1
|
Shu W, Niu W, Zhang Y, Li H. Association between sex hormones and bone age in boys aged 9-18 years from China. J Cell Mol Med 2024; 28:e18181. [PMID: 38506077 PMCID: PMC10951883 DOI: 10.1111/jcmm.18181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/20/2024] [Accepted: 02/04/2024] [Indexed: 03/21/2024] Open
Abstract
This study aimed to analyse the association between sex hormones and bone age (BA) in boys aged 9-18 years, both individually and interactively, and further to explore whether nutritional status may influence this association. A retrospective analysis was performed among 1382 Chinese boys with physical measurements, sexual characteristics, BA radiographs and sex hormone indicators from February 2015 to February 2022. A total of 470 (34.0%) boys had advanced BA. BA was positively associated with estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone in both advanced and normal BA groups after adjusting for age, genetic height and body mass index. Multiple logistic regression showed that after adjusting for covariates, estradiol (odds ratio [OR] = 1.66, 95% confidence interval [CI]: 1.14-2.12), LH (OR = 1.43, 95% CI: 1.04-1.96), and testosterone (OR = 1.58, 95% CI: 1.17-2.13) were significantly associated with the increased risk of advanced BA in boys, and the association was reinforced when these hormones were interactively explored. Stratified by nutritional status, the interaction between estradiol, LH, and testosterone showed a strong association with advanced BA in boys with normal weight.
Collapse
Affiliation(s)
- Wen Shu
- Department of Growth and DevelopmentCapital Institute of PediatricsBeijingChina
- Children's Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Wenquan Niu
- Center for Evidence‐Based MedicineCapital Institute of PediatricsBeijingChina
| | - Yaqin Zhang
- Department of Growth and DevelopmentCapital Institute of PediatricsBeijingChina
| | - Hui Li
- Department of Growth and DevelopmentCapital Institute of PediatricsBeijingChina
- Children's Hospital Capital Institute of Pediatrics, Chinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| |
Collapse
|
2
|
Park TH, Lin JH, Chung CH, Zheng Z, Li C. The skeletal and dental age advancements of children and adolescents with overweight and obesity: A systematic review and meta-analysis. Am J Orthod Dentofacial Orthop 2023; 164:325-339. [PMID: 37367707 DOI: 10.1016/j.ajodo.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Over the past decades, a trend of increasing obesity among children has emerged. This study aimed to evaluate and summarize the impacts of overweight and obesity on children's and adolescents' skeletal and dental developmental advancement that may influence orthodontic management. METHODS Registered with the Prospective Register of Systematic Reviews (registration no. CRD42022347488), this study complies with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Particularly, relevant original studies on skeletal or dental age evaluation were screened from accessible electronic databases and supplemented by hand-searching. Meta-analysis was recruited to calculate differences (and their 95% confidence interval [CI]) between subjects with overweight or obese and normal-weight counterparts. RESULTS After applying the inclusion and exclusion criteria, 17 articles were selected for the final review. Two of the 17 selected studies were found to have a high risk of bias and moderate the other 15. A meta-analysis detected no statistically significant difference in skeletal age between children and adolescents with overweight and normal-weight counterparts (P = 0.24). However, the dental age of children and adolescents with overweight was found to be 0.49 years (95% CI, 0.29-0.70) advanced in comparison with normal-weight counterparts (P <0.00001). In contrast, children and adolescents with obesity were found to have advanced skeletal age by 1.17 (95% CI, 0.48-1.86) years (P = 0.0009) and dental age by 0.56 (95% CI, 0.37-0.76) years (P <0.00001) compared with their normal-weight counterparts. CONCLUSION Because the orthopedic outcomes of the orthodontic intervention are closely tied to the skeletal age of the patients, these results suggest that the orthodontic evaluation and treatment of children and adolescents with obesity might occur earlier than that of the normal-weight population.
