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The capability of plasma Osteoprotegerin as a predictor of cardiovascular disease: A systematic literature review

M Nybo, Dept. of Biochemistry, Pharmacology and Genetics, Odense University Hospital, Odense, 5000, Denmark
L Rasmussen, Dept. of Biochemistry, Pharmacology and Genetics, Odense University Hospital, Odense, Denmark

Correspondence: Mads Nybo, Email: mads.nybo{at}ouh.regionsyddanmark.dk

Abstract

Objective: Osteoprotegerin (OPG) strongly inhibits bone-resorption and may also serve as a vascular calcification inhibitor. However, recent studies have indicated that high plasma OPG is a strong predictor of cardiovascular disease (CVD) and mortality. To evaluate this capability, the knowledge concerning OPG as a CVD predictor was gathered through a systematic literature review.

Design and methods: Studies investigating OPG as a predictor of CVD or mortality were extracted from Medline and the Cochrane Library, retrieving 187 articles. Non-relevant articles were excluded, resulting in a total of 45 articles. After thorough evaluation of the abstracts by both authors, only eight prospective studies containing a follow-up period with a clinical emphasis on CVD were eligible for the literature review.

Results: All studies except one confirmed that OPG measurement adds important prognostic information to the existing markers of CVD and mortality in high-risk populations. Hazard ratios emphasized the significant correlation between plasma OPG concentration and mortality. Due to methodological problems (e.g. population investigated, measurement principle, and statistics performed) meta-analysis could not be performed. As only one study was conducted in a healthy cohort the results can not per se be extrapolated to a general population.

Conclusion: The combined results support that plasma OPG is an independent predictor of CVD and mortality in high-risk populations. However, more longitudinal studies in general cohorts are needed before the use of plasma OPG can be evaluated in this regard.