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Hanusch B, Falkenstein M, Volkenstein S, Dazert S, Lücke T, Sinningen K. No Impairment in Bone Turnover or Executive Functions in Well-Treated Preschoolers with Phenylketonuria-A Pilot Study. Nutrients 2024; 16:2072. [PMID: 38999818 PMCID: PMC11243048 DOI: 10.3390/nu16132072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Patients with phenylketonuria (PKU) present signs of impaired executive functioning and bone health in adolescence and adulthood, depending in part on the success of therapy in childhood. Therefore, nine children with well-treated PKU (4-7 years old, 22.2% ♀, seven with a full set of data, two included into partial analysis) and 18 age-, gender- and season-matched controls were analyzed for differences in executive functioning and bone parameters in plasma. Plasma was analyzed with commercially available kits. Cognitive performance in tonic alertness, visuo-spatial working memory, inhibitory control and task switching was assessed by a task battery presented on a touch screen. Regarding cognition, only the performance in incongruent conditions in inhibitory control was significantly better in children with PKU than in controls. No further differences in cognitive tests were detected. Furthermore, no significant difference in the bone turnover markers osteocalcin, undercarboxylated osteocalcin and CTX were detected between children with PKU and controls, while children with PKU had a significantly higher vitamin D concentration (69.44 ± 12.83 nmol/L vs. 41.87 ± 15.99 nmol/L, p < 0.001) and trended towards lower parathyroid hormone concentrations than controls (48.27 ± 15.16 pg/mL vs. 70.61 ± 30.53 pg/mL, p = 0.066). In this small group of well-treated preschoolers with PKU, no impairments in cognitive performance and bone turnover were observed, while vitamin D supplementation of amino acid supplements seems to be sufficient to achieve good vitamin D status.
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Affiliation(s)
- Beatrice Hanusch
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
| | | | - Stefan Volkenstein
- Department of Otorhinolaryngology, Head and Neck Surgery, Johannes Wesling Klinikum Minden, Ruhr-University Bochum, 32429 Minden, Germany
| | - Stefan Dazert
- Department of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital Bochum, Ruhr-University Bochum, 44787 Bochum, Germany
| | - Thomas Lücke
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
| | - Kathrin Sinningen
- Research Department of Child Nutrition, University Hospital of Pediatrics and Adolescent Medicine, St. Josef-Hospital, Ruhr-University Bochum, 44791 Bochum, Germany
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Berggren SS, Dahlgren J, Andersson O, Bergman S, Roswall J. Reference limits for osteocalcin in infancy and early childhood: A longitudinal birth cohort study. Clin Endocrinol (Oxf) 2024; 100:399-407. [PMID: 38385947 DOI: 10.1111/cen.15036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/26/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE The longitudinal variations in serum levels of the hormone osteocalcin is largely unknown during infancy and early childhood. Our aim was to establish reference limits for total serum osteocalcin during specific time points from birth until 5 years of age and present those in the context of sex, breastfeeding practices and gestational age (GA). DESIGN Blood samples from 551 Swedish children were analysed at birth, 4, 12, 36 and 60 months of age. Total serum osteocalcin was measured using the IDS-iSYS N-MID Osteocalcin assay technique. Information about the mother, birth, anthropometrics and a food diary were collected. RESULTS Sex-specific and age-specific reference limits were established for the five time points. The median osteocalcin levels over time were 40.8, 90.0, 67.8, 62.2 and 80.9 μg/L for boys and 38.1, 95.5, 78.3, 73.9 and 92.6 μg/L for girls. Lower GA was associated to higher osteocalcin at birth, and ongoing breastfeeding was associated to higher osteocalcin levels. CONCLUSION Osteocalcin followed a wavelike pattern with low levels in the umbilical cord and a postnatal peak during the first year which then declined and rose again by the age of five. Knowledge of this wavelike pattern and association to factors as sex, breastfeeding and GA may help clinicians to interpret individual osteocalcin levels and guide in future research.
