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Al-Daghri NM, Wani K, Khattak MNK, Alnaami AM, Al-Saleh Y, Sabico S. The single point insulin sensitivity estimator (SPISE) is associated with bone health in Arab adults. Aging Clin Exp Res 2024; 36:136. [PMID: 38904881 PMCID: PMC11192813 DOI: 10.1007/s40520-024-02789-5] [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: 03/10/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND The Single Point Insulin Sensitivity Estimator (SPISE) index is a surrogate marker for insulin sensitivity. Given the emerging role of bone as an active endocrine organ, its associations with non-invasive measures of extra-skeletal functions such as insulin sensitivity warrant investigation. AIMS This study aimed to explore the relationship between the SPISE index and Bone Mineral Density (BMD) in an adult population. METHODS Data from a total of 1270 Arab adults (84% females, mean age 56.7 ± 8.1 years) from the Osteoporosis Registry Database of the Chair for Biomarkers of Chronic Diseases in King Saud University, Riyadh, Saudi Arabia was used in this study. T-scores and SPISE were calculated. Regression models were used to determine associations between SPISE and bone health indices. RESULTS The low BMD group (N = 853; T-score <-1.0) had significantly higher SPISE values than those with normal BMD (N = 417; T-score - 1.0 and above) (4.6 ± 1.3 vs. 4.3 ± 1.2, p < 0.001). Multivariate linear regression, adjusted for covariates, confirmed a significant inverse association between SPISE and BMD for all participants (β=-0.22, p < 0.001), as well as both groups [normal BMD (β = -0.10, p = 0.02) and low BMD groups (β = -0.15, p < 0.001)]. SPISE, family history of T2DM, and history of fractures collectively account for 17% of the variances perceived in T-score for all participants (p < 0.001). CONCLUSIONS A significant inverse association between the SPISE index and BMD was observed in adults, suggesting a link between BMD and extra-skeletal health. Underlying mechanisms need to be investigated prospectively using BMD as secondary outcomes in lifestyle modification programs.
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Affiliation(s)
- Nasser M Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia.
| | - Kaiser Wani
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Malak N K Khattak
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Abdullah M Alnaami
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Yousef Al-Saleh
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
- Department of Medicine, Health Oasis Hospital, Riyadh, Saudi Arabia
| | - Shaun Sabico
- Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
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Czeck MA, Juckett WT, Kelly AS, Dengel DR. Muscle-to-Bone and Soft Tissue-to-Bone Ratio in Children and Adolescents with Obesity. J Clin Densitom 2023; 26:101360. [PMID: 36931949 PMCID: PMC10175141 DOI: 10.1016/j.jocd.2023.02.001] [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: 01/11/2023] [Revised: 01/31/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES To explore the total and regional muscle-to-bone ratio in children and adolescents with obesity and compare the muscle-to-bone ratio (MBR) and soft tissue-to-bone ratio (SBR) to their peers with normal weight or overweight. STUDY DESIGN A total of 219 male and female pediatrics (mean age=12.3±2.5 years) participated in this study. Body composition was assessed with a total body dual X-ray absorptiometry. The MBR was calculated by dividing lean mass by bone mineral content. The SBR was determined by dividing the soft tissue mass (i.e., lean mass+fat mass) by bone mineral content. Differences in total and regional body composition measures between body mass index (BMI) percentile groups was assessed by ANOVA. RESULTS The obesity group had significantly higher MBR compared to the normal weight group for total (19.24±1.56 vs. 18.26±1.64), arm (17.11±1.67 vs. 15.88±1.81), and leg (18.41±1.68 vs. 16.62±1.55). Similarly, the obesity group had significantly higher MBR in the leg (18.41±1.68) compared to the overweight group (17.24±1.45). However, the overweight group was not significantly different from the normal weight or the obesity group for total and arm MBR. The total, arm, and leg SBR was significantly different between all BMI groups. Across the entire sample, MBR and SBR were negatively associated with high-density lipoprotein. SBR was positively associated with insulin, HOMA-IR, low-density lipoprotein, very low-density lipoprotein, triglycerides, and systolic blood pressure. CONCLUSIONS Children with obesity had a higher MBR and SBR compared to their normal weight peers. In addition, there were significant associations between SBR, higher levels of insulin, atherogenic lipoproteins, and increased systolic blood pressure. Thus, SBR may be useful as a marker for increased cardiometabolic disease risk, though more research in this area is warranted.
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Affiliation(s)
- Madeline A Czeck
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, United States.
| | - William T Juckett
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, United States
| | - Aaron S Kelly
- Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN 55414, United States; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, United States
| | - Donald R Dengel
- School of Kinesiology, University of Minnesota, Minneapolis, MN 55455, United States; Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, MN 55414, United States; Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, United States
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Xia Y, Yang HC, Zhang K, Tian JJ, Li ZF, Yu EM, Li HY, Gong WB, Xie WP, Wang GJ, Xie J. Berberine regulates glucose metabolism in largemouth bass by modulating intestinal microbiota. Front Physiol 2023; 14:1147001. [PMID: 36969581 PMCID: PMC10033662 DOI: 10.3389/fphys.2023.1147001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/24/2023] [Indexed: 03/11/2023] Open
Abstract
This study examined the role of intestinal microbiota in berberine (BBR)-mediated glucose (GLU) metabolism regulation in largemouth bass. Four groups of largemouth bass (133.7 ± 1.43 g) were fed with control diet, BBR (1 g/kg feed) supplemented diet, antibiotic (ATB, 0.9 g/kg feed) supplemented diet and BBR + ATB (1g/kg feed +0.9 g/kg feed) supplemented diet for 50 days. BBR improved growth, decreased the hepatosomatic and visceral weight indices, significantly downregulated the serum total cholesterol and GLU levels, and significantly upregulated the serum total bile acid (TBA) levels. The hepatic hexokinase, pyruvate kinase, GLU-6-phosphatase and glutamic oxalacetic transaminase activities in the largemouth bass were significantly upregulated when compared with those in the control group. The ATB group exhibited significantly decreased final bodyweight, weight gain, specific growth rates and serum TBA levels, and significantly increased hepatosomatic and viscera weight indices, hepatic phosphoenolpyruvate carboxykinase, phosphofructokinase, and pyruvate carboxylase activities, and serum GLU levels. Meanwhile, the BBR + ATB group exhibited significantly decreased final weight, weight gain and specific growth rates, and TBA levels and significantly increased hepatosomatic and viscera weight indices and GLU levels. High-throughput sequencing revealed that compared with those in the control group, the Chao one index and Bacteroidota contents were significantly upregulated and the Firmicutes contents were downregulated in the BBR group. Additionally, the Shannon and Simpson indices and Bacteroidota levels were significantly downregulated, whereas the Firmicutes levels were significantly upregulated in ATB and BBR + ATB groups. The results of in-vitro culture of intestinal microbiota revealed that BBR significantly increased the number of culturable bacteria. The characteristic bacterium in the BBR group was Enterobacter cloacae. Biochemical identification analysis revealed that E. cloacae metabolizes carbohydrates. The size and degree of vacuolation of the hepatocytes in the control, ATB, and ATB + BBR groups were higher than those in the BBR group. Additionally, BBR decreased the number of nuclei at the edges and the distribution of lipids in the liver tissue. Collectively, BBR reduced the blood GLU level and improved GLU metabolism in largemouth bass. Comparative analysis of experiments with ATB and BBR supplementation revealed that BBR regulated GLU metabolism in largemouth bass by modulating intestinal microbiota.
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Affiliation(s)
- Yun Xia
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Hui-Ci Yang
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Kai Zhang
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Jing-Jing Tian
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Zhi-Fei Li
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Er-Meng Yu
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Hong-Yan Li
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Wang-Bao Gong
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Wen-Ping Xie
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
| | - Guang-Jun Wang
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
- *Correspondence: Guang-Jun Wang, ; Jun Xie,
| | - Jun Xie
- Key Laboratory of Tropical and Subtropical Fishery Resource Application and Cultivation, Ministry of Agriculture, Pearl River Fisheries Research Institute, Chinese Academy of Fishery Sciences, Guangzhou, China
- Hainan Fisheries Innovation Research Institute, Chinese Academy of Fishery Sciences, Sanya, China
- *Correspondence: Guang-Jun Wang, ; Jun Xie,
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Mengel E, Tamme R, Remmel L, Purge P, Mäestu E, Jürimäe J, Tillmann V. Pubertal increment in insulin resistance is negatively related to lumbar bone mineral density in 18-year-old males. Osteoporos Int 2023; 34:161-170. [PMID: 36367566 DOI: 10.1007/s00198-022-06591-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022]
Abstract
UNLABELLED Transient insulin resistance seen during puberty is expected to favour body growth, but our results show that increment in insulin resistance even in physiological ranges during puberty might compromise lumbar spine bone mineral density accrual independently of body composition parameters, and therefore adult bone quality might be challenged. INTRODUCTION Insulin resistance (IR) might have a compromising effect on growing bone, and therefore adult bone quality might be challenged. The aim of the present study was to identify whether increases in IR during puberty contribute to bone mineral characteristics in males independently of body composition parameters. METHODS This is a retrospective cohort-based longitudinal observational study. Data from 85 subjects were included. Boys were studied annually during their pubertal years (12 years at baseline) and at follow-up at the age of 18 years. Anthropometry, bone age, fasting blood samples, body composition, total body, and lumbar spine bone mineral characteristics were measured. Insulin resistance was determined by homeostatic model assessment of IR (HOMA-IR). Multiple regression analysis was performed to determine the effect of changes in HOMA-IR during pubertal years as a longitudinal predictor to fixed bone mineral outcome variables at the age of 18 years. All models were adjusted to potential clinically justified confounding variables. RESULTS After adjustment to baseline bone indices and body composition-related predictors, the pubertal increment in the HOMA-IR was a negative independent predictor of lumbar spine bone mineral areal density (β = - 0.202, p = 0.005) and lumbar spine bone mineral apparent density (β = - 0.235, p = 0.005) in 18-year-old males. CONCLUSIONS Pubertal increment in IR has a potential diminishing effect on lumbar spine bone mineral density accrual independently of body composition parameters. Further studies are needed to clarify whether monitoring HOMA-IR during puberty may identify subjects at increased risk of low peak bone mass and possible osteoporosis in the future.
