Association between the circulating total osteocalcin level and the development of cardiovascular disease in middle-aged men: a mean 8.7-year longitudinal follow-up study.

AIM Recent studies have suggested that the serum osteocalcin level is associated with various cardiovascular risk factors. The aim of this study was to determine whether the serum total osteocalcin level is associated with the development of cardiovascular disease (CVD). METHODS A total of 1,290 men 40-78 years of age were enrolled. The subjects were followed regularly at the Health Promotion Center on an outpatient basis and during hospitalization for a mean of 8.7 years, and the incidence of CVD (coronary heart disease [CHD] and stroke) was determined. RESULTS At baseline, the body mass index, body fat percentage, fasting glucose, homeostasis model assessment-insulin resistance, triglyceride and non-high density lipoprotein (HDL) cholesterol levels were inversely and the HDL cholesterol levels were positively associated with the serum osteocalcin levels. In addition, the prevalence of diabetes or metabolic syndrome decreased as the osteocalcin tertile increased. However, no differences were observed in the prevalence of hypertension across the osteocalcin tertiles. Incident CVD occurred in 74 (5.7%) of the study subjects (29 patients with CHD and 47 patients with stroke). According to the Cox proportional hazards models, however, there were no statistical differences in the development of stroke, CHD or CVD across the osteocalcin tertiles after adjusting for other risk factors for CVD, including age, body mass index, current smoking, low-density lipoprotein cholesterol, diabetes, hypertension and the serum creatinine level. CONCLUSION In conclusion, the serum total osteocalcin level was not associated with the development of CVD after adjusting for other risk factors for CVD in this cohort.