Assessment of subclinical myocardial dysfunction and osteogenic biomarkers in normoglycemic individuals with familial predisposition to type 2 diabetes mellitus

First-degree relatives of patients with type 2 diabetes mellitus may exhibit metabolic abnormalities and subclinical myocardial dysfunction before the onset of overt disease. Left Ventricular Speckle-tracking echocardiography (LV-STE) enables early detection of left ventricular impairment, while osteogenic biomarkers such as osteoprotegerin, osteocalcin, and osteopontin have been linked to cardiometabolic risk. This study aimed to evaluate myocardial strain parameters and serum osteogenic biomarkers in normoglycemic first-degree relatives of patients with type 2 diabetes mellitus.We enrolled 160 normoglycemic participants, comprising 80 individuals with at least one first-degree relative diagnosed with type 2 diabetes mellitus and 80 controls without such a family history. Serum osteocalcin, osteopontin, and osteoprotegerin levels were measured by ELISA. LV-STE was used to assess global longitudinal and circumferential strain from apical four-chamber (A4C), two-chamber (A2C), three-chamber (A3C), and short-axis basal/mid/apical views.Compared with the control group, the study group presented significantly lower mean short-axis basal/mid/apical and A4C/A2C/A3C strain values. The serum osteocalcin level was significantly lower and weakly negatively correlated with the fasting plasma glucose level. osteoprotegerin was positively correlated with LDL-C. No significant associations were found between strain parameters and biomarkers.Normoglycemic first-degree relatives of type 2 diabetes mellitus patients exhibit early myocardial impairment detectable by LV-STE and reduced osteocalcin levels. LV-STE may enhance early risk stratification in this population. Longitudinal studies are needed to determine the prognostic value of osteogenic biomarkers in the progression to type 2 diabetes mellitus and cardiovascular disease.