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Affiliation(s)
- Eva Mengel
- Institute of Clinical Medicine, University of Tartu, 51007, Tartu, Estonia.
- Tartu Health Care College, 50411, Tartu, Estonia.
| | - Reeli Tamme
- Institute of Clinical Medicine, University of Tartu, 51007, Tartu, Estonia
- Children's Clinic of Tartu University Hospital, 50406, Tartu, Estonia
| | - Liina Remmel
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Priit Purge
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Evelin Mäestu
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Vallo Tillmann
- Institute of Clinical Medicine, University of Tartu, 51007, Tartu, Estonia
- Children's Clinic of Tartu University Hospital, 50406, Tartu, Estonia
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Alfahal AO, Ali AE, Modawe GO, Doush WM. Association between serum lipid profile, body mass index and osteoporosis in postmenopausal Sudanese women. Afr Health Sci 2022; 22:399-406. [PMID: 36910383 PMCID: PMC9993279 DOI: 10.4314/ahs.v22i3.43] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Epidemiological observations suggest links between osteoporosis and the risk of acute cardiovascular events. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. The reduction of bone density and osteoporosis in postmenopausal women contributes to elevated lipid parameters and body mass index (BMI). Objective To investigate the relationship between serum lipid profile, BMI and osteoporosis in postmenopausal women. Materials and Methods A prospective analytical case control-study conducted in Khartoum north hospital at Khartoum city, capital of the Sudan from April 2017 to March 2018 after ethical approval obtained from the local Research Ethics Committee of Faculty of Medical Laboratories, Alzaeim Alazhary University on the committee meeting number (109) on Wednesday 15th February 2017. A written informed consent was obtained from all participants to participate in the study.Two hundred postmenopausal women were enrolled in the study. The age was studied in one hundred osteoporosis postmenopausal women as a case group and one hundred non-osteoporosis postmenopausal women as control group. The serum lipid profiles were estimated using spectrophotometers (Mandry) and BMI calculated using Quetelet index formula. The data were analysed using SPSS version 16. Results The BMI, serum total cholesterol, triglyceride, HDL and LDL in case group respectively were (24.846±2.1647, 251.190±27.0135 mg/dl, 168.790 ±45.774 mg/dl, 50.620 ± 7.174 mg/dl, 166.868 ±28.978 mg/dl). While the BMI, serum total cholesterol, triglyceride, HDL and LDL in control group respectively were (25.378 ±3.8115, 187.990 ± 26.611 mg/dl, 139.360±20.290 mg/dl, 49.480 ±4.659 mg/dl, 111.667 ±28.0045 mg/dl). All serum lipid profiles significantly increased (p=0.000) in the case group compared to the control group, except serum HDL was insignificant different between the case and control group and also BMI was insignificant different between the case and control group. There was a positive Pearson's correlation between BMD and serum total cholesterol (r= 0.832, P<0.01), serum LDL (r = 0.782, P<0.01) and serum triglyceride (r = 0.72, P<0.01). Conclusions Osteoporotic postmenopausal women had a significant increase in serum lipid profile and BMI. Moreover, we found a positive link between women with cardiovascular diseases and stroke.
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Affiliation(s)
- Asgad Osman Alfahal
- AlzaiemAlazhari University, College of Medical Laboratory Sciences, Department of Clinical Chemistry, Khartoum, Sudan
| | - Abdalla Eltoum Ali
- AlzaiemAlazhari University, College of Medical Laboratory Sciences, Department of Clinical Chemistry, Khartoum, Sudan
| | - Gadallah Osman Modawe
- Omdurman Islamic University, Faculty of Medicine and Health Sciences, Department of Biochemistry, Khartoum, Sudan
| | - Wael Mohialddin Doush
- Omdurman Islamic University, Faculty of Medicine and Health Sciences, Department of Surgery, Khartoum, Sudan
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Anagnostis P, Florentin M, Livadas S, Lambrinoudaki I, Goulis DG. Bone Health in Patients with Dyslipidemias: An Underestimated Aspect. Int J Mol Sci 2022; 23:ijms23031639. [PMID: 35163560 PMCID: PMC8835770 DOI: 10.3390/ijms23031639] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 02/04/2023] Open
Abstract
Beyond being aging-related diseases, atherosclerosis and osteoporosis share common pathogenetic pathways implicated in bone and vascular mineralization. However, the contributory role of dyslipidemia in this interplay is less documented. The purpose of this narrative review is to provide epidemiological evidence regarding the prevalence of bone disease (osteoporosis, fracture risk) in patients with dyslipidemias and to discuss potential common pathophysiological mechanisms linking osteoporosis and atherosclerosis. The effect of hypolipidemic therapy on bone metabolism is also discussed. Despite the high data heterogeneity and the variable quality of studies, dyslipidemia, mainly elevated total and low-density lipoprotein cholesterol concentrations, is associated with low bone mass and increased fracture risk. This effect may be mediated directly by the increased oxidative stress and systemic inflammation associated with dyslipidemia, leading to increased osteoclastic activity and reduced bone formation. Moreover, factors such as estrogen, vitamin D and K deficiency, and increased concentrations of parathyroid hormone, homocysteine and lipid oxidation products, can also contribute. Regarding the effect of hypolipidemic medications on bone metabolism, statins may slightly increase BMD and reduce fracture risk, although the evidence is not robust, as it is for omega-3 fatty acids. No evidence exists for the effects of ezetimibe, fibrates, and niacin. In any case, more prospective studies are needed further to elucidate the association between lipids and bone strength.
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Affiliation(s)
- Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece;
- Correspondence: ; Tel.: +30-2310-257150; Fax: +30-2310-281179
| | - Matilda Florentin
- Department of Internal Medicine, University Hospital of Ioannina, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece;
| | | | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece;
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, 56429 Thessaloniki, Greece;
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Fu YH, Liu WJ, Lee CL, Wang JS. Associations of insulin resistance and insulin secretion with bone mineral density and osteoporosis in a general population. Front Endocrinol (Lausanne) 2022; 13:971960. [PMID: 36204101 PMCID: PMC9530363 DOI: 10.3389/fendo.2022.971960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022] Open
Abstract
We investigated the associations of insulin resistance and β-cell secretion with bone mineral density (BMD) and osteoporosis using data from the National Health and Nutrition Examination Survey. Data on BMD assessed using dual-energy x-ray absorptiometry from 5292 participants were analyzed. Insulin resistance and β-cell secretion were assessed using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and β-cell function (HOMA-β), respectively. We divided the study population into four groups according to HOMA-IR (<2 vs. ≥ 2) and HOMA-β (<100 vs. ≥ 100). BMD and T score at the lumbar spine, hip joint, and femur were used for analyses. Osteoporosis was defined as a T score ≤ -2.5. Logistic regression analyses were conducted to examine the associations of HOMA-IR and HOMA-β with osteoporosis, and the joint effects of HOMA-IR and HOMA-β on osteoporosis. We found a positive association between HOMA-IR and osteoporosis in participants with a HOMA-β ≥ 100 (OR 8.773, 95% CI 2.160-35.637, p=0.002 at the femoral neck). A negative association between HOMA-β and osteoporosis was noted in those with a HOMA-IR <2 (OR 0.183, 95% CI 0.038-0.882, p=0.034 at the femoral neck). Compared with participants who had HOMA-IR <2 and HOMA-β <100, those with HOMA-IR <2 and HOMA-β ≥ 100 had a lower risk of osteoporosis (OR 0.126, 95% CI 0.020-0.805, p=0.032 at the femoral neck). In conclusion, the association between HOMA-β and BMD/osteoporosis changed as HOMA-IR increased. HOMA-β was negatively associated with osteoporosis when HOMA-IR <2. The association was not significant when HOMA-IR ≥ 2.
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Affiliation(s)
- Yi-Hsiu Fu
- Department of Education, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Wei-Ju Liu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chia-Lin Lee
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- *Correspondence: Jun-Sing Wang, ; Chia-Lin Lee,
| | - Jun-Sing Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Rong Hsing Research Center for Translational Medicine, Institute of Biomedical Science, National Chung Hsing University, Taichung, Taiwan
- *Correspondence: Jun-Sing Wang, ; Chia-Lin Lee,
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Constable AM, Vlachopoulos D, Barker AR, Moore SA, Soininen S, Haapala EA, Väistö J, Jääskeläinen J, Voutilainen R, Auriola S, Häkkinen MR, Laitinen T, Lakka TA. The Mediating Role of Endocrine Factors in the Positive Relationship Between Fat Mass and Bone Mineral Content in Children Aged 9-11 Years: The Physical Activity and Nutrition in Children Study. Front Endocrinol (Lausanne) 2022; 13:850448. [PMID: 35399927 PMCID: PMC8987010 DOI: 10.3389/fendo.2022.850448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION We aimed to investigate whether the relationship between fat mass and bone mineral content (BMC) is mediated by insulin, leptin, adiponectin, dehydroepiandrosterone sulphate, testosterone and estradiol in children aged 9-11 years. MATERIALS AND METHODS We utilised cross-sectional data from the Physical Activity and Nutrition in Children study (n = 230 to 396; 112 to 203 girls). Fat mass and BMC were assessed with dual-energy X-ray absorptiometry. Endocrine factors were assessed from fasted blood samples. We applied the novel 4-way decomposition method to analyse associations between fat mass, endocrine factors, and BMC. RESULTS Fat mass was positively associated with BMC in girls (ß = 0.007 to 0.015, 95% confidence interval (CI) 0.005 to 0.020) and boys (ß = 0.009 to 0.015, 95% CI 0.005 to 0.019). The relationship between fat mass and BMC was mediated by free leptin index in girls (ß = -0.025, 95% CI -0.039 to -0.010) and boys (ß = -0.014, 95% CI -0.027 to -0.001). The relationship between fat mass and BMC was partially explained by mediated interaction between fat mass and free leptin index in boys (ß = -0.009, 95% CI -0.013 to -0.004) and by interaction between fat mass and adiponectin in girls (ß = -0.003, 95% CI -0.006 to -0.000). CONCLUSION At greater levels of adiponectin and free leptin index, the fat mass and BMC relationship becomes less positive in girls and boys respectively. The positive association between fat mass with BMC was largely not explained by the endocrine factors we assessed. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/ct2/show/NCT01803776], identifier NCT01803776.