Collapse
Affiliation(s)
- Tiffany H Park
- School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Jia-Hong Lin
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Chun-Hsi Chung
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa
| | - Zhong Zheng
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif.
| | - Chenshuang Li
- Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pa.
| |
Collapse
|
3
|
Analysis of the Relationship between Nutritional Status and Bone Age and Sexual Development in Children and Adolescents. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8325756. [PMID: 36062175 PMCID: PMC9436596 DOI: 10.1155/2022/8325756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/28/2022] [Indexed: 12/02/2022]
Abstract
Purpose To observe the correlation between nutritional status, bone age, and sexual development in children and adolescents. Methods 895 children and adolescents who underwent physical examination in the growth and development clinic and height clinic of our hospital from 2019 to 2021 were selected as the research objects. The subjects were divided into emaciation group, normal group, overweight group, and obesity group. The bone age level, bone age assessment, sexual development, and early maturity rate of each group were compared. Results The bone age difference (BAD) of the overweight and obesity groups was higher than that of the normal group, and the BAD of the obesity group was higher than that of the emaciation group (P < 0.05). Compared with the normal group, the risk of advancement of bone age in the overweight group increased by 2.674 times (male) and 1.908 times (female), the risk of advancement of bone age in the obesity group increased by 6.376 times (male) and 14.687 times (female), the risk of retardation of bone age in the emaciation group increased by 2.150 times (male) and 3.092 times (female). Whether it was male or female, the sexual development of overweight and obese was higher than that of the normal weight group in the same age group. Among female children, the sexual precocious puberty rate of the overweight + obesity group is higher. Conclusion The nutritional status of children and adolescents is closely related to their bone age and sexual development.
Collapse
|
4
|
Satoh M. Bone age in prepubertal children with nonfamilial or familial idiopathic short stature and prepubertal short-stature children born small for gestational age: a longitudinal data analysis. Clin Pediatr Endocrinol 2021; 30:171-177. [PMID: 34629739 PMCID: PMC8481081 DOI: 10.1297/cpe.30.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022] Open
Abstract
This retrospective study aimed to clarify the characteristics of bone maturation using
longitudinal data in short-stature prepubertal children. Children with chronological ages
(CAs) of 4.5–10.5 yr with nonfamilial idiopathic short stature (ISS, n = 95), familial ISS
(FSS, n = 21), and short-stature children born small for gestational age (SGA, n = 23)
were selected, of which 435 left-hand plain radiographic images were evaluated. Bone age
(BA) delay was defined as BA minus CA. In the ISS group, there was a statistically
significant difference in median BA delay among the CA groups (P < 0.001), as median BA
delay gradually increased from 5- to 9-yr-old groups (−1.06 [range, −2.17 to 0.27] and
−2.45 [range, −4.35 to −0.32] yr, respectively). In the FSS group, median BA delays were
approximately −1 yr in all CA groups. In the SGA group, median BA delay gradually
decreased from 7- to 10-yr-old groups (−1.96 [range, −2.99 to 0.56] and −0.04 [range,
−2.44 to 0.92] yr, respectively), but with no significant difference (P = 0.647). The
heavier weight of children with FSS and the probable earlier onset of adrenarche in
children born SGA compared to those with ISS could have affected bone maturation.
