Relationships between Bone Turnover Markers and Factors Associated with Metabolic Syndrome in Prepubertal Girls and Boys

Abstract

The associations between individual components of metabolic syndrome (MetS) and bone health in children are complex, and data on this topic are sparse and inconsistent. We assessed the relationship between bone turnover markers and markers of the processes underlying MetS (insulin resistance and inflammation) in a group of presumably healthy children aged 9–11 years: 89 (51 girls, 38 boys) presenting without any features of MetS and 26 (10 girls, 16 boys) with central obesity and two features of MetS. Concentrations of glucose, triglycerides (TG), HDL cholesterol (HDL-C), C-reactive protein (CRP), HbA1c, total 25-hydroxyvitamin D (25(OH)D), intact-P1NP (N-terminal propeptide of type I procollagen), CTX-1 (C-terminal telopeptide of type I collagen) were assayed and insulin resistance was assessed (HOMA-IR). BMI centile, waist circumference (WC) and blood pressure were measured. The presence of MetS in girls resulted in significantly lower concentrations of CTX-1 and a trend to lower CTX-1 in boys. The concentrations of bone formation marker i-P1NP were not affected. Among the features associated with MetS, HOMA-IR appeared as the best positive predictor of MetS in girls, whereas CRP was the best positive predictor in boys. A significant influence of HOMA-IR on the decrease in CTX-1 in girls was independent of BMI centile and WC, and the OR of having CTX-1 below the median was 2.8-fold higher/1SD increased in HOMA-IR (p = 0.003). A weak relationship between CTX-1 and CRP was demonstrated in girls (r = −0.233; p = 0.070). Although TG, as a MetS component, was the best significant predictor of MetS in both sexes, there were no correlations between bone markers and TG. We suggest that dyslipidemia is not associated with the levels of bone markers in prepubertal children whereas CRP is weakly related to bone resorption in girls. In prepubertal girls, insulin resistance exerts a dominant negative impact on bone resorption, independent of BMI centile and waist circumference.

Association between Fasting and Postprandial Levels of Liver Enzymes with Metabolic Syndrome and Suspected Prediabetes in Prepubertal Children

“…In our study, participants with MetS were characterized by a significantly higher TG/HDL-C which was the second best predictor of MetS. In contrast, fasting glucose and HbA1c levels were similar, irrespective of MetS occurrence, as indicated in our previous study on children [21]. The correlation between GGT activity and lipid biomarkers (TG and TG/HDL-C), the significant increase in these two biomarkers towards higher GGT activity in tertiles (p = 0.018), but most importantly the association of postprandial changes with the presence of MetS, allow us to suggest that GGT level may indicate metabolic disturbances associated with lipid metabolism in children with MetS.…”

C-Reactive Protein as a Marker of Inflammation in Children and Adolescents with Metabolic Syndrome: A Systematic Review and Meta-Analysis

“…Bilinski et al reported that CRP was a good predictor of MetS in males, but not in females. Unfortunately, the designs of the included studies did not allow us to address this issue [50]. Due to the fluctuations in information regarding this topic, and the uncertainty in the data we obtained, we cannot issue a statement regarding the usage of hsCRP in distinguishing obesity from MetS.…”

Diagnostic Performance of Biomarker-Based Scores as Predictors of Metabolic Dysfunction-Associated Fatty Liver Disease Risk in Healthy Children

“…This cross-sectional study included 144 children aged 9–11, randomly selected from a cohort of 284 primary school children enrolled in a previous study [ 13 ]. In the study group, MAFLD was recognized in 43 subjects, based on the below described criteria.…”

“…Pediatric reference intervals for age and sex, related to the instrumentation and applied methodology, with URL ≥ 22 IU/L and ≥24 for ALT in girls and boys, GGT ≥ 16 IU/L and AST ≥ 36 IU/L were accepted according to Adeli et al [ 17 ]. BMI percentile classifications were performed in accordance with the guideline: overweight ≥ 85 and <95; obesity ≥ 95 percentile [ 13 ]. Central obesity was defined by a waist circumference (≥90th percentile of WC by sex and age for European population), increased blood pressure as SBP ≥ 90th percentile of BP by sex, height and age [ 13 ].…”