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Affiliation(s)
- Annie M. Constable
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- *Correspondence: Annie M. Constable,
| | - Dimitris Vlachopoulos
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom
| | - Alan R. Barker
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom
| | - Sarah A. Moore
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Sonja Soininen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Social and Health Center, City of Varkaus, Finland
| | - Eero A. Haapala
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juuso Väistö
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | | | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Timo A. Lakka
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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Karim K, Giribabu N, Salleh N. Marantodes pumilum Var Alata (Kacip Fatimah) ameliorates derangement in RANK/RANKL/OPG pathway and reduces inflammation and oxidative stress in the bone of estrogen-deficient female rats with type-2 diabetes. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 91:153677. [PMID: 34333329 DOI: 10.1016/j.phymed.2021.153677] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND M. pumilum has been claimed to protect the bone against the adverse effect of estrogen deficiency. Additionally, it also exhibits anti-diabetic activity. In view of these, this study aims to identify the mechanisms underlying the bone protective effect of M. pumilum in the presence of both estrogen deficiency and diabetes mellitus (DM). METHODS Ovariectomized, diabetic female rats were given M. pumilum leave aqueous extract (MPLA) (50 and 100 mg/kg/day), estrogen, glibenclamide and estrogen plus glibenclamide for 28 consecutive days. At the end of the treatment, fasting blood glucose (FBG), serum insulin, Ca2+, PO43- and bone alkaline phosphatase (BALP) levels were measured. Rats were sacrificed and femur bones were harvested for determination of expression level and distribution of RANK, RANKL, OPG and oxidative stress and inflammatory proteins by molecular biological techniques. RESULTS 100 mg/kg/day MPLA treatment decreased the FBG and BALP levels but increased the serum insulin, Ca2+ and PO43- levels in estrogen deficient, diabetic rats. Expression and distribution of RANKL, NF-κB p65, IKKβ, IL-6, IL-1β and Keap-1 decreased however expression and distribution of RANK, OPG, BMP-2, Type-1 collagen, Runx2, TRAF6, Nrf2, NQO-1, HO-1, SOD and CAT increased in the bone of estrogen deficient, diabetic rats which received 100 mg/kg/day MPLA with greater effects than estrogen-only, glibenclamide-only and estrogen plus glibenclamide treatments. CONCLUSION MPLA helps to overcome the adverse effect of estrogen deficiency and DM on the bone and thus this herb could potentially be used for the treatment and prevention of osteoporosis in postmenopausal women with diabetes.
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Affiliation(s)
- Kamarulzaman Karim
- Department of Physiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Nelli Giribabu
- Department of Physiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Naguib Salleh
- Department of Physiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Nóbrega da Silva V, Goldberg TBL, Silva CC, Kurokawa CS, Fiorelli LNM, Rizzo ADCB, Corrente JE. Impact of metabolic syndrome and its components on bone remodeling in adolescents. PLoS One 2021; 16:e0253892. [PMID: 34197518 PMCID: PMC8248706 DOI: 10.1371/journal.pone.0253892] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 06/15/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Osteoporosis and metabolic syndrome (MetS) are diseases that have serious public health consequences, reducing the quality of life of patients and increasing morbidity and mortality, with substantial healthcare expenditures. OBJECTIVE To evaluate the impact of MetS on bone mineral density (BMD) and biochemical markers of bone formation and resorption in adolescents with excess weight. METHOD A descriptive and analytical cross-sectional study was performed that evaluated 271 adolescents of both sexes (10 to 16 years). From the total sample, 42 adolescents with excess weight and the presence of MetS (14%) were selected. A further 42 adolescents with excess weight and without MetS were chosen, matched for chronological age, bone age, and pubertal developmental criteria to those with MetS, for each sex. Anthropometric measurements, blood pressure collection, and biochemical tests were performed in all adolescents, as well as evaluation of BMD and the bone biomarkers osteocalcin (OC), bone alkaline phosphatase (BAP), and carboxy-terminal telopeptide (S-CTx). RESULTS The adolescents with excess weight and MetS exhibited significantly lower transformed BMD and concentrations of BAP, OC, and S-CTx compared to the matched group, except for OC in boys. A negative and significant correlation was observed between total body BMD and BAP (r = -0.55568; p = 0.005), OC (r = -0.81760; p = < .000), and S-CTx (r = -0.53838; p = 0.011) in girls. CONCLUSION Metabolic syndrome may be associated with reduced bone mineral density and biochemical markers of bone formation and resorption in adolescents with excess weight.
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Affiliation(s)
- Valéria Nóbrega da Silva
- Department of Pediatrics, Postgraduate Program in Tocogynecology, Discipline of Adolescent Medicine, Botucatu Medical School, UNESP, São Paulo State University, Botucatu, SP, Brazil
| | - Tamara Beres Lederer Goldberg
- Department of Pediatrics, Postgraduate Program in Tocogynecology, Discipline of Adolescent Medicine, Botucatu Medical School, UNESP, São Paulo State University, Botucatu, SP, Brazil
| | - Carla Cristiane Silva
- Department of Physical Education, University of North Paraná, Jacarezinho, Paraná, Brazil
| | - Cilmery Suemi Kurokawa
- Department of Pediatrics, Clinical and Experimental Pediatric Research Center, Botucatu Medical School, UNESP, São Paulo State University, Botucatu, SP, Brazil
| | - Luciana Nunes Mosca Fiorelli
- Department of Pediatrics, Postgraduate Program in Tocogynecology, Discipline of Adolescent Medicine, Botucatu Medical School, UNESP, São Paulo State University, Botucatu, SP, Brazil
| | - Anapaula da Conceição Bisi Rizzo
- Department of Pediatrics, Postgraduate Program in Tocogynecology, Discipline of Adolescent Medicine, Botucatu Medical School, UNESP, São Paulo State University, Botucatu, SP, Brazil
| | - José Eduardo Corrente
- Department of Statistics, Biosciences, UNESP, São Paulo State University, Botucatu, SP, Brazil
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11
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Abstract
UNLABELLED Insulin resistance may be linked to bone health in young people. This study is the first on adolescents that jointly examined the association of bone health with insulin resistance and body composition. Our results revealed significant negative association between bone parameters and insulin resistance, even after adjustment for confounding factors. PURPOSE Previous studies are suggestive of the protective role of insulin on bone in adults. Whether this association exists in younger individuals is not clear, yet. This investigation aimed to evaluate the association between insulin resistance, bone parameters, and body composition amongst Iranian adolescents᾽ population. METHODS A cross-sectional study was conducted on 423 participants (224 girls and 199 boys) aged 9-19 years old. Insulin resistance was assessed, using a homeostatic model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Bone mineral density (BMD), bone mineral content (BMC), total body fat mass (TBFM), and total body lean mass (TBLM) were measured, using dual energy X-ray absorptiometry (DXA), and bone mineral apparent density (BMAD) was calculated. RESULTS In multiple regression analyses adjusted for potential confounders, the HOMA-IR showed statistically significant negative association with most of the bone parameters (β = - 1.1 to - 0.002, P = 0.004 to 0.036). On the subject of QUICKI index, this relationship was detected only for lumbar spine (LS) parameters (β = 0.062 to 37.21, P = 0.0001 to 0.026) and femoral neck bone mineral content (FNBMC) (β = 1.297, P = 0.013). CONCLUSION Our results suggest that insulin resistance may be inversely and independently associated with the bone indices in younger individuals. Whether high insulin levels have detrimental effects on growing bone is still unclear and has to be answered.
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12
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Jensen RB, Bytoft B, Lohse Z, Johnsen SK, Nielsen MF, Oturai PS, Højlund K, Damm P, Clausen TD, Jensen DM. Impact of Lean Body Mass and Insulin Sensitivity on the IGF-1-Bone Mass Axis in Adolescence: the EPICOM Study. J Clin Endocrinol Metab 2021; 106:e772-e781. [PMID: 33236084 DOI: 10.1210/clinem/dgaa861] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Insulin-like growth factor-1 (IGF-1) is involved in the growth of muscle and bone mass and contributes to glucose homeostasis. The offspring of mothers with diabetes during pregnancy have an increased risk of insulin resistance (IR). OBJECTIVE We hypothesized that bone mass was decreased in the offspring of mothers with type 1 diabetes (T1D), and that the IGF-1-bone mass relationship would be negatively influenced by IR. DESIGN Data from the Epigenetic, Genetic and Environmental Effects on Growth, Metabolism and Cognitive Functions in Offspring of Women with Type 1 Diabetes (EPICOM) study performed from 2012 to 2013 were included. SETTING This work is a follow-up study of a nationwide register study. PATIENTS A total of 278 adolescent index offspring whose mothers had T1D and 303 matched controls were studied. MAIN OUTCOME MEASURE Bone mineral content (BMC) determined by a dual-energy x-ray absorptiometry scan and the interaction with IGF-1 and insulin sensitivity were measured. RESULTS There was no difference in BMC, bone mineral density, height (SD score [SDS]), or BMC/height between index and control offspring. IGF-1 (SDS) did not differ between the groups but insulin-like growth factor-binding protein 3 (SDS) was higher in index boys compared to controls (B = .31 [95% CI, 0.06-0.57], P = .02). The statistical path analysis showed that IGF-1 predicted BMC/height (B = .24 [95% CI, 0.02-0.45], P = .03), but lean mass was a mediator of this. IGF-1 and the homeostatic model assessment of IR were positively associated (B = .75 [95% CI, 0.37-1.12], P < .001). There was no moderating effect of the interaction between IR and IGF-1 on lean mass in the entire cohort (B = .005 [95% CI, -0.03 to 0.04], P = .81) or when analyzing index cases and controls separately. CONCLUSION We found that lean mass was an intermediary factor in the IGF-1-bone mass relationship in a large cohort of adolescents, and this relationship was not moderated by IR.