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Affiliation(s)
- Sara S Berggren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Health Center Hyltebruk, Hyltebruk, Halland, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Västra Götalandregion, Queen Silvia Children's Hospital, Lund, Sweden
| | - Ola Andersson
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Bergman
- Department of Public Health and Community Medicine, Primary Health Care Unit, University of Gothenburg, Gothenburg, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Josefine Roswall
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Sweden
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Rodríguez-Narciso S, Martínez-Portilla RJ, Guzmán-Guzmán IP, Careaga-Cárdenas G, Rubio-Navarro BJ, Barba-Gallardo LF, Delgadillo-Castañeda R, Villafan-Bernal JR. Osteocalcin serum concentrations and markers of energetic metabolism in pediatric patients. Systematic review and metanalysis. Front Pediatr 2023; 10:1075738. [PMID: 36714656 PMCID: PMC9878130 DOI: 10.3389/fped.2022.1075738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/13/2022] [Indexed: 01/15/2023] Open
Abstract
Background Osteocalcin plays a role in glucose metabolism in mice, but its relevance in human energetic metabolism is controversial. Its relationship with markers of energetic metabolism in the pediatric population has not been systematically addressed in infants and adolescents. Objective This study aims to assess the mean differences between tOC, ucOC, and cOC among healthy children and children with type 1 or type 2 diabetes (T1D or T2D) and the correlation of these bone molecules with metabolic markers. Methods A systematic review and metanalysis were performed following PRISMA criteria to identify relevant observational studies published in English and Spanish using PubMed, Scopus, EBSCO, and Web of Science databases. The risk of bias was assessed using New Castle-Ottawa scale. Effect size measures comprised standardized mean difference (SMD) and Pearson correlations. Heterogeneity and meta-regressions were performed. Results The 20 studies included were of high quality and comprised 3,000 pediatric patients who underwent tOC, cOC, or ucOC measurements. Among healthy subjects, there was a positive correlation of ucOC with WC and weight, a positive correlation of tOC with FPG, HDL-c, WC, height, and weight, and a negative correlation between tOC and HbA1c. Among diabetic subjects, a negative correlation of ucOC with HbA1c and glycemia in both T1D and T2D was found and a negative correlation between tOC and HbA1c in T1D but not in T2D. The ucOC concentrations were lower in T2D, T1D, and patients with abnormal glucose status than among controls. The serum concentrations of tOC concentrations were lower among T1D than in controls. The patient's age, altitude, and HbA1c influenced the levels of serum tOC. Conclusion Osteocalcin is involved in energy metabolism in pediatric subjects because it is consistently related to metabolic and anthropometric parameters. Systematic Review Registration https://www.crd.york.ac.uk/prospero/, identifier: CRD42019138283.
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Affiliation(s)
| | - Raigam Jafet Martínez-Portilla
- Clinical Research Division, Evidence-Based Medicine Department, National Institute of Perinatology, Mexico City, Mexico
- Molecular and Maternal-Fetal Medicine, Iberoamerican Research Network in Translational, Mexico City, Mexico
| | | | | | | | | | | | - José Rafael Villafan-Bernal
- Molecular and Maternal-Fetal Medicine, Iberoamerican Research Network in Translational, Mexico City, Mexico
- Investigador por México, National Council of Science and Technology (CONACYT), Mexico City, Mexico
- Laboratory of Immunogenomics and Metabolic Diseases, Mexican National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico
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Relationships between Body Weight Status and Serum Levels of Adipokine, Myokine and Bone Metabolism Parameters in Healthy Normal Weight and Thin Children. J Clin Med 2022; 11:jcm11144013. [PMID: 35887780 PMCID: PMC9320693 DOI: 10.3390/jcm11144013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 02/06/2023] Open
Abstract
Optimal body weight and body composition for age are relevant to child development and healthy life. Changes in lean mass and fat mass as well as its distribution are associated with alterations in the secretion of myokines and adipokines by muscle and adipose tissues. These factors are very important for bone health. The aim of the study was to assess serum leptin, adiponectin, resistin, visfatin and omentin as adipokines and myostatin and irisin as myokines with regard to their associations with bone parameters in healthy normal weight and thin children. We studied 81 healthy prepubertal children (aged 5 to 9 years) divided into three groups: group A—35 children with a BMI z-score between +1 and −1 SD; group B—36 children with a BMI z-score between −1 and −2 SD; and group C—10 thin children with a BMI z-score of <−2 SD. We observed significantly (p < 0.001) lower fat mass, fat/lean mass ratio and bone mineral density (BMD) across weight status with the lowest values in the group of thin children. We noticed significantly (p < 0.05) lower concentrations of 25-hydroxyvitamin D, resistin and high-molecular-weight (HMW) adiponectin but higher levels of myostatin as the BMI z-score deceased. We found that BMI and leptin levels were directly correlated with fat mass, lean mass, bone mineral content (BMC) and BMD. Resistin levels were negatively associated with lean mass, while visfatin concentrations were positively related to total BMD. In healthy prepubertal children there were differences in body composition and in bone mineral density across decreasing BMI status. We suggest that changes in serum myostatin and 25-hydroxyvitamin D levels may play a role in bone status of thin children. Moreover, significant relations between adipokines and bone parameters may confirm crosstalk between fat tissue and bone in these children.
