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Licensed Unlicensed Requires Authentication Published by De Gruyter May 19, 2018

Osteocalcin value to identify subclinical atherosclerosis over atherosclerotic cardiovascular disease (ASCVD) risk score in middle-aged and elderly Chinese asymptomatic men

  • Yiting Xu , Xiaojing Ma , Qin Xiong , Xueli Zhang , Yun Shen and Yuqian Bao EMAIL logo



Our study examined whether osteocalcin contributed to identifying carotid intima-media thickness (C-IMT) over the atherosclerotic cardiovascular disease (ASCVD) risk score.


We recruited 618 middle-aged and elderly men from communities in Shanghai. Serum osteocalcin levels were determined using an electrochemiluminescence immunoassay. C-IMT was measured by ultrasonography.


The study included 245 men with low ASCVD risk and 373 men with moderate-to-high ASCVD risk. Serum osteocalcin levels were lower in the moderate-to-high risk vs. low risk men (p=0.042). Multivariate stepwise regression analysis showed that body mass index (BMI) and glycated hemoglobin were predictors for reduced osteocalcin levels (both p<0.001). Among all subjects, the proportion with an elevated C-IMT was higher in the low-osteocalcin group than in the high-osteocalcin group (p=0.042), and the significance of this result was greater when considering only subjects with a moderate-to-high ASCVD risk (p=0.011). The recognition rate of elevated C-IMT was superior with both low osteocalcin and moderate-to-high ASCVD risk vs. either parameter alone (p<0.001 and p=0.015, respectively). Osteocalcin was independently and inversely associated with elevated C-IMT after adjusting for the 10-year ASCVD risk score (p=0.004). The negative relationship remained statistically significant in subjects with a moderate-to-high ASCVD risk in particular (standardized β=−0.104, p=0.044).


In middle-aged and elderly men, serum osteocalcin levels strengthen identifying subclinical atherosclerosis over ASCVD risk score, especially among subjects with a moderate-to-high ASCVD risk.

Corresponding author: Prof. Yuqian Bao, MD, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, 600 Yishan Road, Shanghai 200233, P.R. China, Phone: +86-21-64369181, Fax: +86-21-64368031
aYiting Xu and Xiaojing Ma contributed equally to this work.
  1. Author contributions: Yuqian Bao conceived and designed the experiments. Yiting Xu, Xiaojing Ma, Qin Xiong, Xueli Zhang and Yun Shen performed the experiments. Yiting Xu and Xiaojing Ma performed the statistical analysis and wrote the paper. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: The authors disclose receipt of the following financial support for the research, authorship and/or publication of this article: This work was funded by the Project of National Natural Science Foundation of China (grant number 31571212) and the innovation foundation of translational medicine of Shanghai Jiao Tong University School of Medicine and Shanghai SJTUSM Biobank [grant number 15ZH4006].

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


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Received: 2018-01-12
Accepted: 2018-04-18
Published Online: 2018-05-19
Published in Print: 2018-10-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

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