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Affiliation(s)
- Rikke Beck Jensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Bytoft
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Zuzana Lohse
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Sine Knorr Johnsen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Frost Nielsen
- Department of Endocrinology & KMEB Molecular Endocrinology Unit, Odense University Hospital, Odense, Denmark
| | - Peter Sandor Oturai
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kurt Højlund
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tine D Clausen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynecology and Obstetrics, Nordsjællands Hospital Hillerød, Denmark
| | - Dorte M Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
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13
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The risk of eating disorders and bone health in young adults: the mediating role of body composition and fitness. Eat Weight Disord 2019; 24:1145-1154. [PMID: 29134506 DOI: 10.1007/s40519-017-0458-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/23/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To analyze the independent relationship between the risk of eating disorders and bone health and to examine whether this relationship is mediated by body composition and cardiorespiratory fitness (CRF). METHODS In this cross-sectional study, bone-related variables, lean mass, fat mass (by DXA), risk of eating disorders (SCOFF questionnaire), height, weight, waist circumference and CRF were measured in 487 university students aged 18-30 years from the University of Castilla-La Mancha, Spain. ANCOVA models were estimated to test mean differences in bone mass categorized by body composition, CRF or risk of eating disorders. Subsequently, linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis. RESULTS The marginal estimated mean ± SE values of total body bone mineral density for the categories "no risk of eating disorders" and "risk of eating disorders" were 1.239 ± 0.126 < 1.305 ± 0.089, P = 0.021. However, this relationship disappeared after adjustment for any of the parameters of body composition or CRF. Therefore, all body composition parameters (except for lean mass) and CRF turned out to be full mediators in the association between the risk of eating disorders and bone health in young adults. CONCLUSIONS Body composition and CRF mediate the association between the risk of eating disorders and bone health. These findings highlight the importance of maintaining a healthy weight and good CRF for the prevention of the development of eating disorders and for the maintenance of good bone health in young adults. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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14
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Loh WJ, Stevenson JC, Godsland IF. Independent relationships between bone mineral density, regional body fat and insulin sensitivity in white males. Clin Endocrinol (Oxf) 2019; 91:63-71. [PMID: 30973644 DOI: 10.1111/cen.13989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 03/16/2019] [Accepted: 04/09/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adiposity and insulin sensitivity may affect bone mineral density (BMD), but the confounding effect of weight hinders discrimination of independent associations. We explored whether regional fat masses and insulin sensitivity are independently related to BMD. MATERIALS AND METHODS Relationships between total and regional body fat, insulin sensitivity and measures of BMD in 8 different regions were evaluated in a cross section of 590 generally healthy, white males, 274 of whom received measurement of insulin sensitivity (Si) using the intravenous glucose tolerance test. Measurements included total, android and gynoid fat and lean body mass and regional BMDs by dual-energy X-ray absorptiometry. Linear regression analyses were combined in a mediation analysis to explore associations with each regional BMD. RESULTS Weight correlated positively with total fat mass (R2 = 0.67, P < 0.001) and negatively with Si (R2 = 0.14, P < 0.001). Body composition measures were consistently positively related to BMD in all regions except lumbar and thoracic spine. Accounting for body weight rendered negative majority of associations between total and regional fat masses and BMDs. An independent association between android fat and spine BMD was particularly apparent. Si was positively associated with total and limb BMD (P < 0.01) specifically among exercisers. Accounting for Si diminished the associations of total fat (negative) and lean body mass (positive) with total and limb BMD. CONCLUSION Android fat is independently negatively associated with spine BMD. Among those taking exercise, increased insulin sensitivity is associated with higher limb BMD and may underlie positive associations between lean body mass and BMD.
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Affiliation(s)
- Wann Jia Loh
- Diabetes, Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, London, UK
- Department of Endocrinology, Changi General Hospital, Singapore
| | - John C Stevenson
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Ian F Godsland
- Diabetes, Endocrinology and Metabolic Medicine, Faculty of Medicine, Imperial College London, London, UK
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15
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Rønne MS, Heidemann M, Lylloff L, Schou AJ, Tarp J, Bugge A, Laursen JO, Jørgensen NR, Husby S, Wedderkopp N, Mølgaard C. Bone mass development is sensitive to insulin resistance in adolescent boys. Bone 2019; 122:1-7. [PMID: 30738213 DOI: 10.1016/j.bone.2019.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE Insulin resistance may exert a negative influence on bone mass in childhood and adolescence. The objective was to assess the association between insulin resistance and total body less head (TBLH) bone mineral content (BMC) and to investigate whether body composition, physical activity or osteocalcin levels may influence this association. METHODS A longitudinal study with follow-up over more than 6 years was performed and included 562 apparently healthy participants with a mean age of 9.6 years at baseline. Participants underwent DXA scanning at baseline. At the two follow-ups, participants had performed another DXA scanning, had blood samples taken for fasting insulin, glucose and osteocalcin and had physical activity measured with an accelerometer. HOMA-IR was calculated as an index of insulin resistance. RESULTS HOMA-IR was negatively associated with TBLH BMC in boys at follow-ups (β = -31.4, p < 0.001) after adjustment for maturity, height, bone area, and baseline level of TBLH BMC. The negative association remained almost unchanged after further adjustments for body composition and physical activity. No association between HOMA-IR and TBLH BMC was found in girls. CONCLUSION Insulin resistance may be detrimental for bone development through puberty in boys independent of body composition and the level of physical activity.
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Affiliation(s)
- Maria Sode Rønne
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark.
| | - Malene Heidemann
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark
| | - Louise Lylloff
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; Department of Clinical Biochemistry, Hospital Unit West, Gl. Landevej 61, 7400 Herning, Denmark
| | - Anders J Schou
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark
| | - Jakob Tarp
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Anna Bugge
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Physiotherapy and Occupational Therapy, University College Copenhagen, Sigurdsgade 26, 2200 København N, Denmark
| | - Jens Ole Laursen
- Emergency Department, Hospital of South Jutland, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; OPEN, Odense Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, J.B.Winsløws Vej 9 A, 3, 5000 Odense C, Denmark
| | - Steffen Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Orthopaedics, Hospital of Southwestern Denmark, Finsensgade 34, 6700 Esbjerg, Denmark
| | - Christian Mølgaard
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 København N, Denmark
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16
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Chi JH, Shin MS, Lee BJ. Identification of hypertriglyceridemia based on bone density, body fat mass, and anthropometry in a Korean population. BMC Cardiovasc Disord 2019; 19:66. [PMID: 30902041 PMCID: PMC6431057 DOI: 10.1186/s12872-019-1050-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 03/15/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypertriglyceridemia is strongly associated with the risks of cardiovascular disease, coronary heart disease, and metabolic syndrome. The relationship between hypertriglyceridemia or high triglyceride levels and bone mineral density remains controversial. Furthermore, to date, no study has simultaneously examined the association among hypertriglyceridemia, bone area, bone mineral content, bone mineral density, body fat mass, and anthropometrics. The present study aimed to evaluate the association among hypertriglyceridemia, anthropometrics and various bone density and body fat composition variables to identify the best indicator of hypertriglyceridemia in a Korean population. METHODS The data were obtained from the fifth Korea National Health and Nutrition Examination Survey. In total, 3918 subjects aged 20-80 years participated in this study. In the variable analysis of the waist circumference (WC), trunk fat mass (Trk-Ft), body mass index, etc., a binary logistic regression analysis was performed to examine the significance of the differences between the normal group and hypertriglyceridemia groups. RESULTS In both men and women, the WC showed the strongest association with hypertriglyceridemia in the crude analysis (odds ratio (OR) = 1.738 [confidence interval = 1.529-1.976] and OR = 2.075 [1.797-2.397]), but the Trk-Ft was the most strongly associated with the disease after adjusting for age and body mass index (adjusted OR = 1.565 [1.262-1.941] and adjusted OR = 1.730 [1.291-2.319]). In particular, the Pelvis area (Plv-A) was the most significant among the bone variables in women (adjusted OR = 0.641 [0.515-0.796]). In the predictive power analysis, the best indicator of hypertriglyceridemia was WC in women (the area under the receiver operating characteristic curve (AUC) = 0.718 [0.685-0.751]) and Trk-Ft in men (AUC = 0.672 [0.643-0.702]). The WC was also the most predictive among the anthropometric variables in men (AUC = 0.670 [0.641-0.700]). The strength of the association and predictive power was stronger in women than in men. CONCLUSIONS The WC in women and Trk-Ft in men exhibited the best predictive power for hypertriglyceridemia. Our findings support the use of basic information for the identification of hypertriglyceridemia or high triglyceride levels in initial health screening efforts.
