value of circulating OPN was 43.55 ng/mL (95% CI = 31.5-57.0 ng/mL). OPN plasma levels were correlated with Agatston score index (r = 0.418, P = 0.009), T2DM (r = 0.411, P = 0.006), gender (r = 0.395, P < 0.001 for male), TC (r = 0.405, P = 0.006), hsC-RP (r = 0.368, P = 0.008), age (r = 0.256, P = 0.001), smoking (r = 0.255, P = 0.001) and inversely to LVEF (r = -0.579, P = 0.001). Cox-regression analyzes showed that in T2DM patients upper quartile OPN compared with the lowest quartile are associated with Agatston score index (adjusted OR = 3.23, 95% CI = 1.09-5.20; P = 0.044), numerous of damaged coronary arteries (adjusted OR = 2.60, 95% CI = 1.10-9.20, P = 0.005). The findings suggest that the predictive power of the model for asymptomatic CAD patients with T2DM, the estimated AUC (area under curve) was 0.788. In this case, the concentration of OPN that had the best predict potential on the risk of coronary atherosclerosis was 48.5 ng/mL. In conclusions, we believe that elevated OPN in plasma can be considered as an independent predictor of coronary calcification in T2DM patients with known CAD.