Children and adolescents with obesity have reduced serum bone turnover markers and 25-hydroxyvitamin D but increased parathyroid hormone concentrations – Results derived from new pediatric reference ranges

Geserick, Mandy; Vogel, Mandy; Eckelt, Felix; Schlingmann, Maike; Hiemisch, Andreas; Baber, Ronny; Thiery, Joachim; Körner, Antje; Kieß, Wieland; Kratzsch, Jürgen

doi:10.1016/j.bone.2019.115124

Cited by 44 publications

(41 citation statements)

References 35 publications

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“…Previous work in adolescents with obesity has demonstrated a decrease in bone turnover markers in late adolescence. We would thus not expect the significant increase in bone turnover markers seen in our study from time alone 28 …”

Section: Discussionmentioning

confidence: 68%

The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

et al. 2020

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Summary 25‐hydroxy vitamin D (25 OHD) deficiency and secondary hyperparathyroidism have been seen after metabolic and bariatric surgery, but data are lacking on the bone health outcomes of adolescent sleeve gastrectomy (SG). The purpose of this study was to examine bone‐related nutrition after SG, compared to laparoscopic adjustable gastric band (LAGB), and trend bone turnover markers following SG. This is an observational study of 197 adolescents who underwent LAGB (n = 98) or SG (n = 99). Bone health labs were collected at baseline and 6 and/or 12 months after LAGB or SG, with additional analysis of bone turnover markers in the SG group. Calcium and 25 OHD levels increased at 6 and 12 months after LAGB and SG, with no difference between the surgeries. Parathyroid hormone levels decreased only in the SG group. SG patients had increased osteocalcin and carboxy‐terminal cross‐linking telopeptide of type 1 collagen (CTX) at 6 and 12 months post‐SG, although CTX decreased between 6 and 12 months. Excess weight loss at 6 months predicted the rise in CTX, but the changes in osteocalcin and CTX could not be attributed to 25 OHD deficiency, hypocalcemia or hyperparathyroidism. Patients had improved 25 OHD levels post‐surgery, which may be secondary to stringent vitamin supplementation guidelines. However, there were marked increases in bone turnover markers following SG. More studies are needed to evaluate the effects of SG on adolescent bone health and to correlate the early changes in bone turnover with bone mineral density and fracture risk.

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Section: Discussionmentioning

confidence: 68%

The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

et al. 2020

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“…Furthermore, Goulding et al showed that elevated adiposity is linked with increased risk of distal forearm fractures in male children and adolescents [ 37 ]. Very recently, Geserick et al reported that BMI was found to affect bone markers in children and adolescents with obesity [ 38 ]. In detail, age- and gender-adjusted bone formation and bone resorption markers were found to be significantly lower in obese children compared to the controls.…”

Section: Discussionmentioning

confidence: 99%

“…Studies about the correlation of BMI and the bone markers Procollagen type 1 N-pro-peptides (PINP) and carboxy-terminal cross-linking telopeptide of type 1 collagen (CTX-I) are rare and controversial: some studies describe an increase [ 39 , 40 ], but others show a reduction of these bone markers in obese children [ 5 , 41 ]. Moreover, Geserick et al also reported that obese children have significantly lower 25(OH) vitamin D and increased PTH-SDS levels compared to the controls [ 38 ]. Consistently, we found increased levels of PTH in our patients, whereas 25(OH) vitamin D levels, although lower compared with the controls, did not reach the statistical significance.…”

Section: Discussionmentioning

confidence: 99%

Shedding “LIGHT” on the Link between Bone and Fat in Obese Children and Adolescents

Brunetti

Faienza

Piacente

et al. 2020

IJMS

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Obesity may affect bone health, but literature reports are contradictory about the correlation of body mass index (BMI) and bone markers. LIGHT, one of the immunostimulatory cytokines regulating the homeostasis of bone and adipose tissue, could be involved in obesity. The study involved 111 obese subjects (12.21 ± 3.71 years) and 45 controls. Patients underwent the evaluation of bone status by quantitative ultrasonography (QUS). LIGHT amounts were evaluated in sera by ELISA, whereas its expression on peripheral blood cells was evaluated by flow cytometry. Osteoclastogenesis was performed by culturing peripheral blood mononuclear cells (PBMCs) with or without anti-LIGHT antibodies. Obese patients showed significant high BMI-standard deviation score (SDS), weight-SDS, and Homeostatic model assessment for insulin resistance (HOMA-IR) that negatively correlated with the reduced Amplitude Dependent Speed of Sound (AD-SoS)-Z-score and Bone Transmission Time (BTT-Z)-score. They displayed significantly higher serum levels of LIGHT compared with controls (497.30 ± 363.45 pg/mL vs. 186.06 ± 101.41 pg/mL, p < 0.001). LIGHT expression on monocytes, CD3+-T-cells, and neutrophils was also higher in obese patients than in the controls. Finally, in PBMC cultures, the addition of anti-LIGHT antibodies induced a significant osteoclastogenesis inhibition. Our study highlighted the high serum levels of LIGHT in obese children and adolescents, and its relationship with both the grade of obesity and bone impairment.

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“…Levels of total Ca were quantified by photometric color tests, P was measured by a photometric UV test by the Cobas clinical chemistry unit. Coefficients of variations for measurements of the same patients’ sera were published recently [20, 21].…”

Section: Methodsmentioning

confidence: 99%

Age-Related Association of Calcitonin with Parameters of Anthropometry, Bone and Calcium Metabolism during Childhood

et al. 2020

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Introduction: The thyroid parafollicular hormone calcitonin (CT) shows particularly high blood levels in early childhood, a period of high bone turnover, which decrease with increasing age. Data about the physiological role of CT during infancy, childhood, and adolescence are contradictory or lacking. Objective: We hypothesize that CT demonstrates age-related correlations with parameters of bone growth and turnover as well as with parameters of calcium homeostasis. Methods: 5,410 measurements of anthropometric data and venous blood samples were collected from 2,636 participants of the LIFE Child study, aged 2 months–18 years. Univariate correlations and multiple regression analysis were performed between serum CT and anthropometric indicators (height standard deviation scores [SDS] and BMI-SDS), markers of calcium (Ca) homeostasis (Ca, parathyroid hormone, 25-OH vitamin D, and phosphate [P]), bone formation (procollagen type 1 N-terminal propeptide [P1NP], osteocalcin), and bone resorption (β-CrossLaps). Results: CT was significantly associated with Ca (β = 0.26, p < 0.05) and P1NP/100 (β = 0.005, p < 0.05) in children aged 2 months–1.1 years. These relations were independent of age and sex and could not be confirmed in children aged 1.1–8 years. Independent of age, sex, puberty, P, and height SDS CT showed a significant positive relation to Ca (β = 0.26; p < 0.001) in children aged 8–18 years. Conclusions: Our findings suggest a unique association between CT and Ca in periods of rapid bone growth and point to a possible involvement of CT in promoting bone formation during the first year of life.

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Children and adolescents with obesity have reduced serum bone turnover markers and 25-hydroxyvitamin D but increased parathyroid hormone concentrations – Results derived from new pediatric reference ranges

Cited by 44 publications

References 35 publications

The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

Shedding “LIGHT” on the Link between Bone and Fat in Obese Children and Adolescents

Age-Related Association of Calcitonin with Parameters of Anthropometry, Bone and Calcium Metabolism during Childhood

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