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Affiliation(s)
- Jeong Hee Chi
- Department of Software, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029 Republic of Korea
| | - Moon Sun Shin
- Department of Computer Engineering, Konkuk University, 268 Chungwon-daero, Chungju-Si, Chungcheongbuk-Do 380-701 Republic of Korea
| | - Bum Ju Lee
- Future Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Deajeon 305-811 Republic of Korea
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Hetherington-Rauth M, Bea JW, Blew RM, Funk JL, Lee VR, Roe DJ, Sardinha LB, Going SB. Relationship of cardiometabolic risk biomarkers with DXA and pQCT bone health outcomes in young girls. Bone 2019; 120:452-458. [PMID: 30572143 PMCID: PMC9395974 DOI: 10.1016/j.bone.2018.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 11/14/2018] [Accepted: 12/16/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Excess weight exerts the positive effect of mechanical loading on bone during development whereas obesity-related metabolic dysfunction may have a detrimental impact. In adults, the presence of metabolic syndrome and type 2 diabetes has been associated with compromised bone density, quality, and strength, and an increased incidence of fractures. The few studies that have investigated the role of cardio-metabolic disease risk biomarkers (CMR) on bone strength in children have given conflicting results. The aim of this study was to assess the combined and independent relationships of cardio-metabolic biomarkers with total body and regional bone parameters in young girls. METHODS In 306, 9-12 year old girls, measures of whole body fat and lean mass, areal bone mineral density (aBMD), bone mineral content (BMC), and bone area (BA) were obtained by dual-energy x-ray absorptiometry (DXA). Bone mineral density (vBMD), geometry, and strength of metaphyseal and diaphyseal regions of the femur and tibia and a diaphyseal region of the radius were measured using peripheral quantitative computed tomography (pQCT). Fasting serum measures of CMRs included, fasting glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglyceride (TG), systolic and diastolic blood pressure (SBP and DBP), and C-reactive protein (CRP). Multiple linear regression was used to assess the independent associations of a single CMR with total body and peripheral measures of bone strength after controlling for the other CMRs, plus total body soft tissue, and other relevant covariates. Also, a standardized total CMR composite score, calculated by standardizing to z-scores and then summing z-scores of each CMR biomarker, was regressed with total body and regional bone measures to assess the relationship of a cluster of risk factors with bone health. RESULTS Total CMR composite score had inverse associations (p < 0.001) with DXA total BMC and BA. Inverse associations (p < 0.05) of CMR risk score with pQCT regional bone measures occurred with total and trabecular BA at the 4% tibia. Of the individual CMRs, HOMA-IR and CRP were significant predictors of total body bone measures by DXA accounting for ~1-5% of the variance in BMC, BA, and/or aBMD. HOMA-IR was the main predictor of regional pQCT bone outcomes, accounting for the most variance in trabecular vBMD (2.6%) and BSI (3.8%) at the 4% tibia. Most markers of dyslipidemia (TG, HDL-C, LDL-C) and hypertension (SBP, DBP) were not associated (p > 0.05) with any total body or regional bone outcomes with the exception of the inverse relationship of LDL-C with total and trabecular BA and the positive relationship of DBP with cortical vBMD at the radius. CONCLUSION Of the obesity-related metabolic impairments, insulin resistance and chronic inflammation may compromise whole body bone development in young girls. In particular, trabecular bone, such as that found at the metaphysis of long bones, may be more susceptible to the detrimental effects associated with obesity-related metabolic dysfunction.
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Affiliation(s)
- Megan Hetherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal.
| | - Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA; Departments of Medicine, University of Arizona, Tucson, AZ 85721, USA; The University of Arizona Cancer Center, Tucson, AZ 85724, USA..
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
| | - Janet L Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA; Departments of Medicine, University of Arizona, Tucson, AZ 85721, USA.
| | - Vinson R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
| | - Denise J Roe
- The University of Arizona Cancer Center, Tucson, AZ 85724, USA.; Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ 85721, USA.
| | - LuÍs B Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
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Üstyol A, Atabek ME. Prediyabeti olan obez çocukların kemik mineral dansitometreleri. EGE TIP DERGISI 2018. [DOI: 10.19161/etd.414976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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19
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Frost M, Balkau B, Hatunic M, Konrad T, Mingrone G, Højlund K. The relationship between bone turnover and insulin sensitivity and secretion: Cross-sectional and prospective data from the RISC cohort study. Bone 2018; 108:98-105. [PMID: 29305997 DOI: 10.1016/j.bone.2017.12.029] [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] [Received: 09/06/2017] [Revised: 12/18/2017] [Accepted: 12/29/2017] [Indexed: 01/27/2023]
Abstract
Bone metabolism appears to influence insulin secretion and sensitivity, and insulin promotes bone formation in animals, but similar evidence in humans is limited. The objectives of this study are to explore if bone turnover markers were associated with insulin secretion and sensitivity and to determine if bone turnover markers predict changes in insulin secretion and sensitivity. The study population encompassed 576 non-diabetic adult men with normal glucose tolerance (NGT; n=503) or impaired glucose regulation (IGR; n=73). Baseline markers of bone resorption (CTX) and formation (P1NP) were determined in the fasting state and after a 2-h hyperinsulinaemic, euglycaemic clamp. An intravenous glucose tolerance test (IVGTT) and a 2-h oral glucose tolerance test (OGTT) were performed at baseline, and the OGTT was repeated after 3years. There were no differences in bone turnover marker levels between NGT and IGR. CTX and P1NP levels decreased by 8.0% (p<0.001) and 1.9% (p<0.01) between baseline and steady-state during the clamp. Fasting plasma glucose was inversely associated with CTX and P1NP both before and after adjustment for recruitment centre, age, BMI, smoking and physical activity. However, baseline bone turnover markers were neither associated with insulin sensitivity (assessed using hyperinsulinaemic euglycaemic clamp and OGTT) nor with insulin secretion capacity (based on IVGTT and OGTT) at baseline or at follow-up. Although inverse associations between fasting glucose and markers of bone turnover were identified, this study cannot support an association between insulin secretion and sensitivity in healthy, non-diabetic men.
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Affiliation(s)
- Morten Frost
- Endocrine Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - Beverley Balkau
- CESP, Faculty of Medicine - University Paris-South, Faculty of Medicine - University Versailles-St Quentin, INSERM U1018, University Paris-Saclay, Villejuif, France
| | - Mensud Hatunic
- Endocrinology Department, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Thomas Konrad
- Clinic of Pediatrics I, Johann Wolfgang Goethe Universität am Main, Frankfurt, Germany
| | - Geltrude Mingrone
- Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy; Diabetes and Nutritional Sciences, King's College London, London, UK
| | - Kurt Højlund
- Endocrine Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Section of Molecular Diabetes & Metabolism, Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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20
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Soininen S, Sidoroff V, Lindi V, Mahonen A, Kröger L, Kröger H, Jääskeläinen J, Atalay M, Laaksonen DE, Laitinen T, Lakka TA. Body fat mass, lean body mass and associated biomarkers as determinants of bone mineral density in children 6-8years of age - The Physical Activity and Nutrition in Children (PANIC) study. Bone 2018; 108:106-114. [PMID: 29307776 DOI: 10.1016/j.bone.2018.01.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 11/24/2017] [Accepted: 01/03/2018] [Indexed: 11/23/2022]
Abstract
Lean body mass (LM) has been positively associated with bone mineral density (BMD) in children and adolescents, but the relationship between body fat mass (FM) and BMD remains controversial. Several biomarkers secreted by adipose tissue, skeletal muscle, or bone may affect bone metabolism and BMD. We investigated the associations of LM, FM, and such biomarkers with BMD in children. We studied a population sample of 472 prepubertal Finnish children (227 girls, 245 boys) aged 6-8years. We assessed BMD, LM, and FM using whole-body dual-energy x-ray absorptiometry and analysed several biomarkers from fasting blood samples. We studied the associations of LM, FM, and the biomarkers with BMD of the whole body excluding the head using linear regression analysis. LM (standardized regression coefficient β=0.708, p<0.001), FM (β=0.358, p<0.001), and irisin (β=0.079, p=0.048) were positive correlates for BMD adjusted for age, sex, and height in all children. These associations remained statistically significant after further adjustment for LM or FM. The positive associations of dehydroepiandrosterone sulphate (DHEAS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), leptin, free leptin index, and high-sensitivity C-reactive protein and the negative association of leptin receptor with BMD were explained by FM. The positive associations of DHEAS and HOMA-IR with BMD were also explained by LM. Serum 25-hydroxyvitamin D was a positive correlate for BMD adjusted for age, sex, and height and after further adjustment for FM but not for LM. LM and FM were positive correlates for BMD also in girls and boys separately. In girls, insulin, HOMA-IR, leptin, and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height, and FM, none of the biomarkers was associated with BMD. In boys, leptin and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height and FM, 25(OH)D was positively and IGF-1 and leptin were negatively associated with BMD. FM strongly modified the association between leptin and BMD. LM but also FM were strong, independent positive correlates for BMD in all children, girls, and boys. Irisin was positively and independently associated with BMD in all children. The associations of other biomarkers with BMD were explained by LM or FM.
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Affiliation(s)
- Sonja Soininen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Institute of Dentistry, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Social and Health Center, City of Varkaus, Savontie 55, 78300 Varkaus, Finland.
| | - Virpi Sidoroff
- Department of Pediatrics, North-Karelia Central Hospital, Tikkamäentie 16, 80210 Joensuu, Finland.
| | - Virpi Lindi
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Anitta Mahonen
- Institute of Biomedicine, Medical Biochemistry, School of Medicine, University of Eastern Finland, PO Box 1627, Kuopio, Finland.
| | - Liisa Kröger
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Heikki Kröger
- Department of Orthopedics and Traumatology, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Mustafa Atalay
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - David E Laaksonen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Internal Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Timo A Lakka
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland.
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21
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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.
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Torres-Costoso A, Pozuelo-Carrascosa DP, Álvarez-Bueno C, Ferri-Morales A, Miota Ibarra J, Notario-Pacheco B, Martínez-Vizcaíno V. Insulin and bone health in young adults: The mediator role of lean mass. PLoS One 2017; 12:e0173874. [PMID: 28323845 PMCID: PMC5360249 DOI: 10.1371/journal.pone.0173874] [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] [Received: 09/28/2016] [Accepted: 02/28/2017] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The positive relationship between lean mass (LM) and bone health is well known, but a positive association between insulin and LM has also been described. Insulin has some anabolic properties on bone through the stimulation of osteoblast differentiation, yet the role of LM as a confounder or mediator in this relationship remains uncertain. OBJECTIVE To examine whether the association between insulin levels and bone health is mediated by LM. METHODS A cross-sectional study was conducted at the Castilla La Mancha University (Spain) involving 466 young adults (113 young men; 19.5±2.3 years). LM and total-body bone mineral content (BMC) were measured by dual energy x-ray absorptiometry, and insulin was measured in fasting serum samples. RESULTS Young adults with high total LM had higher values of total-body BMC than their peers after controlling for age and sex, this relationship persisted after adjusting for insulin levels (p<0.001). In mediation analyses, insulin levels were positively associated with total-body BMC (b = 0.05; p<0.001) and total LM acted as an intermediate variable, attenuating the association between insulin levels and total-body BMC (b = -31.98; p>0.05) as indicated by Sobel test values for indirect effect (z = 4.43; p<0.001). CONCLUSIONS LM plays an important role in the relationship between insulin levels and bone health, in such a way that while increases in LM have a positive influence on bone health, they are also negatively associated with insulin levels.
