Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.
Department of Physiology and Bosch Institute for Medical Research, University of Sydney, Sydney, Australia.
Osteoporos Int. 2017 Aug;28(8):2265-2273. doi: 10.1007/s00198-017-3994-3. Epub 2017 Mar 13.
Undercarboxylated osteocalcin (ucOC) may play a role in glucose homeostasis and cardiometabolic health. This review examines the epidemiological and interventional evidence associating osteocalcin (OC) and ucOC with metabolic risk and cardiovascular disease. The complexity in assessing such correlations, due to the observational nature of human studies, is discussed. Several studies have reported that higher levels of ucOC and OC are correlated with lower fat mass and HbA1c. In addition, improved measures of glycaemic control via pharmacological and non-pharmacological (e.g. exercise or diet) interventions are often associated with increased circulating levels of OC and/or ucOC. There is also a relationship between lower circulating OC and ucOC and increased measures of vascular calcification and cardiovascular disease. However, not all studies have reported such relationship, some with contradictory findings. Equivocal findings may arise because of the observational nature of the studies and the inability to directly assess the relationship between OC and ucOC on glycaemic control and cardiovascular health in humans. Studying OC and ucOC in humans is further complicated due to numerous confounding factors such as sex differences, menopausal status, vitamin K status, physical activity level, body mass index, insulin sensitivity (normal/insulin resistance/T2DM), tissue-specific effects and renal function among others. Current observational and indirect interventional evidence appears to support a relationship between ucOC with metabolic and cardiovascular disease. There is also emerging evidence to suggest a direct role of ucOC in human metabolism. Further mechanistic studies are required to (a) clarify causality, (b) explore mechanisms involved and
非羧化骨钙素 (ucOC) 可能在葡萄糖稳态和心脏代谢健康中发挥作用。本综述检查了将骨钙素 (OC) 和 ucOC 与代谢风险和心血管疾病相关联的流行病学和干预证据。由于人类研究的观察性质，讨论了评估这种相关性的复杂性。几项研究报告称，较高水平的 ucOC 和 OC 与较低的脂肪量和 HbA1c 相关。此外，通过药理学和非药理学（例如运动或饮食）干预措施改善血糖控制的措施通常与循环 OC 和/或 ucOC 水平升高相关。循环 OC 和 ucOC 水平较低与血管钙化和心血管疾病的增加措施之间也存在关系。然而，并非所有研究都报告了这种关系，有些研究结果相互矛盾。由于研究的观察性质以及无法直接评估 OC 和 ucOC 与人类血糖控制和心血管健康之间的关系，因此可能会出现不确定的发现。由于许多混杂因素，如性别差异、绝经状态、维生素 K 状态、身体活动水平、体重指数、胰岛素敏感性（正常/胰岛素抵抗/T2DM）、组织特异性效应和肾功能等，研究人类中的 OC 和 ucOC 进一步复杂化。目前的观察性和间接干预证据似乎支持 ucOC 与代谢和心血管疾病之间的关系。也有新的证据表明 ucOC 在人类代谢中具有直接作用。需要进一步的机制研究来 (a) 阐明因果关系，(b) 探索涉及的机制