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Takaya J, Tanabe Y, Kaneko K. Increased lipocalin 2 levels in adolescents with type 2 diabetes mellitus. J Pediatr Endocrinol Metab 2021; 34:979-985. [PMID: 34118796 DOI: 10.1515/jpem-2021-0216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 05/02/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Bone can act as an endocrine organ through the secretion of bone-specific hormones, i.e., osteokines. Recent research has demonstrated that lipocalin 2 (LCN2) secreted by osteoblasts are part of an important endocrine system that is finely tuned with other organs to ensure homeostatic balance and health. The aim of this study was to explore the association between bone and glucose metabolism in adolescents with obesity and type 2 diabetes mellitus (DM2). METHODS The participants were 8 adolescents with DM2 (5 males, 3 females; age: 17.0 (14.0-20.0) years, median (interquartile range)), 14 adolescents with simple obesity (9 males, 5 females; age: 13.5 (12.4-15.5) years), and 15 controls (6 males, 9 females; age: 13.3 (11.0-15.0) years). Serum LCN2 and under-carboxylated osteocalcin (un-OC) levels were measured using enzyme-linked immunosorbent assays. RESULTS The LCN2 levels were higher in patients with DM2 (58.1 (34.2-95.0) ng/mL; median (interquartile range)), but not in those with obesity (30.8 (23.1-38.3) ng/mL), when compared to the controls (18.2 (9.8-25.7) ng/mL). In the whole study group overall, serum LCN2 was positively correlated with the Model Assessment of Insulin Resistance score (r=0.339, p=0.046) and body mass index (r=0.580, p<0.0001), and negatively correlated with adiponectin (r=-0.462, p=0.005). A multiple stepwise regression model showed that serum adiponectin was an independent predictor of serum LCN2. CONCLUSIONS The results of this study indicate that further investigations are warranted to determine whether LCN2 may act as a sensitive indicator of early-stage insulin resistance.
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Affiliation(s)
- Junji Takaya
- Department of Pediatrics, Kawachi General Hospital, Higashi-Osaka, Osaka, 578-0954, Japan.,Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Yuko Tanabe
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
| | - Kazunari Kaneko
- Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan
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Osteocalcin Is Independently Associated with C-Reactive Protein during Lifestyle-Induced Weight Loss in Metabolic Syndrome. Metabolites 2021; 11:metabo11080526. [PMID: 34436467 PMCID: PMC8400285 DOI: 10.3390/metabo11080526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/16/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022] Open
Abstract
Bone-derived osteocalcin has been suggested to be a metabolic regulator. To scrutinize the relation between osteocalcin and peripheral insulin sensitivity, we analyzed changes in serum osteocalcin relative to changes in insulin sensitivity, low-grade inflammation, and bone mineral density following lifestyle-induced weight loss in individuals with metabolic syndrome (MetS). Participants with MetS were randomized to a weight loss program or to a control group. Before and after the 6-month intervention period, clinical and laboratory parameters and serum osteocalcin levels were determined. Changes in body composition were analyzed by dual-energy X-ray absorptiometry (DXA). In participants of the intervention group, weight loss resulted in improved insulin sensitivity and amelioration of inflammation. Increased serum levels of osteocalcin correlated inversely with BMI (r = −0.63; p< 0.001), total fat mass (r = −0.58, p < 0.001), total lean mass (r = −0.45, p < 0.001), C-reactive protein (CRP) (r = −0.37; p < 0.01), insulin (r = −0.4; p < 0.001), leptin (r = −0.53; p < 0.001), triglycerides (r = −0.42; p < 0.001), and alanine aminotransferase (ALAT) (r = −0.52; p < 0.001). Regression analysis revealed that osteocalcin was independently associated with changes in CRP but not with changes in insulin concentration, fat mass, or bone mineral density, suggesting that weight loss-induced higher serum osteocalcin is primarily associated with reduced inflammation.