Collapse
Affiliation(s)
- Mari Satoh
- Department of Pediatrics, Toho University Omori Medical Center, Tokyo, Japan
| |
Collapse
|
5
|
Giglione E, Lapolla R, Cianfarani S, Faienza MF, Fintini D, Weber G, Delvecchio M, Valerio G. Linear growth and puberty in childhood obesity: what is new? Minerva Pediatr (Torino) 2021; 73:563-571. [PMID: 34309346 DOI: 10.23736/s2724-5276.21.06543-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pediatric obesity is a growing and alarming global health problem and represents an important determinant of morbidity. Since nutrition plays an important role in regulating growth and development, the excess weight gain related to overnutrition can affect growth patterns, bone maturation and pubertal development. The purpose of this review is to summarize the current knowledge about the effect of primary obesity on linear growth and pubertal development in children and adolescents. Evidences about regulatory hormones and adipokines that may be involved in the physiology of childhood growth in the context of obesity were also discussed. The most recent literature confirms previous studies indicating that linear growth is accelerated (mainly due to longer trunks rather than longer legs) and bone age is advanced in prepubertal children with obesity, while there is a reduction of pubertal height gain and attainment of normal adult height. Conflicting results are reported on the timing of puberty, specifically in boys. Indeed, previous studies suggested earlier onset of puberty in obese girls and overweight boys, and a delayed puberty in obese boys. Conversely, the most recent studies show more consistently an earlier onset and completion of pubertal development also in boys with obesity. Considering the false belief of health associated with transient taller stature in children and the adverse outcomes related to early puberty, interventions on diet and physical activity are urgently needed to tackle the epidemics of childhood obesity in public health and clinical setting.
Collapse
Affiliation(s)
| | - Rosa Lapolla
- Dipartimento Materno-Infantile, AOR San Carlo, Potenza, Italy
| | - Stefano Cianfarani
- Dipartimento Pediatrico Universitario Ospedaliero, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Maria F Faienza
- Department of Biomedical Sciences and Human Oncology, Pediatric Unit, University A. Moro, Bari, Italy
| | - Danilo Fintini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children Hospital, Rome, Italy
| | - Giovanna Weber
- Department of Pediatrics, IRCCS San Raffaele Hospital, Milan, Italy
| | - Maurizio Delvecchio
- Metabolic Disorders and Genetic Unit, Giovanni XXIII Children Hospital, Bari, Italy
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples Parthenope, Naples, Italy -
| |
Collapse
|
6
|
Kvist O, Luiza Dallora A, Nilsson O, Anderberg P, Sanmartin Berglund J, Flodmark C, Diaz S. A cross-sectional magnetic resonance imaging study of factors influencing growth plate closure in adolescents and young adults. Acta Paediatr 2021; 110:1249-1256. [PMID: 33047349 PMCID: PMC7983983 DOI: 10.1111/apa.15617] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/16/2020] [Accepted: 10/08/2020] [Indexed: 12/21/2022]
Abstract
Aim To assess growth plate fusion by magnetic resonance imaging (MRI) and evaluate the correlation with sex, age, pubertal development, physical activity and BMI. Methods Wrist, knee and ankle of 958 healthy subjects aged 14.0‐21.5 years old were examined using MRI and graded by two radiologists. Correlations of growth plate fusion score with age, pubertal development, physical activity and BMI were assessed. Results Complete growth plate fusion occurred in 75%, 85%, 97%, 98%, 98% and 90%, 97%, 95%, 97%, 98% (radius, femur, proximal‐ and distal tibia and calcaneus) in 17‐year‐old females and 19‐year‐old males, respectively. Complete fusion occurs approximately 2 years earlier in girls than in boys. Pubertal development correlated with growth plate fusion score (ρ = 0.514‐0.598 for the different growth plate sites) but regular physical activity did not. BMI also correlated with growth plate fusion (ρ = 0.186‐0.384). Stratified logistic regression showed increased odds ratio (OR F: 2.65‐8.71; M: 1.71‐4.03) for growth plate fusion of obese or overweight subects versus normal‐weight subjects. Inter‐observer agreement was high (Κ = 0.87‐0.94). Conclusion Growth plate fusion can be assessed by MRI; occurs in an ascending order, from the foot to the wrist; and is significantly influenced by sex, pubertal development and BMI, but not by physical activity.
