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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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Tubic B, Magnusson P, Mårild S, Leu M, Schwetz V, Sioen I, Herrmann D, Obermayer-Pietsch B, Lissner L, Swolin-Eide D. Different osteocalcin forms, markers of metabolic syndrome and anthropometric measures in children within the IDEFICS cohort. Bone 2016; 84:230-236. [PMID: 26772621 DOI: 10.1016/j.bone.2016.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/11/2015] [Accepted: 01/05/2016] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Osteocalcin (OC), an aboundant non-collagenous bone protein, is inversely associated with parameters of glucose metabolism. Interactions between bone tissue and energy metabolism have not been thoroughly investigated during childhood. This study investigated OC, metabolic parameters and anthropometric characteristics in normal weight and overweight/obese children. METHODS This study comprised 108 (46 normal weight/62 overweight/obese) Swedish 2-9year old children. Anthropometric data, insulin, glucose, glycosylated haemoglobin (HbA1c), HOMA index, vitamin D, adiponectin, total OC, carboxylated OC (cOC) and undercarboxylated OC (ucOC) were analysed. RESULTS No difference was found for total OC between the normal and overweight/obese groups, with a mean (±SD) value of 82.6 (±2.8) ng/mL and 77.0 (±2.4) ng/mL, (P=0.11), respectively. Overweight children had lower cOC levels, mean 69.1 (±2.2) ng/mL, vs. normal weight children, mean 75.6 (±2.5) ng/mL (P=0.03). The mean ucOC levels of 7.9 (±0.4) ng/mL in overweight children did not differ vs. normal weight children, mean level 7.0 (±0.4) ng/mL, (P=0.067). None of the three OC forms correlated with any of the measured parameters. CONCLUSIONS The cOC levels were lower in overweight children. There was no correlation between the three OC forms and any of the measured anthropometric or metabolic parameters. OC has been suggested to have a possible metabolic role, but in general the current study in prepubertal children does not support the hypothesis of an association between OC and a positive metabolic profile.
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Affiliation(s)
- Bojan Tubic
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, SE-416 85 Göteborg, Sweden.
| | - Per Magnusson
- Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, SE-581 85, Linköping, Sweden.
| | - Staffan Mårild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, SE-416 85 Göteborg, Sweden.
| | - Monica Leu
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Box 454, SE-405 30 Göteborg, Sweden.
| | - Verena Schwetz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, A-8036, Graz, Austria.
| | - Isabelle Sioen
- Department of Public Health, Ghent University, De Pintelaan 185, B-9000 Gent, Belgium; Research Foundation, Flanders, Brussels, Belgium.
| | - Diana Herrmann
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstr. 30, DE-28359, Bremen, Germany.
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, A-8036, Graz, Austria.
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Box 454, SE-405 30 Göteborg, Sweden.
| | - Diana Swolin-Eide
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, SE-416 85 Göteborg, Sweden.
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Holvik K, van Schoor NM, Eekhoff EMW, den Heijer M, Deeg DJH, Lips P, de Jongh R. Plasma osteocalcin levels as a predictor of cardiovascular disease in older men and women: a population-based cohort study. Eur J Endocrinol 2014; 171:161-70. [PMID: 24801588 DOI: 10.1530/eje-13-1044] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The role of osteocalcin (OC) in cardiovascular disease (CVD) is unresolved. We aimed to study the association between plasma OC concentrations and the risk of non-fatal and fatal CVDs. We also aimed to investigate whether such an association, if present, would be mediated by established metabolic risk factors. DESIGN A population-based longitudinal cohort study. METHODS In 1995/1996, OC was determined in blood samples drawn from 1319 subjects aged 65-88 years participating in the Longitudinal Aging Study Amsterdam in 1995/1996. The self-reported CVD events were collected every 3 years until 2005/2006, and CVD deaths until 1st January 2007. Cox proportional hazards regression was performed, considering potential confounders (smoking, physical activity, and BMI) and mediators (blood pressure, plasma triglycerides, total and HDL cholesterol, fructosamine, and aortic calcification). RESULTS During the median 4.1 years follow-up, 709 subjects (53.8%) suffered a CVD event. There was no overall association between OC and CVD: hazard ratio (HR) was 0.97 (95% CI 0.90-1.04) per nmol/l higher plasma OC, adjusted for age and sex. There was a statistical interaction between plasma OC, age, and sex on CVD (P=0.014). In those subjects aged ≥75 years, age-adjusted HRs (95% CI) were 0.86 (0.75-0.99) in men and 1.16 (1.03-1.31) in women per nmol/l higher plasma OC. Adjustment for covariates only slightly attenuated the association in older-old men, but did not affect the association in older-old women. CONCLUSION A higher plasma OC concentration was associated with a reduced risk of CVD in older-old men and with an increased risk of CVD in older-old women. We found no evidence that this was mediated by arterial calcification or metabolic risk factors.