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Bone formation and resorption markers at 7 years of age: Relations with growth and bone mineralization. PLoS One 2019; 14:e0219423. [PMID: 31437153 PMCID: PMC6705799 DOI: 10.1371/journal.pone.0219423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/24/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose We aimed to describe bone formation and resorption markers in generally healthy prepubertal children using total alkaline phosphatase (tALP), osteocalcin (OC) and β-isomerized C-terminal telopeptides of type I collagen (β-CTx) serum concentrations and to estimate markers’ correlations with anthropometric growth (height, weight, body mass index and trajectories of weight gain) as well as bone mineral content (BMC) and areal density (aBMD). Methods We assessed 395 7-year-old children from the Generation XXI cohort with tALP, OC and β-CTx concentrations determined from a fasting venous blood sample and BMC/aBMD measured by dual-energy X-ray absorptiometry. Gender-specific reference intervals for tALP, OC and β-CTx in 7-year-old children were established by calculating the 2.5th and 97.5th percentiles. Pearson and partial correlation coefficients (controlling for sex, age, body size and season) between bone markers and growth measures were computed. Results tALP increased with height (rpartial controlled for sex = 0.26, 95%CI: 0.17, 0.35), was higher in overweight than in healthy weight children, and in children who gained weight above average during infancy. No correlations were found between OC or β-CTx and growth. In girls, OC was slightly correlated with subtotal BMC (rpartial = 0.22, 95%CI: 0.08, 0.35), subtotal aBMD (rpartial = 0.20, 95%CI: 0.06, 0.33) and lumbar spine aBMD (rpartial = 0.23, 95%CI: 0.09, 0.36). tALP and β-CTx were not correlated with any of the DXA-derived bone measures. Conclusion This study contributed to the description of bone turnover at 7 years of age and suggested that bone metabolism markers measured in a single point in time have limited ability to describe anthropometric growth and overall bone status in generally healthy prepubertal children.
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Seppä S, Tenhola S, Voutilainen R. Association of Serum Total Osteocalcin Concentrations With Endogenous Glucocorticoids and Insulin Sensitivity Markers in 12-Year-Old Children: A Cross-Sectional Study. Front Endocrinol (Lausanne) 2019; 10:798. [PMID: 31803143 PMCID: PMC6877498 DOI: 10.3389/fendo.2019.00798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Accepted: 11/01/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Osteocalcin (OC) is an osteoblast-derived marker of bone turnover that has recently been linked to glucose metabolism, glucocorticoid action, and cardiovascular risk. Objective: We determined whether serum total OC (tOC) is associated with cardiometabolic factors, such as insulin sensitivity (IS) markers and endogenous glucocorticoids in 12-year-old children. In addition, we assessed whether low birth weight or exposure to maternal preeclampsia affect tOC concentrations. Methods: In this cross-sectional study, 192 children (109 girls) were studied at 12 years of age. Seventy of them had been born small (SGA), 78 appropriate for gestational age (AGA), and 44 from preeclamptic pregnancies (PRE) as AGA. Blood pressure was measured, and fasting blood samples were collected for markers of glucose metabolism, osteoblast, adipocyte, and adrenocortical function. IS was estimated by Quantitative Insulin Sensitivity Check Index (QUICKI). Free cortisol index (FCI) was calculated as serum cortisol/corticosteroid binding globulin. Results: The highest tOC concentrations were detected in midpubertal children (Tanner B/G stage 3). The children in the highest tOC quartile (n = 48) had lower body mass index (BMI), waist-to-height ratio, diastolic blood pressure, leptin, cortisol/cortisone ratio and FCI, and higher insulin-like growth factor I (IGF-I), IGF-binding protein-1 (IGFBP-1), IGFBP-3, and alkaline phosphatase (ALP) than those in the lower tOC quartiles (p < 0.02 for all). QUICKI was similar in these subgroups. In logistic regression analysis, pubertal developmental stages 2 and 3, high ALP, IGF-I, and low FCI and BMI (p < 0.02 for all) were associated independently with higher tOC. The means of serum tOC and IS markers were similar in the SGA, AGA, and PRE subgroups. Conclusions: In both sexes, the highest tOC levels were detected in midpubertal children reflecting the fast pubertal growth phase. Higher tOC levels were associated with lower BMI and FCI, whereas no association was found with IS. Birth weight or exposure to preeclampsia had no effect on tOC concentrations.
