Association between Serum Osteocalcin and Cardiometabolic Risk Factors in Latent Autoimmune Diabetes in Adults: Insights from Glutamic Acid Decarboxylase Subgroup Analysis.

AIMS: This study aimed to explore the association between serum osteocalcin and cardiometabolic risk factors in latent autoimmune diabetes in adults (LADA).

BACKGROUND

Patients with LADA tend to experience poorer glycaemic control, placing them at a higher risk of cardiovascular disease.

OBJECTIVE

This study aimed to explore the relationship between osteocalcin levels and cardiometabolic risk factors, such as HbA1c, lipids, insulin resistance and obesity, in patients with LADA.

METHODS

This retrospective study included 110 patients suffering from LADA with high glutamic acid decarboxylase (GAD) levels (≥180 IU/ml) and 286 with low GAD levels (<180 IU/ml) between January 2018 and December 2021. All participants were aged ≥30 years. Blood samples, collected after 8 hours of fasting, were analysed for osteocalcin and other biomarkers using chemiluminescence immunoassay. Logistic regression analysis assessed the relationship between osteocalcin and cardiometabolic risk factors.

RESULTS

The LADAhigh group had a lower body mass index (19.5 vs 23.4 kg/m2, p = 0.014) and a lower proportion of obesity (19.1% vs 25.2%, p = 0.001) compared with the LADAlow group. Participants in the LADAhigh group were slightly older (58.7 vs 58.3 years, p = 0.641). Fasting blood glucose was higher (8.9 vs 8.4 mmol/l, p = 0.068), and C-peptide was lower (1.0 vs 1.8 ng/ml, p = 0.024). Osteocalcin levels were significantly lower in the LADAhigh group (12.19 vs 13.96 ng/ml, p = 0.004). Subgroup analyses revealed significant correlations, such as those between osteocalcin and HbA1c in the LADAlow group and an inverse relationship with triglyceride in men from the LADAhigh group. Logistic regression analysis indicated that lower osteocalcin levels were significantly associated with a higher risk of poor glycaemic control and increased obesity.

CONCLUSION

Lower osteocalcin levels in patients with LADA with high GAD are associated with worse cardiometabolic parameters and increased cardiovascular risk. Osteocalcin may be a potential marker for assessing cardiometabolic risk in patients with LADA.