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Affiliation(s)
- Kristin Holvik
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The NetherlandsDivision of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Elisabeth M W Eekhoff
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Martin den Heijer
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Lips
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Renate de Jongh
- Division of EpidemiologyNorwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, NorwayDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care ResearchEndocrine SectionDepartment of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Straub RH. Interaction of the endocrine system with inflammation: a function of energy and volume regulation. Arthritis Res Ther 2014; 16:203. [PMID: 24524669 PMCID: PMC3978663 DOI: 10.1186/ar4484] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
During acute systemic infectious disease, precisely regulated release of energy-rich substrates (glucose, free fatty acids, and amino acids) and auxiliary elements such as calcium/phosphorus from storage sites (fat tissue, muscle, liver, and bone) are highly important because these factors are needed by an energy-consuming immune system in a situation with little or no food/water intake (sickness behavior). This positively selected program for short-lived infectious diseases is similarly applied during chronic inflammatory diseases. This review presents the interaction of hormones and inflammation by focusing on energy storage/expenditure and volume regulation. Energy storage hormones are represented by insulin (glucose/lipid storage and growth-related processes), insulin-like growth factor-1 (IGF-1) (muscle and bone growth), androgens (muscle and bone growth), vitamin D (bone growth), and osteocalcin (bone growth, support of insulin, and testosterone). Energy expenditure hormones are represented by cortisol (breakdown of liver glycogen/adipose tissue triglycerides/muscle protein, and gluconeogenesis; water retention), noradrenaline/adrenaline (breakdown of liver glycogen/adipose tissue triglycerides, and gluconeogenesis; water retention), growth hormone (glucogenic, lipolytic; has also growth-related aspects; water retention), thyroid gland hormones (increase metabolic effects of adrenaline/noradrenaline), and angiotensin II (induce insulin resistance and retain water). In chronic inflammatory diseases, a preponderance of energy expenditure pathways is switched on, leading to typical hormonal changes such as insulin/IGF-1 resistance, hypoandrogenemia, hypovitaminosis D, mild hypercortisolemia, and increased activity of the sympathetic nervous system and the renin-angiotensin-aldosterone system. Though necessary during acute inflammation in the context of systemic infection or trauma, these long-standing changes contribute to increased mortality in chronic inflammatory diseases.
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Finnerty CC, Ali A, McLean J, Benjamin N, Clayton RP, Andersen CR, Mlcak RP, Suman OE, Meyer W, Herndon DN. Impact of stress-induced diabetes on outcomes in severely burned children. J Am Coll Surg 2014; 218:783-95. [PMID: 24655871 DOI: 10.1016/j.jamcollsurg.2014.01.038] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 01/16/2014] [Indexed: 01/04/2023]
Abstract
BACKGROUND Post-burn hyperglycemia leads to graft failure, multiple organ failure, and death. A hyperinsulinemic-euglycemic clamp is used to keep serum glucose between 60 and 110 mg/dL. Because of frequent hypoglycemic episodes, a less-stringent sliding scale insulin protocol is used to maintain serum glucose levels between 80 and 160 mg/dL after elevations >180 mg/dL. STUDY DESIGN We randomized pediatric patients with massive burns into 2 groups, patients receiving sliding scale insulin to lower blood glucose levels (n = 145) and those receiving no insulin (n = 98), to determine the differences in morbidity and mortality. Patients 0 to 18 years old with burns covering ≥ 30% of the total body surface area and not randomized to receive anabolic agents were included in this study. End points included glucose levels, infections, resting energy expenditure, lean body mass, bone mineral content, fat mass, muscle strength, and serum inflammatory cytokines, hormones, and liver enzymes. RESULTS Maximal glucose levels occurred within 6 days of burn injury. Blood glucose levels were age dependent, with older children requiring more insulin (p < 0.05). Daily maximum and daily minimum, but not 6 am, glucose levels were significantly different based on treatment group (p < 0.05). Insulin significantly increased resting energy expenditure and improved bone mineral content (p < 0.05). Each additional wound infection increased incidence of hyperglycemia (p = 0.004). There was no mortality in patients not receiving insulin, only in patients who received insulin (p < 0.004). Muscle strength was increased in patients receiving insulin (p < 0.05). CONCLUSIONS Burn-induced hyperglycemia develops in a subset of severely burned children. Length of stay was reduced in the no insulin group, and there were no deaths in this group. Administration of insulin positively impacted bone mineral content and muscle strength, but increased resting energy expenditure, hypoglycemic episodes, and mortality. New glucose-lowering strategies might be needed.
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Affiliation(s)
- Celeste C Finnerty
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX; Institute for Translational Sciences, University of Texas Medical Branch, Galveston, TX; Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston, TX.
| | - Arham Ali
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Josef McLean
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Nicole Benjamin
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Robert P Clayton
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Clark R Andersen
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Ronald P Mlcak
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX
| | - Oscar E Suman
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | - Walter Meyer
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX
| | - David N Herndon
- Shriners Hospitals for Children-Galveston, University of Texas Medical Branch, Galveston, TX; Department of Surgery, University of Texas Medical Branch, Galveston, TX
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Abstract
Increasing evidence supports an association between the skeleton and energy metabolism. These interactions are mediated by a variety of hormones, cytokines and nutrients. Here, the evidence for a role of osteocalcin in the regulation of glucose metabolism in humans is reviewed. Osteocalcin is a bone matrix protein that regulates hydroxyapatite size and shape through its vitamin-K-dependent, γ-carboxylated form. The concentration of osteocalcin in the circulation is a measure of bone formation. The undercarboxylated form of osteocalcin is active in glucose metabolism in mice. Total serum osteocalcin concentrations in humans are inversely associated with measures of glucose metabolism; however, human data are inconclusive with regard to the role of uncarboxylated osteocalcin in glucose metabolism because most studies do not account for the influence of vitamin K on the proportion of undercarboxylated osteocalcin or differentiate between the total and uncarboxylated forms of osteocalcin. Furthermore, most human studies do not concomitantly measure other bone turnover markers to isolate the role of osteocalcin as a measure of bone formation from its effect on glucose metabolism. Carefully designed studies are required to define the role of osteocalcin and its carboxylated or undercarboxylated forms in the regulation of glucose metabolism in humans.
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Affiliation(s)
- Sarah L Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA 02111, USA.
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