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Affiliation(s)
- Satu Seppä
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- *Correspondence: Satu Seppä
| | - Sirpa Tenhola
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- Department of Pediatrics, Kymenlaakso Central Hospital, Kotka, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
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Ambroszkiewicz J, Gajewska J, Rowicka G, Klemarczyk W, Chelchowska M. Assessment of Biochemical Bone Turnover Markers and Bone Mineral Density in Thin and Normal-Weight Children. Cartilage 2018; 9:255-262. [PMID: 29156943 PMCID: PMC6042038 DOI: 10.1177/1947603516686145] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Objective There is scant research examining the prevalence of thinness in early childhood, despite its potential negative consequences for health and development across the life course. The objective of this study was to assess bone status through measurement of bone mineral density and biochemical bone turnover markers, with special attention paid to carboxylated (c-OC) as well as undercarboxylated (uc-OC) forms of osteocalcin, in the groups of thin and normal-weight children. Design The study included 80 healthy prepubertal children (median age 7.0 years), who were divided (according to Cole's international cutoffs) into 2 subgroups: thin children ( n = 40, body mass index [BMI] = 13.5 kg/m2) and normal-weight children ( n = 40, BMI = 16.1 kg/m2). Bone mineral density (BMD) and bone mineral content (BMC) were assessed by dual-energy x-ray absorptiometry method. Serum concentrations of C-terminal telopeptide of collagen type I (CTX), total osteocalcin (OC), and c-OC, and uc-OC forms of osteocalcin were determined using enzyme-linked immunosorbent assays. Results In thin children, we observed higher levels of bone resorption marker CTX compared with normal-weight peers. Total osteocalcin concentrations were comparable in both groups of children; however, in thin children we observed higher median values of uc-OC (34.40 vs. 29.30 ng/mL, P < 0.05) and similar c-OC levels (25.65 vs. 28.80 ng/mL). The ratio of c-OC to uc-OC was significantly lower ( P < 0.05) in thin than in normal-weight children. Total BMD and BMC were significantly decreased ( P < 0.0001) in thin children compared with normal-weight peers (0.724 ± 0.092 vs. 0.815 ± 0.060 g/cm2 and 602.7 ± 159.2 vs. 818.2 ± 220.1 g, respectively). Conclusion Increased concentrations of CTX and uc-OC might lead to disturbances in bone turnover and a decrease in bone mineral density in thin children.
