Interrelationship between bone turnover markers, calciotropic hormones and leptin in obese Saudi children.

OBJECTIVE: Fat-bone relationship involves the interaction among endocrine, inflammatory, immune processes and bone turnover. We tried to assess the association between Leptin and bone turnover markers (OCN, β-CTx, ALP), calciotropic hormones PTH and 25(OH)D in obese Saudi children.

PATIENTS AND METHODS: A cross-sectional study performed with 60 obese children and 36 lean children. For all subjects, OCN, ALP, β-CTx, PTH, 25(OH)D, leptin, Ca and Pi were investigated. Levels of leptin were measured by [ELISA] method, and OCN, β-CTx, PTH and 25-(OH)D by an electrochemiluminescence immunoassay.

RESULTS: Sixty obese Saudi children had means weight (38.3 vs. 13.8 kg), height (121.0 vs. 91.8 cm) leptin (23.04 vs.16.88 ng/ml), PTH (31.5 vs. 14.7 pg/ml), Pi (1.67 vs. 1.54 mmol/l) were significantly higher and 25(OH)D (21.02 vs. 29.45 ng/ml) was significantly lower than controls. There was no difference in serum OCN, β-CTx, ALP and calcium between groups (p > 0.05). In the correlation study, OCN were significantly positively correlated with height, ALP, age, PTH, and β-CTx (r = 0.347, 0.32, p < 0.05), (r = 0.35, 0.51, 0.66, p < 0.01 respectively), while serum 25(OH)D was negatively correlated with PTH, weight, height and BMI (r = -0.45, -0.55, -0.55, -0.47, p < 0.01 respectively). PTH was positively correlated with leptin and β-CTx (r = 0.41, 0.44, p < 0.01), but not to ALP and BMI percentile. β-CTx correlated significantly positive with Pi (r = 0.34 p < 0.05) and ALP with BMI percentile (r = 0.42, p < 0.05). Multiple regression analysis demonstrated that PTH was predicted by leptin and β-CTx (R2 = 0.55); β-CTx by leptin and OCN (R2 = 0.498); OCN by PTH and β-CTx (R2 = 0.47); and 25(OH)D by PTH (R2 = 0.21).

CONCLUSIONS: The obese children had increased levels of leptin and PTH with strong associated with bone turn over markers OCN, β-CTx and deficiency of 25(OH)D which may be playing an important role in the pathogenesis of obesity and related bone metabolic risk diseases as osteoporosis and fractures.