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Affiliation(s)
- Ana Torres-Costoso
- Universidad de Castilla-La Mancha. School of Nursing and Physiotherapy, Toledo, Spain
| | | | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain
| | | | - Jose Miota Ibarra
- Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain
| | | | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha. Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile. Facultad de Ciencias de la Salud., Talca, Chile
- * E-mail:
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23
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da Silva VN, Fiorelli LNM, da Silva CC, Kurokawa CS, Goldberg TBL. Do metabolic syndrome and its components have an impact on bone mineral density in adolescents? Nutr Metab (Lond) 2017; 14:1. [PMID: 28053645 PMCID: PMC5209875 DOI: 10.1186/s12986-016-0156-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 12/21/2016] [Indexed: 12/03/2022] Open
Abstract
In recent years, there has been growing concern about the occurrence of metabolic syndrome (MetS) at an early age and its effects on bone mass in adolescents. Adolescence is considered a critical period for bone mass gain. Impaired bone acquisition during this phase can lead to “suboptimal” peak bone mass and increase the risk of osteopenia/osteoporosis and fractures in old age. The objective of this review was to perform a critical analysis of articles that specifically focus on this age group, evaluating the influence of MetS and its components on bone mineral density in adolescents. A possible relationship between this syndrome and bone mass has been demonstrated, but the number of studies addressing this topic in adolescents is small. Despite the scarcity of evidence, the results of those studies show that Metabolic Syndrome is negatively correlated with bone mass and also that some components of MetS are negatively correlated with bone mineral density in adolescents. However, the associations between MetS and bone mass development need to be further explored in the age group corresponding to adolescence. Further good-quality studies are necessary to complement the understanding of this relationship.
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Affiliation(s)
- Valéria Nóbrega da Silva
- Department of Pediatrics, Discipline of Adolescent Medicine, Postgraduate Program in Gynecology, Obstetrics, and Mastology, Botucatu School of Medicine, UNESP, São Paulo State University, Botucatu, São Paulo Brazil
| | - Luciana Nunes Mosca Fiorelli
- Department of Pediatrics, Discipline of Adolescent Medicine, Postgraduate Program in Gynecology, Obstetrics, and Mastology, Botucatu School of Medicine, UNESP, São Paulo State University, Botucatu, São Paulo Brazil
| | | | - Cilmery Suemi Kurokawa
- Clinical and Experimental Pediatric Research Center, Department of Pediatrics and Postgraduate Program in Tropical Disease, Botucatu School of Medicine, UNESP, São Paulo State University, Botucatu, São Paulo Brazil
| | - Tamara Beres Lederer Goldberg
- Department of Pediatrics, Discipline of Adolescent Medicine, Postgraduate Program in Gynecology, Obstetrics, and Mastology, Botucatu School of Medicine, UNESP, São Paulo State University, Botucatu, São Paulo Brazil
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24
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Dalskov S, Ritz C, Larnkjær A, Damsgaard CT, Petersen RA, Sørensen LB, Ong KK, Astrup A, Michaelsen KF, Mølgaard C. Associations between adiposity, hormones, and gains in height, whole-body height-adjusted bone size, and size-adjusted bone mineral content in 8- to 11-year-old children. Osteoporos Int 2016; 27:1619-1629. [PMID: 26667245 DOI: 10.1007/s00198-015-3428-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 11/13/2015] [Indexed: 12/31/2022]
Abstract
UNLABELLED We examined fat-independent associations of hormones with height and whole-body bone size and mineral content in 633 school children. IGF-1 and osteocalcin predict growth in height, while fat, osteocalcin, and in girls also, IGF-1 predict growth in bone size. Leptin and ghrelin are inversely associated with bone size in girls. INTRODUCTION Obesity causes larger bone size and bone mass, but the role of hormones in this up-regulation of bone in obesity is not well elucidated. We examined longitudinal associations between baseline body fat mass (FM), and fat-independent fasting levels of ghrelin, adiponectin, leptin, insulin, insulin-like growth factor-I (IGF-1), osteocalcin, and intact parathyroid hormone, and subsequent changes in height and in whole-body height-adjusted bone area "BAheight" and size-adjusted bone mineral content "BMCsize" in 8- to 11-year-olds. METHODS Analyses were carried out separately for boys (n = 325) and girls (n = 308) including data from baseline, 3 and 6 months from OPUS School Meal Study. RESULTS In both sexes: gain in BAheight was positively associated with baseline FM (≥2.05 cm(2)/kg, both p ≤ 0.003). Furthermore, gain in height was positively associated with baseline IGF-1 (≥0.02 cm/ng/ml, p = 0.001) and osteocalcin (≥0.13 cm/ng/ml, p ≤ 0.009); and gain in BAheight was positively associated with baseline osteocalcin (≥0.35 cm(2)/ng/ml, p ≤ 0.019). In girls only, gain in BAheight was also positively associated with baseline IGF-1 (0.06 cm(2)/ng/ml, p = 0.017) and inversely associated with both baseline ghrelin (-0.01 cm(2)/pg/ml, p = 0.001) and leptin (-1.21 cm(2)/μg/ml, p = 0.005). In boys, gain in BMCsize was positively associated with osteocalcin (0.18 g/ng/ml, p = 0.030). CONCLUSIONS This large longitudinal study suggests that in 8- to 11-year-old children, IGF-1 and osteocalcin predict growth in height, while FM, osteocalcin, and in girls also, IGF-1 predict growth in BAheight. Fat-independent inverse associations of leptin and ghrelin with BAheight in girls' are contrary to proposed growth-stimulating effects of leptin. Osteocalcin in boys predicts gain in BMCsize.
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Affiliation(s)
- S Dalskov
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark.
| | - C Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - A Larnkjær
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - C T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - R A Petersen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - L B Sørensen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - K K Ong
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - A Astrup
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - K F Michaelsen
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
| | - C Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958, Frederiksberg C, Denmark
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25
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Park SW, Nam GE, Jung DW, Yoon SJ, Han K, Park YG, Choi JS, Lee JE, Sang JE, Yoon YJ, Kim DH. Association of lipid parameters and insulin resistance with bone health in South Korean adolescents. Osteoporos Int 2016; 27:635-42. [PMID: 26329100 DOI: 10.1007/s00198-015-3306-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 08/24/2015] [Indexed: 10/23/2022]
Abstract
UNLABELLED This study investigated the association between lipid profiles and insulin resistance and bone mineral content (BMC) in Korean adolescents and found that BMC was inversely associated with triglyceride (TG) and homeostasis model assessment of insulin resistance (HOMA-IR). This association did not differ according to obesity status in either boys or girls. INTRODUCTION To prevent future osteoporosis, it is important to identify factors that affect bone health in adolescents as well as adults. This study aimed to examine the association between lipid profiles and insulin resistance and BMC in Korean adolescents. METHODS Data from 706 boys and 621 girls, who participated in the Korea National Health and Nutrition Examination Survey from 2008 to 2011, were analyzed. Lipid profiles were measured, and HOMA-IR was calculated to assess insulin resistance. BMC was measured for the total femur, femur neck, and lumbar spine by using whole-body dual-energy X-ray absorptiometry (DXA). RESULTS TG level and HOMA-IR were negatively correlated with BMC at all three sites in boys. In girls, TG level showed a negative correlation with BMC at the femur neck and lumbar spine, and HOMA-IR was negatively associated with BMC at the femur neck only. These inverse associations did not differ according to obesity status in either sex. Adjusted means of BMC at the three sites in boys tended to decrease in the higher tertile groups of TG and HOMA-IR, and the adjusted means of BMC for the total femur in girls tended to decrease in the higher tertile groups of TG and HOMA-IR. CONCLUSIONS BMC was inversely associated with TG and HOMA-IR in Korean adolescents, and this association was more pronounced in boys. This association did not differ according to obesity status in either sex.
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Affiliation(s)
- S-W Park
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea
| | - G-E Nam
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea.
| | - D-W Jung
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea
| | - S-J Yoon
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea
| | - K Han
- Department of Biostatistics, Catholic University College of Medicine, Seoul, 137-701, South Korea
| | - Y-G Park
- Department of Biostatistics, Catholic University College of Medicine, Seoul, 137-701, South Korea
| | - J-S Choi
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea
| | - J-E Lee
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea
| | - J-E Sang
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea
| | - Y-J Yoon
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea
| | - D-H Kim
- Department of Family Medicine, Korea University Ansan Hospital, College of Medicine, Korea University, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, 425-707, South Korea.
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26
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Kindler JM, Pollock NK, Laing EM, Jenkins NT, Oshri A, Isales C, Hamrick M, Lewis RD. Insulin Resistance Negatively Influences the Muscle-Dependent IGF-1-Bone Mass Relationship in Premenarcheal Girls. J Clin Endocrinol Metab 2016; 101:199-205. [PMID: 26574958 PMCID: PMC4701844 DOI: 10.1210/jc.2015-3451] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT IGF-1 promotes bone growth directly and indirectly through its effects on skeletal muscle. Insulin and IGF-1 share a common cellular signaling process; thus, insulin resistance may influence the IGF-1-muscle-bone relationship. OBJECTIVE We sought to determine the effect of insulin resistance on the muscle-dependent relationship between IGF-1 and bone mass in premenarcheal girls. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional study conducted at a university research center involving 147 girls ages 9 to 11 years. MAIN OUTCOME MEASURES Glucose, insulin, and IGF-1 were measured from fasting blood samples. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated from glucose and insulin. Fat-free soft tissue (FFST) mass and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry. Our primary outcome was BMC/height. RESULTS In our path model, IGF-1 predicted FFST mass (b = 0.018; P = .001), which in turn predicted BMC/height (b = 0.960; P < .001). IGF-1 predicted BMC/height (b = 0.001; P = .002), but not after accounting for the mediator of this relationship, FFST mass. The HOMA-IR by IGF-1 interaction negatively predicted FFST mass (b = -0.044; P = .034). HOMA-IR had a significant and negative effect on the muscle-dependent relationship between IGF-1 and BMC/height (b = -0.151; P = .047). CONCLUSIONS Lean body mass is an important intermediary factor in the IGF-1-bone relationship. For this reason, bone development may be compromised indirectly via suboptimal IGF-1-dependent muscle development in insulin-resistant children.
