Abstract
Bone-derived proteins, including carboxylated osteocalcin (cOC), are thought to play a role in cardiovascular and metabolic health. cOC is recognized for its strong affinity for calcium hydroxyapatite and its possible involvement in vascular calcification and lipid metabolism. Although the undercarboxylated form of osteocalcin (ucOC) has been widely researched, the connections between cOC and cardiovascular risk markers, such as mean arterial pressure (MAP), pulse pressure (PP), and the atherogenic index, are still not well understood. This cross-sectional study comprised 81 adults from Western Mexico; selection was based on rigorous inclusion criteria. Participants underwent various measurements, including anthropometric, biochemical, and cardiovascular assessments, such as the body mass index (BMI), body fat percentage, serum glucose, insulin resistance (HOMA-IR), glycated hemoglobin (HbA1c), lipid profile, creatinine, blood pressure parameters, and the atherogenic index. Serum cOC levels were determined using an enzyme-linked immunosorbent assay (ELISA). The study examined the relationships between cOC and cardiovascular/metabolic markers using inferential statistics and correlation coefficients. Multivariate linear analysis was performed to identify factors independently associated with the serum levels of cOC. Multivariate analysis revealed that MAP (B coefficient: 0.138, 95% CI: 0.028-0.247, p = 0.015) and the atherogenic index (B coefficient: 0.599, 95% CI: -0.039-1.161, p = 0.037) are independent predictors of cOC levels. A positive correlation was observed between cOC, PP, the atherogenic index, and HbA1, as well as an inverse correlation between cOC and HDL-c among the participants. Additionally, PP was positively correlated with HOMA-IR. Participants with elevated cOC levels showed higher MAP and atherogenic index values, indicating a potential connection between cOC and cardiovascular risk. cOC is independently associated with MAP and the atherogenic index, suggesting it may play a role in vascular remodeling and lipid metabolism. These results emphasize the importance of the bone-vascular axis in cardiovascular health and indicate that cOC might be a useful biomarker for assessing cardiovascular risk. Additional research is necessary to confirm these findings in larger, long-term studies and to investigate the mechanisms that connect cOC with cardiovascular outcomes.