Association of serum total osteocalcin with type 2 XXXX and intermediate metabolic phenotypes: systematic review and meta-analysis of observational evidence.

@entity209 @entity1 @entity413 @entity6
UNASSIGNED: Serum total osteocalcin, a marker of bone formation, may regulate @entity413 metabolism and influence the risk of developing adverse metabolic outcomes. We conducted a systematic review and meta-analysis of published observational evidence, to assess and quantify the associations of serum total osteocalcin with type 2 @entity6 and intermediate metabolic phenotypes [e.g., @entity209 ( @entity209 )]. Relevant studies were identified in a literature search of MEDLINE, EMBASE, Web of Science, and reference lists of relevant studies to May 2015. Mean differences and risk estimates (odds ratios or relative risks) with 95  % CIs were aggregated using random-effects models. Fifty-two observational (38 cross-sectional, eight cohort, five case-control, and one both cross-sectional and cohort) studies with data on 46,998 non-overlapping @entity1 were included. Baseline serum total osteocalcin levels were significantly lower in type 2 @entity6 compared with non-type 2 @entity6 and in @entity209 compared with non- @entity209 in pooled analysis of cross-sectional evidence. Pooled risk estimates (95  % CIs) for type 2 @entity6 in a comparison of extreme fourths of total osteocalcin levels were 0.23 (95  % CI 0.12, 0.46) and 0.89 (95  % CI 0.78, 1.01) for cross-sectional and cohort studies respectively. The corresponding estimate was 0.39 (0.27, 0.56) for @entity209 from cross-sectional evidence. In both cross-sectional and cohort studies, a unit increase in serum total osteocalcin levels was associated with a significant mean increase in HOMA-B and mean reduction in HbA1c; with significant mean reductions in fasting plasma @entity413 levels, HOMA-IR, and body mass index in only cross-sectional studies. Available evidence-mainly from cross-sectional studies, supports inverse associations of serum total osteocalcin with risk of adverse metabolic outcomes. Large-scale prospective studies are needed to establish whether serum total osteocalcin may be useful in the prevention of adverse metabolic outcomes such as type 2 @entity6 .