Collapse
Affiliation(s)
- Ola Kvist
- Department of Paediatric Radiology Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institute Stockholm Sweden
| | - Ana Luiza Dallora
- Department of Health Blekinge Institute of Technology Karlskrona Sweden
| | - Ola Nilsson
- Department of Women’s and Children’s Health Karolinska Institute Stockholm Sweden
- School of Medical Sciences Örebro University Örebro Sweden
| | - Peter Anderberg
- Department of Health Blekinge Institute of Technology Karlskrona Sweden
| | | | | | - Sandra Diaz
- Department of Paediatric Radiology Karolinska University Hospital Stockholm Sweden
- Department of Women’s and Children’s Health Karolinska Institute Stockholm Sweden
- Department of Radiology Lunds University Lund Sweden
| |
Collapse
|
7
|
The relevance of body mass index in forensic age assessment of living individuals: an age-adjusted linear regression analysis using multivariable fractional polynomials. Int J Legal Med 2020; 134:1861-1868. [PMID: 32700015 PMCID: PMC8266698 DOI: 10.1007/s00414-020-02381-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/17/2020] [Indexed: 11/23/2022]
Abstract
In forensic age assessment of living individuals, developmental stages of skeletal maturation and tooth mineralization are examined and compared with a reference population. It is of interest which factors can affect the development of these features. We investigated the effect of body mass index (BMI) on the developmental stages of the medial epiphysis of the clavicle, the distal epiphysis of the radius, the distal epiphysis of the femur, the proximal epiphysis of the tibia, and the left lower third molar in a total of 581 volunteers, 294 females and 287 males aged 12–24 years, using 3 T MRI. BMI values in the cohort ranged from 13.71 kg/m2 in a 12-year-old female to 35.15 kg/m2 in an 18-year-old female. The effect of BMI on the development of the characteristics was investigated using linear regression models with multivariable fractional polynomials. In the univariable analysis, BMI was associated with all feature systems (beta between 0.10 and 0.44; p < 0.001). When accounting for the physiological increase of BMI with increasing age, the effect of BMI was lower and in the majority of the models no longer clinically relevant. Betas decreased to values between 0.00 and 0.05. When adding feature variables to a model already including age, r2 values increased only minimally. For an overall bone ossification score combining all characteristics, the adjusted ß was 0.11 (p = 0.021) and 0.08 (p = 0.23) for females and males, respectively. Low ß and r2 values (0.00 (adjusted)–0.16 (crude)) were present in both models for third molar development already in the unadjusted analyses. In conclusion, our study found no to little effect of BMI on osseous development in young adults. Teeth development in both sexes was completely independent of BMI. Therefore, dental methods should be part of every age assessment.
Collapse
|
8
|
Oh MS, Kim S, Lee J, Lee MS, Kim YJ, Kang KS. Factors associated with Advanced Bone Age in Overweight and Obese Children. Pediatr Gastroenterol Hepatol Nutr 2020; 23:89-97. [PMID: 31988879 PMCID: PMC6966218 DOI: 10.5223/pghn.2020.23.1.89] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 10/02/2019] [Indexed: 11/14/2022] Open
Abstract
PURPOSE Obese children may often present with advanced bone age. We aimed to evaluate the correlation between factors associated with childhood obesity and advanced bone age. METHODS We enrolled 232 overweight or obese children. Anthropometric and laboratory data, and the degree of nonalcoholic fatty liver disease (NAFLD) were measured. We analyzed factors associated with advanced bone age by measuring the differences between bone and chronological ages. RESULTS The normal and advanced bone age groups were comprised of 183 (78.9%) and 49 (21.1%) children, respectively. The prevalence of advanced bone age significantly increased as the percentiles of height, weight, waist circumference, and body mass index (BMI) increased. BMI z-score was higher in the advanced bone age group than in the normal bone age group (2.43±0.52 vs. 2.10±0.46; p<0.001). The levels of insulin (27.80±26.13 μU/mL vs. 18.65±12.33 μU/mL; p=0.034) and homeostatic model assessment-insulin resistance (6.56±6.18 vs. 4.43±2.93; p=0.037) were significantly higher, while high density lipoprotein-cholesterol levels were lower (43.88±9.98 mg/dL vs. 48.95±10.50 mg/dL; p=0.005) in the advanced bone age group compared to those in the normal bone age group, respectively. The prevalence of advanced bone age was higher in obese children with metabolic syndrome than in those without (28.2% vs. 14.7%; p=0.016). The prevalence of advanced bone age was higher in obese children with a more severe degree of NAFLD. CONCLUSION Advanced bone age is associated with a severe degree of obesity and its complications.