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Affiliation(s)
- Jadwiga Ambroszkiewicz
- Screening Department, Institute of Mother and Child, Warsaw, Poland,Jadwiga Ambroszkiewicz, Screening Department, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Joanna Gajewska
- Screening Department, Institute of Mother and Child, Warsaw, Poland
| | - Grazyna Rowicka
- Department of Nutrition, Institute of Mother and Child, Warsaw, Poland
| | - Witold Klemarczyk
- Department of Nutrition, Institute of Mother and Child, Warsaw, Poland
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Gajewska J, Ambroszkiewicz J, Klemarczyk W, Chełchowska M, Weker H, Szamotulska K. The effect of weight loss on body composition, serum bone markers, and adipokines in prepubertal obese children after 1-year intervention. Endocr Res 2018; 43:80-89. [PMID: 29192796 DOI: 10.1080/07435800.2017.1403444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
UNLABELLED Purpose/Aim: The influence of weight loss on bone turnover and bone quality in childhood remains controversial, but it may implicate interactions between adiposity and bone metabolism. Therefore, we studied the relationships between bone markers and adipokines during weight loss in obese children. MATERIALS AND METHODS We determined serum leptin, soluble leptin receptor, adiponectin, bone alkaline phosphatase (BALP), C-terminal telopeptide of type I collagen (CTX-I), osteocalcin (OC), carboxylated-OC (Gla-OC), undercarboxylated-OC (Glu-OC), sclerostin, body composition, and bone mineral density (BMD) in 40 obese prepubertal children before and after therapy. The control group, matched for sex and age, consisted of 40 non-obese children. RESULTS We found that values of the total body less head-bone mineral content (TBLH-BMC) and TBLH-BMD were significantly increased, but TBLH-BMD Z-score was decreased by 25% (p = 0.002) in obese children with weight loss after therapy. We observed increases of CTX-I to OC ratio (p = 0.009), and Gla-OC concentrations (p = 0.049). Changes in TBLH-BMD Z-score in patients were positively correlated with changes in BMI Z-score (p = 0.001), percentage of fat mass (p = 0.004), and BALP activity (p = 0.01). Changes in BALP activity were negatively correlated (p < 0.001) with changes in adiponectin concentrations, while changes in sclerostin levels were positively correlated (p = 0.001) with leptin changes. CONCLUSIONS We suggest that alterations in adipokines metabolism were associated with a lower rate of bone mineral accrual as a result of decreased bone formation rather than increased bone resorption. The lower rate of bone mass accrual in weight losing children may be an effect of reduced BALP levels related to increase in adiponectin levels.
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Affiliation(s)
- Joanna Gajewska
- a Screening Department , Institute of Mother and Child , Warsaw , Poland
| | | | - Witold Klemarczyk
- b Department of Nutrition , Institute of Mother and Child , Warsaw , Poland
| | | | - Halina Weker
- b Department of Nutrition , Institute of Mother and Child , Warsaw , Poland
| | - Katarzyna Szamotulska
- c Department of Epidemiology and Biostatistics , Institute of Mother and Child , Warsaw , Poland
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Ambroszkiewicz J, Chełchowska M, Szamotulska K, Rowicka G, Klemarczyk W, Strucińska M, Gajewska J. Bone status and adipokine levels in children on vegetarian and omnivorous diets. Clin Nutr 2018; 38:730-737. [PMID: 29609869 DOI: 10.1016/j.clnu.2018.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 01/30/2018] [Accepted: 03/17/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS Measurements of bone mineral density (BMD) reflect bone status but not the dynamics of bone turnover. Biochemical markers, which show global skeletal activity, were validated for the assessment of bone formation and resorption processes. Adipokines also play a significant role in the regulation of bone metabolism. OBJECTIVE To assess body composition, bone mineral density, bone turnover markers and adipokine levels in relation to vegetarian and omnivorous diets. METHODS The study included 53 vegetarian and 53 omnivorous prepubertal healthy children matched for age and sex (median age 7.0 years). Body composition and BMD were assessed by dual-energy X-ray absorptiometry. 25-hydroxyvitamin D and parathormone levels were measured by chemiluminescence method. Serum carboxy-terminal propeptide of type I collagen (CICP), total osteocalcin (OC) and its forms carboxylated (c-OC) and undercarboxylated (uc-OC), C-terminal cross-linking telopeptide of collagen type I (CTX), leptin and adiponectin levels were determined using immunoenzymatic assays. RESULTS Both groups of children were comparable in terms of body composition, except for the percentage of fat mass, which was lower (19.24 vs. 21.77%, p = 0.018) in vegetarians. Mean values of total BMD z-score and lumbar spine BMD z-score were lower (-0.583 vs. -0.194, p = 0.009 and -0.877 vs. -0.496, p = 0.019, respectively) in vegetarians compared with omnivores. Serum leptin level was about 2-fold lower (1.39 vs. 2.94 ng/mL, p < 0.001) in vegetarians, however, adiponectin concentration was similar in both groups. Vegetarians had similar concentration of 25-hydroxyvitamin D, but higher parathormone (40.8 vs. 32.1 pg/mL, p = 0.015) and CTX (1.94 vs. 1.76 ng/mL, p = 0.077) levels than omnivores. Total osteocalcin and CICP concentrations were comparable in both groups, however, c-OC/uc-OC ratio was higher (1.43 vs. 1.04 ng/mL, p < 0.05) in vegetarians. We found positive correlation between c-OC and nutritional parameters adjusted for total energy intake (plant protein, phosphorus, magnesium and fiber intakes) in vegetarian children. CONCLUSIONS Prepubertal children on a vegetarian diet had significantly lower total and lumbar spine BMD z-scores, but absolute values of bone mineral density did not differ. BMD z-scores did not correlate with bone metabolism markers and nutritional variables, but were positively associated with anthropometric parameters. Lower leptin levels in vegetarian children reflect lower body fat. Longitudinal studies are necessary to evaluate the impact of the observed association on bone health at adulthood.
