根据 SCORE2-Diabetes 算法，骨蛋白与心血管风险相关。

Bone proteins are associated with cardiovascular risk according to the SCORE2-Diabetes algorithm.

机构信息

Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain.

Institute of Health Carlos III, CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, 28029, Spain.

出版信息

Cardiovasc Diabetol. 2024 Aug 24;23(1):311. doi: 10.1186/s12933-024-02406-9.

DOI:10.1186/s12933-024-02406-9

PMID:39182106

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11344922/

Abstract

BACKGROUND

Typical bone proteins, such as sclerostin and periostin, have been associated with cardiovascular disease (CVD). Simultaneously, several risk scores have been developed to predict CVD in the general population. Therefore, we aimed to evaluate the association of these bone proteins related to CVD, with the main vascular risk scales: Framingham Risk Score (FRS), REGICOR and SCORE2-Diabetes, in patients with type 2 diabetes. We focus in particular on the SCORE2-Diabetes algorithm, which predicts 10-year CVD risk and is specific to the study population.

METHODS

This was a cross-sectional study including 104 patients with type 2 diabetes (62 ± 6 years, 60% males). Clinical data, biochemical measurements, and serum bioactive sclerostin and periostin levels were collected, and different risk scales were calculated. The association between bioactive sclerostin or periostin with the risk scales was analyzed.

RESULTS

A positive correlation was observed between circulating levels of bioactive sclerostin (p < 0.001) and periostin (p < 0.001) with SCORE2-Diabetes values. However, no correlation was found with FRS or REGICOR scales. Both serum bioactive sclerostin and periostin levels were significantly elevated in patients at high-very high risk of CVD (score ≥ 10%) than in the low-moderate risk group (score < 10%) (p < 0.001 for both). Moreover, analyzing these proteins to identify patients with type 2 diabetes at high-very high vascular risk using ROC curves, we observed significant AUC values for bioactive sclerostin (AUC = 0.696; p = 0.001), periostin (AUC = 0.749; p < 0.001), and the model combining both (AUC = 0.795; p < 0.001). For diagnosing high-very high vascular risk, serum bioactive sclerostin levels > 131 pmol/L showed 51.6% sensitivity and 78.6% specificity. Similarly, serum periostin levels > 1144 pmol/L had 64.5% sensitivity and 76.2% specificity.

CONCLUSIONS

Sclerostin and periostin are associated with vascular risk in the SCORE2-Diabetes algorithm, opening a new line of investigation to identify novel biomarkers of cardiovascular risk in the type 2 diabetes population.

摘要

背景

骨蛋白（如硬化蛋白和骨膜蛋白）与心血管疾病（CVD）有关。同时，已经开发了几种风险评分来预测普通人群的 CVD。因此，我们旨在评估这些与 CVD 相关的骨蛋白与主要血管风险评分（Framingham 风险评分（FRS）、REGICOR 和 SCORE2-糖尿病）之间的关联，在 2 型糖尿病患者中。我们特别关注 SCORE2-糖尿病算法，该算法预测 10 年 CVD 风险，并且是针对研究人群的。

方法

这是一项横断面研究，包括 104 例 2 型糖尿病患者（62±6 岁，60%为男性）。收集了临床数据、生化测量值以及血清生物活性硬化蛋白和骨膜蛋白水平，并计算了不同的风险评分。分析了生物活性硬化蛋白或骨膜蛋白与风险评分之间的相关性。

结果

循环生物活性硬化蛋白（p<0.001）和骨膜蛋白（p<0.001）水平与 SCORE2-糖尿病值呈正相关。然而，与 FRS 或 REGICOR 评分无相关性。在 CVD 高-极高风险（评分≥10%）的患者中，血清生物活性硬化蛋白和骨膜蛋白水平均显著升高（p<0.001 均）。与低-中危风险组（评分<10%）相比。此外，通过 ROC 曲线分析这些蛋白以识别 2 型糖尿病患者的高-极高血管风险，我们观察到生物活性硬化蛋白（AUC=0.696；p=0.001）、骨膜蛋白（AUC=0.749；p<0.001）和组合模型（AUC=0.795；p<0.001）的 AUC 值均有显著意义。对于诊断高-极高血管风险，血清生物活性硬化蛋白水平>131pmol/L 显示 51.6%的敏感性和 78.6%的特异性。同样，血清骨膜蛋白水平>1144pmol/L 具有 64.5%的敏感性和 76.2%的特异性。