Collapse
Affiliation(s)
- Min-Su Oh
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Sorina Kim
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Juyeon Lee
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Mu Sook Lee
- Division of Diagnostic and Interventional Radiology, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Yoon-Joo Kim
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| | - Ki-Soo Kang
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Korea
| |
Collapse
|
9
|
Martos-Moreno GÁ, Martínez-Villanueva J, González-Leal R, Chowen JA, Argente J. Sex, puberty, and ethnicity have a strong influence on growth and metabolic comorbidities in children and adolescents with obesity: Report on 1300 patients (the Madrid Cohort). Pediatr Obes 2019; 14:e12565. [PMID: 31373441 DOI: 10.1111/ijpo.12565] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/24/2019] [Accepted: 07/05/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The capacity to correctly assess insulin resistance and its role in further obesity-associated metabolic derangement in children is under debate, and its determinants remain largely unknown. OBJECTIVE We investigated the association of the insulin secretion profile with other metabolic derangements and anthropometric features in children and adolescents with obesity, exploring the role of ethnicity. PATIENTS AND METHODS Growth and metabolic features, including fasting insulin levels and insulin secretory profile in an oral glucose tolerance test (OGTT), were analyzed according to ethnicity in 1300 patients with obesity (75.8% Caucasians/19.0% Latinos). RESULTS Height and bone age were influenced by sex, ethnicity, and insulinemia. Latino patients had higher insulin (P < .001), but similar glycemia both prepubertally and postpubertally, compared with Caucasians. Type 2 diabetes was uncommon (0.1%). Impaired glucose tolerance was associated to higher age, BMI, uric acid, and triglyceride levels (all P < .05), as was fasting hyperinsulinism. Impaired fasting glucose or HbA1c 5.7% to 6.4% showed no association with further metabolic derangement. A delayed insulin peak in the OGTT was associated to more severe metabolic disturbances. CONCLUSIONS Obesity-associated hyperglycemia is unusual in our environment whereas fasting and late postprandial hyperinsulinemia are highly prevalent, with this being influenced by race and closely related with lipid metabolism impairment.
Collapse
Affiliation(s)
- Gabriel Á Martos-Moreno
- Department of Endocrinology, Research Institute "La Princesa", Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo, 65E-28009, Madrid, Spain.,Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Julián Martínez-Villanueva
- Department of Endocrinology, Research Institute "La Princesa", Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo, 65E-28009, Madrid, Spain
| | - Rocío González-Leal
- Department of Endocrinology, Research Institute "La Princesa", Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo, 65E-28009, Madrid, Spain
| | - Julie A Chowen
- Department of Endocrinology, Research Institute "La Princesa", Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo, 65E-28009, Madrid, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Jesús Argente
- Department of Endocrinology, Research Institute "La Princesa", Hospital Infantil Universitario Niño Jesús, Avenida Menéndez Pelayo, 65E-28009, Madrid, Spain.,Department of Pediatrics, Universidad Autónoma de Madrid, Madrid, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain.,CEI UAM + CSIC, IMDEA Food Institute, Madrid, Spain