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Affiliation(s)
- J M Kindler
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - N K Pollock
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - E M Laing
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - N T Jenkins
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - A Oshri
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - C Isales
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - M Hamrick
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
| | - R D Lewis
- Department of Foods and Nutrition (J.M.K., E.M.L., R.D.L.), College of Family and Consumer Sciences, University of Georgia, Athens, Georgia 30602; Department of Pediatrics (N.K.P.), Georgia Prevention Institute, Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912; Department of Kinesiology, College of Education (N.T.J.), and Department of Health and Human Development, College of Family and Consumer Sciences (O.A.), University of Georgia, Athens, Georgia 30602; and Department of Neuroscience and Regenerative Medicine (C.I.), and Department of Cellular Biology and Anatomy (M.H.), Medical College of Georgia, Georgia Regents University, Augusta, Georgia 30912
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Genetic Sharing with Cardiovascular Disease Risk Factors and Diabetes Reveals Novel Bone Mineral Density Loci. PLoS One 2015; 10:e0144531. [PMID: 26695485 PMCID: PMC4687843 DOI: 10.1371/journal.pone.0144531] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 11/19/2015] [Indexed: 01/14/2023] Open
Abstract
Bone Mineral Density (BMD) is a highly heritable trait, but genome-wide association studies have identified few genetic risk factors. Epidemiological studies suggest associations between BMD and several traits and diseases, but the nature of the suggestive comorbidity is still unknown. We used a novel genetic pleiotropy-informed conditional False Discovery Rate (FDR) method to identify single nucleotide polymorphisms (SNPs) associated with BMD by leveraging cardiovascular disease (CVD) associated disorders and metabolic traits. By conditioning on SNPs associated with the CVD-related phenotypes, type 1 diabetes, type 2 diabetes, systolic blood pressure, diastolic blood pressure, high density lipoprotein, low density lipoprotein, triglycerides and waist hip ratio, we identified 65 novel independent BMD loci (26 with femoral neck BMD and 47 with lumbar spine BMD) at conditional FDR < 0.01. Many of the loci were confirmed in genetic expression studies. Genes validated at the mRNA levels were characteristic for the osteoblast/osteocyte lineage, Wnt signaling pathway and bone metabolism. The results provide new insight into genetic mechanisms of variability in BMD, and a better understanding of the genetic underpinnings of clinical comorbidity.
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Lim HH. Effect of serum cholesterol on bone mineral density in normal-weight children and adolescents. J Pediatr Endocrinol Metab 2015; 28:1313-9. [PMID: 26181045 DOI: 10.1515/jpem-2014-0360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 04/24/2015] [Indexed: 11/15/2022]
Abstract
We investigated whether there is a relationship between serum cholesterol and bone mineral density (BMD), independent of BMI in children and adolescents. This study was based on data from the KNHANES 2009-2010. The data for 1557 children and adolescents were analyzed and classified into three groups: underweight, normal-weight, and overweight. We analyzed the relationships between serum cholesterol and BMD z-scores. Whole body BMD z-score was revealed as an inverse association with the serum cholesterol quartile in only normal-weight group (p=0.008). Serum cholesterol level correlated more inversely with BMD z-score in normal-weight boys (r2=0.040, p=0.002) than in girls (r2=0.019, p=0.042). Multivariate regression analysis identified serum cholesterol as association with BMD in normal-weight (r2=0.020, p=0.002). Serum cholesterol concentration may be a detrimental risk factor for BMD in normal-weight children and adolescents independent of BMI.
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Viljakainen HT, Ben-Shlomo Y, Kinra S, Ebrahim S, Kuper H, Radhakrishna KV, Kulkarni B, Tobias JH. Urban-Rural Differences in Bone Mineral Density: A Cross Sectional Analysis Based on the Hyderabad Indian Migration Study. PLoS One 2015; 10:e0140787. [PMID: 26484878 PMCID: PMC4618924 DOI: 10.1371/journal.pone.0140787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 09/30/2015] [Indexed: 11/23/2022] Open
Abstract
Background Fracture risk is rising in countries undergoing rapid rural to urban migration, but whether this reflects an adverse effect of urbanization on intrinsic bone strength, as reflected by bone mineral density (BMD), is currently unknown. Methods Lumbar spine (LS) and total hip (TH) BMD, and total body fat and lean mass, were obtained from DXA scans performed in the Hyderabad arm of the Indian Migration Study (54% male, mean age 49 years). Sib-pair comparisons were performed between rural-urban migrants (RUM) and rural non-migrated (RNM) siblings (N = 185 sib-pairs). Results In analyses adjusted for height, gender, age and occupation, rural to urban migration was associated with higher lumbar and hip BMD and greater predicted hip strength; ΔLS BMD 0.030 (0.005, 0.055) g/cm2, ΔTH BMD 0.044 (0.024; 0.064) g/cm2, Δcross-sectional moment of inertia 0.162 (0.036, 0.289) cm4. These differences were largely attenuated after adjusting for body composition, insulin levels and current lifestyle factors ie. years of smoking, alcohol consumption and moderate to vigorous physical activity. Further analyses suggested that differences in lean mass, and to a lesser extent fat mass, largely explained the BMD differences which we observed. Conclusions Rural to urban migration as an adult is associated with higher BMD and greater predicted hip strength, reflecting associated alterations in body composition. It remains to be seen how differences in BMD between migration groups will translate into fracture risk in becoming years.
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Affiliation(s)
- Heli T. Viljakainen
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Sanjay Kinra
- Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shah Ebrahim
- Department of Non Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
- South Asia Network for Chronic Disease. Public Health Foundation of India, New Delhi, India
| | - Hannah Kuper
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | | | - Jon H. Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
- * E-mail:
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Pirilä S, Taskinen M, Turanlahti M, Kajosaari M, Mäkitie O, Saarinen-Pihkala UM, Viljakainen H. Bone health and risk factors of cardiovascular disease--a cross-sectional study in healthy young adults. PLoS One 2014; 9:e108040. [PMID: 25310090 PMCID: PMC4195604 DOI: 10.1371/journal.pone.0108040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 08/25/2014] [Indexed: 12/20/2022] Open
Abstract
Objective Both osteoporosis and cardiovascular disease (CVD) are diseases that comprise a growing medical and economic burden in ageing populations. They share many risk factors, including ageing, low phy-sical activity, and possibly overweight. We aimed to study associations between individual risk factors for CVD and bone mineral density (BMD) and turnover markers (BTMs) in apparently healthy cohort. Design A cross-sectional assessment of 155 healthy 32-year-old adults (74 males) was performed for skeletal status, CVD risk factors and lifestyle factors. Methods We analysed serum osteocalcin, procollagen I aminoterminal propeptide (P1NP), collagen I carboxy-terminal telopeptide (ICTP) and urine collagen I aminoterminal telopeptide (U-NTX), as well as serum insulin, plasma glucose, triglyceride and HDL-cholesterol levels. BMD, fat and lean mass were asses-sed using DXA scanning. Associations were tested with partial correlations in crude and adjusted mo-dels. Bone status was compared between men with or without metabolic syndrome (defined according to the NCEP-ATPIII criteria) with multivariate analysis. Results Osteocalcin and P1NP correlated inversely with insulin (R = −0.243, P = 0.003 and R = −0.187, P = 0.021) and glucose (R = −0.213, P = 0.009 and R = −0.190, P = 0.019), but after controlling for fat mass and lifestyle factors, the associations attenuated with insulin (R = −0.162, P = 0.053 and R = −0.093, P = 0.266) and with glucose (R = −0.099, P = 0.240 and R = −0.133, P = 0.110), respectively. Whole body BMD associated in-versely only with triglycerides in fully adjusted model. In men with metabolic syndrome, whole body BMD, osteocalcin and P1NP were lower compared to healthy men, but these findings disappeared in fully adjusted model. Conclusions In young adults, inverse associations between BTM/BMD and risk factors of CVD appeared in crude models, but after adjusting for fat mass, no association continued to be present. In addition to fat mass, lifestyle factors, especially physical activity, modified the associations between CVD and bone charac-teristics. Prospective studies are needed to specify the role of mediators and lifestyle factors in the prevention of CVD and osteoporosis.
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Affiliation(s)
- Satu Pirilä
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- * E-mail:
| | - Mervi Taskinen
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Maila Turanlahti
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Merja Kajosaari
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Ulla M. Saarinen-Pihkala
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Heli Viljakainen
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Nóbrega da Silva V, Goldberg TBL, Mosca LN, Bisi Rizzo ADC, Teixeira ADS, Corrente JE. Metabolic syndrome reduces bone mineral density in overweight adolescents. Bone 2014; 66:1-7. [PMID: 24875293 DOI: 10.1016/j.bone.2014.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Revised: 05/16/2014] [Accepted: 05/17/2014] [Indexed: 11/18/2022]
Abstract
Growing concern has focused on the occurrence of metabolic syndrome (MetS) and its effects on bone mass. There is little information available in the literature concerning the relationship between MetS and BMD in adolescents. The aim of this study was to evaluate the effects of MetS and its components on bone mineral density (BMD) in overweight adolescent boys and girls. This cross-sectional study assessed 271 overweight adolescents with or without MetS (age 10 to 16years). Anthropometric and biochemical tests were performed. Lumbar spine, proximal femur and total and subtotal body BMD values were obtained by bone densitometry with dual-energy X-ray absorptiometry. MetS was observed in 14% of the adolescents. Overweight adolescents of both genders who were positive for MetS presented with significant decreases in BMD (g/cm(2)/kg bodyweight) at all sites evaluated (p<0.01). Female adolescents with large waist circumference, low HDLc, hypertriglyceridemia and high blood pressure showed significant reductions in BMD at all sites evaluated (p<0.01) and, with the exception of increased triglycerides (which had no effect on BMD, p>0.05), the same pattern was observed in male adolescents. Linear regression analyses revealed that waist circumference was negatively correlated with BMD in both genders and that triglycerides were negatively correlated with BMD only in female adolescents. Our results suggest that overweight adolescents with MetS have lower BMD than adolescents without MetS. Among all MetS components measured, increased waist circumference had the strongest relationship with reductions in BMD.