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Affiliation(s)
- Jadwiga Ambroszkiewicz
- Screening Department, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Magdalena Chełchowska
- Screening Department, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Katarzyna Szamotulska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Grażyna Rowicka
- Department of Nutrition, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Witold Klemarczyk
- Department of Nutrition, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Małgorzata Strucińska
- Department of Nutrition, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
| | - Joanna Gajewska
- Screening Department, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
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Giudici KV, Kindler JM, Martin BR, Laing EM, McCabe GP, McCabe LD, Hausman DB, Martini LA, Lewis RD, Weaver CM, Peacock M, Hill Gallant KM. Associations among osteocalcin, leptin and metabolic health in children ages 9-13 years in the United States. Nutr Metab (Lond) 2017; 14:25. [PMID: 28286536 PMCID: PMC5341348 DOI: 10.1186/s12986-017-0171-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 02/14/2017] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to investigate the relationships among osteocalcin, leptin and metabolic health outcomes in children ages 9–13 years. Methods This was a cross-sectional analysis of baseline data from 161 boys and 157 girls (ages 9–13 years) who previously participated in a double-blinded randomized placebo controlled trial of vitamin D supplementation. Relationships among fasting serum total osteocalcin (tOC), undercarboxylated osteocalcin (ucOC), leptin, and metabolic health outcomes were analyzed. Results Approximately 52% of study participants were obese based on percent body fat cutoffs (>25% for boys and >32% for girls) and about 5% had fasting serum glucose within the prediabetic range (i.e. 100 to 125 mg/dL). Serum tOC was not correlated with leptin, glucose, insulin, HOMA-IR, or HOMA-β after adjusting for percent body fat. However, serum ucOC negatively correlated with leptin (partial r = −0.16; p = 0.04) and glucose (partial r = −0.16; p = 0.04) after adjustment for percent body fat. Leptin was a positive predictor of insulin, glucose, HOMA-IR, and HOMA-β after adjusting for age, sex and percent body fat (all p < 0.001). Conclusions These data depict an inverse relationship between leptin and various metabolic health outcomes in children. However, the notion that tOC or ucOC link fat with energy metabolism in healthy children was not supported. Clinical trial registration number NCT00931580.
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Affiliation(s)
- Kelly Virecoulon Giudici
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, São Paulo, CEP 01246-904 Brazil
| | - Joseph M Kindler
- Department of Foods and Nutrition, University of Georgia, 305 Sanford Dr, Athens, GA 30602 USA
| | - Berdine R Martin
- Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907 USA
| | - Emma M Laing
- Department of Foods and Nutrition, University of Georgia, 305 Sanford Dr, Athens, GA 30602 USA
| | - George P McCabe
- Department of Statistics, Purdue University, 150 N. University Street, West Lafayette, IN 47907 USA
| | - Linda D McCabe
- Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907 USA
| | - Dorothy B Hausman
- Department of Foods and Nutrition, University of Georgia, 305 Sanford Dr, Athens, GA 30602 USA
| | - Lígia Araújo Martini
- Department of Nutrition, School of Public Health, University of São Paulo, Avenida Doutor Arnaldo 715, São Paulo, CEP 01246-904 Brazil
| | - Richard D Lewis
- Department of Foods and Nutrition, University of Georgia, 305 Sanford Dr, Athens, GA 30602 USA
| | - Connie M Weaver
- Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907 USA
| | - Munro Peacock
- Department of Medicine, Indiana University School of Medicine, 545 Barnhill Dr, Indianapolis, IN 46202 USA
| | - Kathleen M Hill Gallant
- Department of Nutrition Science, Purdue University, 700 W. State Street, West Lafayette, IN 47907 USA
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