| |
Collapse
|
10
|
Effect of soy on bone turn-over markers in men with type 2 diabetes and hypogonadism - a randomised controlled study. Sci Rep 2017; 7:15366. [PMID: 29133833 PMCID: PMC5684229 DOI: 10.1038/s41598-017-15402-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/26/2017] [Indexed: 11/18/2022] Open
Abstract
Type 2 diabetes (T2DM) is associated with increased risk of fractures. Soy supplementation has been shown to have a beneficial effect on bone turnover markers (BTM) in postmenopausal women. However, the effect of soy supplementation on BTM in T2DM and particularly in men is unclear. We performed an analysis of a randomized double blind parallel study of 200 men with T2DM treated with soy, either with or without isoflavones. Outcome measures were type I collagen crosslinked beta C-telopeptide (βCTX), and type 1 procollagen-N-propeptide (P1NP). The men, with a total testosterone <12 nmol/L, were treated with 15 g soy protein containing 66 mg of isoflavones (SPI) or 15 g soy protein alone without isoflavones (SP) daily for three months. There was a 15% reduction in βCTX after three months of SPI compared to SP supplementation. There was no significant difference in P1NP with either SPI or SP supplementation. There was a significant linear correlation between the reduction in βCTX in the SPI group with the reduction in HbA1c (r2 = 0.42; p = 0.04) and HOMA-IR (r2 = 0.54; p = 0.02). Our study indicates that there was a significant reduction in bone resorption following 3 months of SPI supplementation that correlated with an improvement of glycemic control in men with T2DM.
Collapse
|
11
|
de Groot CJ, van den Berg A, Ballieux BE, Kroon HM, Rings EH, Wit JM, van den Akker EL. Determinants of Advanced Bone Age in Childhood Obesity
. Horm Res Paediatr 2017; 87:254-263. [PMID: 28365712 PMCID: PMC5637288 DOI: 10.1159/000467393] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 03/01/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Childhood obesity is associated with advanced bone age (BA). Previous studies suggest that androgens, oestrogens, sex hormone-binding globulin, and insulin are responsible for this phenomenon, but results are contradictory and might be biased by confounders. We aim to elucidate this matter by applying a multivariate approach. METHOD We performed a correlation analysis of BA standard deviation score (SDS) with age- and sex-specific SDS for androgens, oestrogens, and with indicators of insulin secretion derived from oral glucose tolerance testing, in a group of obese children. A multivariate analysis was performed to investigate which parameters were independently predictive of BA SDS. RESULTS In this cohort (n = 101; mean age 10.9 years; mean BA 11.8 years; mean BMI SDS 3.3), BMI SDS was significantly correlated to BA SDS (r = 0.55, p < 0.001). In a regression analysis in the total cohort (B = 0.27, p < 0.001) as well as in females (B = 0.34, p = 0.042), males (B = 0.31, p = 0.006), and pubertal children (B = 0.32, p = 0.046), dehydroepiandrosterone sulphate (DHEAS) showed a positive, independent association with BA SDS. No association with indicators of insulin secretion was found. CONCLUSION BMI SDS is highly correlated to BA SDS in obese children. Increased DHEAS has a central role in advanced BA in obese children.
.