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Affiliation(s)
- Valéria Nóbrega da Silva
- Postgraduate Program in Gynecology, Obstetrics, and Mastology, Discipline of Adolescent Medicine, Department of Pediatrics, Botucatu Medicine School, UNESP, São Paulo State University, Botucatu, SP 18618-970, Brazil.
| | - Tamara Beres Lederer Goldberg
- Postgraduate Program in Gynecology, Obstetrics, and Mastology, Discipline of Adolescent Medicine, Department of Pediatrics, Botucatu Medicine School, UNESP, São Paulo State University, Botucatu, SP 18618-970, Brazil.
| | - Luciana Nunes Mosca
- Postgraduate Program in Gynecology, Obstetrics, and Mastology, Discipline of Adolescent Medicine, Department of Pediatrics, Botucatu Medicine School, UNESP, São Paulo State University, Botucatu, SP 18618-970, Brazil.
| | - Anapaula da Conceição Bisi Rizzo
- Postgraduate Program in Gynecology, Obstetrics, and Mastology, Discipline of Adolescent Medicine, Department of Pediatrics, Botucatu Medicine School, UNESP, São Paulo State University, Botucatu, SP 18618-970, Brazil.
| | - Altamir dos Santos Teixeira
- Tropical Disease and Image Diagnosis, Botucatu Medicine School, UNESP, São Paulo State University, Botucatu, SP 18618-970, Brazil.
| | - José Eduardo Corrente
- Department of Statistics, Institute of Biosciences, UNESP, São Paulo State University, Botucatu, SP, Brazil.
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Garg MK, Marwaha RK, Tandon N, Bhadra K, Mahalle N. Relationship of lipid parameters with bone mineral density in Indian population. Indian J Endocrinol Metab 2014; 18:325-332. [PMID: 24944926 PMCID: PMC4056130 DOI: 10.4103/2230-8210.131165] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Cardiovascular disease and osteoporosis share common risk factors including dyslipidemia. There are conflicting reports of differential relation of various lipid parameters on bone mineral density (BMD). Hence, we studied the correlation between lipid parameters and BMD in healthy adult. MATERIALS AND METHODS A total of 2347 participants (male 39.4%; female 60.6%) included in this cross-sectional study were divided according to sex and age. Fasting blood samples were drawn for biochemical parameters. BMD at lumbar spine, femur, and forearm were measured by dual energy X-ray absorptiometry (DXA). RESULTS In males, BMD at femur and lumbar spine decreased significantly with increasing quartiles of total cholesterol (TC) (P < 0.0001, and 0.004) and low-density lipoprotein cholesterol (LDL-c) (P = 0.001, and 0.01). In premenopausal women, BMD at femoral neck (P = 0.001) and lumbar spine (P = 0.029) showed declining trend with LDL-c (P = 0.007). In postmenopausal women, only BMD at total femur decreased significantly with TC (P = 0.024) and LDL-c (P = 0.036). All above findings were confirmed in correlation studies. In multiple regression analysis after adjusting for age, body mass index, ionized calcium, alkaline phosphatase, 25 hydroxy vitamin D, and parathyroid hormone levels correlation of BMD with TC and LDL-c persisted. TC, LDL-c was higher in subjects with low bone density compared those with normal bone density in both sexes. CONCLUSIONS TC and LDL-c had weak but significant negative correlation with BMD at femur and lumbar spine.
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Affiliation(s)
- M. K. Garg
- Department of Endocrinology and Metabolism, Command Hospital (Southern Command), Pune, Maharastra, India
| | - Raman K. Marwaha
- Department of Endocrinology and Metabolism, International Life Sciences Institute-India, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Kuntal Bhadra
- Department of Endocrinology and Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, Delhi, India
| | - N. Mahalle
- Department of Pathology, Biochemistry Division, Deenanath Mangeshkar Hospital and Research Center, Erandawane, Pune, Maharashtra, India
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Choi YJ, Kim DJ, Lee Y, Chung YS. Insulin is inversely associated with bone mass, especially in the insulin-resistant population: the Korea and US National Health and Nutrition Examination Surveys. J Clin Endocrinol Metab 2014; 99:1433-41. [PMID: 24483156 DOI: 10.1210/jc.2013-3346] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND Insulin is an important osteotropic hormone but may be negatively associated with bone mass after adjustment for body mass index in adolescent populations. However, the association between insulin and bone mass in adults remains unclear. OBJECTIVE The objective of the study was to investigate whether insulin was associated with bone mass in adults and, if so, whether the association was positive or negative. DESIGN This study had a cross-sectional design, using data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2009 and the US National Health and Nutrition Examination Survey (NHANES) 1999-2006. SETTING The setting for the study was the Korean and US population. PARTICIPANTS A total of 7271 KNHANES and 3399 NHANES participants were included. MAIN OUTCOME MEASURES Anthropometric parameters and bone mass data, fasting glucose and insulin, height, weight, and markers related to insulin resistance were measured. RESULTS After adjusting for confounding factors, there was an inverse relationship between insulin and total body bone mineral content in the KNHANES and NHANES subjects. In a stratified analysis, an association between insulin and bone mass was apparent, especially in the highest homeostatic model of assessment of insulin resistance quartile in the Korean subjects. However, this association was seen only in men in the US subjects. CONCLUSIONS There is an inverse relationship between insulin and total body bone mineral content after adjustment for confounding factors in Korean and US subjects, especially in the insulin-resistant population. This strongly suggests that the adverse influence of insulin on bone mass likely reflects the effects of other factors associated with insulin resistance rather than being a direct action of insulin itself.
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Affiliation(s)
- Yong Jun Choi
- Departments of Endocrinology and Metabolism (Y.J.C., D.J.K., Y.-S.C.) and Preventive Medicine and Public Health (Y.L.) and Institute on Aging (D.J.K., Y.L., Y.-S.C.), Ajou University School of Medicine, Suwon 443-380, South Korea
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Shin D, Kim S, Kim KH, Lee K, Park SM. Association between insulin resistance and bone mass in men. J Clin Endocrinol Metab 2014; 99:988-95. [PMID: 24423302 DOI: 10.1210/jc.2013-3338] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
CONTEXT The association between insulin resistance and bone mass is still not clear. OBJECTIVE The purpose of this study was to evaluate the association between insulin resistance and bone mass. DESIGN AND SETTING This was a cross-sectional survey of the nationally representative population. PARTICIPANTS A total of 3113 men (aged ≥20 years) from the fourth Korean National Health and Nutrition Examination Survey of 2008-2009 were included. MAIN OUTCOME MEASURES Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry. Osteopenia and osteoporosis were defined using the World Health Organization T score criteria. Fasting plasma insulin and glucose levels were measured, and insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. RESULTS Age-, height-, and weight-adjusted mean BMD values significantly decreased as quartiles of HOMA-IR and the fasting plasma insulin level increased (P for trends <.001). In multivariable logistic regression analyses, participants who had a higher HOMA-IR or fasting plasma insulin level had a higher odds ratio for osteoporosis/osteopenia. Interestingly, the association between fasting plasma insulin level and whole-body BMD differed by the degree of insulin resistance. In the lowest quartile of HOMA-IR, the fasting insulin level was positively associated with BMD. As insulin resistance increased, however, the fasting insulin level was inversely associated with BMD, and this relationship became more significant as the degree of insulin resistance increased. CONCLUSIONS In a nationally representative sample of Korean men, insulin resistance and the fasting plasma insulin level were inversely associated with bone mass. Further studies are required to confirm this association and reveal the underlying mechanisms.
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Affiliation(s)
- Doosup Shin
- Jangseong Public Health Center (D.S.), Jangseong, 515-800 South Korea; Department of Family Medicine (S.K.), Korea Cancer Center Hospital, Seoul 139-240, South Korea; Department of Family Medicine (K.H.K., S.M.P.) and Department of Biomedical Sciences (S.M.P.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, South Korea; and Department of Family Medicine (K.L.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do 463-707, South Korea
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Effects of dietary protein and glycaemic index on biomarkers of bone turnover in children. Br J Nutr 2014; 111:1253-62. [PMID: 24503413 DOI: 10.1017/s0007114513003760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
For decades, it has been debated whether high protein intake compromises bone mineralisation, but no long-term randomised trial has investigated this in children. In the family-based, randomised controlled trial DiOGenes (Diet, Obesity and Genes), we examined the effects of dietary protein and glycaemic index (GI) on biomarkers of bone turnover and height in children aged 5-18 years. In two study centres, families with overweight parents were randomly assigned to one of five ad libitum-energy, low-fat (25-30% energy (E%)) diets for 6 months: low protein/low GI; low protein/high GI; high protein/low GI; high protein/high GI; control. They received dietary instructions and were provided all foods for free. Children, who were eligible and willing to participate, were included in the study. In the present analyses, we included children with data on plasma osteocalcin or urinary N-terminal telopeptide of collagen type I (U-NTx) from baseline and at least one later visit (month 1 or month 6) (n 191 in total, n 67 with data on osteocalcin and n 180 with data on U-NTx). The level of osteocalcin was lower (29.1 ng/ml) in the high-protein/high-GI dietary group than in the low-protein/high-GI dietary group after 6 months of intervention (95% CI 2.2, 56.1 ng/ml, P=0.034). The dietary intervention did not affect U-NTx (P=0.96) or height (P=0.80). Baseline levels of U-NTx and osteocalcin correlated with changes in height at month 6 across the dietary groups (P<0.001 and P=0.001, respectively). The present study does not show any effect of increased protein intake on height or bone resorption in children. However, the difference in the change in the level of osteocalcin between the high-protein/high-GI group and the low-protein/high-GI group warrants further investigation and should be confirmed in other studies.
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