Collapse
Affiliation(s)
- Cornelis J. de Groot
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands,*Cornelis J. de Groot, Willem-Alexander Children's Hospital, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, NL–2300 RC Leiden (Netherlands), E-Mail
| | - Adriaan van den Berg
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands
| | - Bart E.P.B. Ballieux
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Herman M. Kroon
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Edmond H.H.M. Rings
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands,Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jan M. Wit
- Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands
| | | |
Collapse
|
12
|
Viljakainen HT, Koistinen HA, Tervahartiala T, Sorsa T, Andersson S, Mäkitie O. Metabolic milieu associates with impaired skeletal characteristics in obesity. PLoS One 2017. [PMID: 28640843 PMCID: PMC5480955 DOI: 10.1371/journal.pone.0179660] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
High leptin concentration, low-grade inflammation, and insulin resistance often coexist in obese subjects; this adverse metabolic milieu may be the main culprit for increased fracture risk and impaired bone quality seen in patients with type 2 diabetes. We examined the associations of leptin, hs (high sensitivity)- CRP and insulin resistance with bone turnover markers (BTMs) and bone characteristics in 55 young obese adults (median BMI 40 kg/m2) and 65 non-obese controls. Mean age of the subjects was 19.5 ± 2.5 years (mean ± SD). Concentrations of leptin, adiponectin, hs-CRP, MMP-8 and TIMP-1, fasting plasma glucose and insulin (to calculate HOMA), BTMs (BAP, P1NP, CTX-1, and TRAC5b) were measured. Bone characteristics were determined with pQCT at radius and tibia, and with DXA for central sites. Leptin, hs-CRP and HOMA correlated inversely with BTMs: the partial coefficients were 1.5–1.9 fold higher in males than in females. After adjusting for age, BMI, and other endocrine factors, leptin displayed an independent effect in males on radial bone mass (p = 0.019), tibial trabecular density (p = 0.025) and total hip BMD (p = 0.043), with lower densities in males with high leptin. In females, the model adjusting for age, BMI, and other endocrine factors, revealed that hs-CRP had independent effects on radial bone mass (p = 0.034) and lumbar spine BMD (p = 0.016), women with high hs-CRP having lower values. Partial correlations of adiponectin and TIMP-1 with bone characteristics were discrepant; MMP-8 showed no associations. In conclusion, in young obese adults and their controls, leptin, hs-CRP and HOMA associate inversely with BTMs and bone characteristics. Leptin appears to be the key independent effector in males, whereas hs-CRP displayed a predominant role in females.
Collapse
Affiliation(s)
- Heli T. Viljakainen
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- * E-mail:
| | - Heikki A. Koistinen
- Department of Medicine and Abdominal Center: Endocrinology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
- Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
13
|
Verroken C, Zmierczak HG, Goemaere S, Kaufman JM, Lapauw B. Insulin Resistance Is Associated With Smaller Cortical Bone Size in Nondiabetic Men at the Age of Peak Bone Mass. J Clin Endocrinol Metab 2017; 102:1807-1815. [PMID: 28001453 DOI: 10.1210/jc.2016-3609] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/19/2016] [Indexed: 01/27/2023]
Abstract
CONTEXT In type 2 diabetes mellitus, fracture risk is increased despite preserved areal bone mineral density. Although this apparent paradox may in part be explained by insulin resistance affecting bone structure and/or material properties, few studies have investigated the association between insulin resistance and bone geometry. OBJECTIVE We aimed to explore this association in a cohort of nondiabetic men at the age of peak bone mass. DESIGN, SETTING, AND PARTICIPANTS Nine hundred ninety-six nondiabetic men aged 25 to 45 years were recruited in a cross-sectional, population-based sibling pair study at a university research center. MAIN OUTCOME MEASURES Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR), with insulin and glucose measured from fasting serum samples. Bone geometry was assessed using peripheral quantitative computed tomography at the distal radius and the radial and tibial shafts. RESULTS In age-, height-, and weight-adjusted analyses, HOMA-IR was inversely associated with trabecular area at the distal radius and with cortical area, periosteal and endosteal circumference, and polar strength strain index at the radial and tibial shafts (β ≤ -0.13, P < 0.001). These associations remained essentially unchanged after additional adjustment for dual-energy X-ray absorptiometry-derived body composition, bone turnover markers, muscle size or function measurements, or adiponectin, leptin, insulin-like growth factor 1, or sex steroid levels. CONCLUSION In this cohort of nondiabetic men at the age of peak bone mass, insulin resistance is inversely associated with trabecular and cortical bone size. These associations persist after adjustment for body composition, muscle size or function, or sex steroid levels, suggesting an independent effect of insulin resistance on bone geometry.
Collapse
Affiliation(s)
- Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hans-Georg Zmierczak
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jean-Marc Kaufman
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| |
Collapse
|