The Effect of BMI, Age, Gender, and Pubertal Stage on Bone Turnover Markers in Chinese Children and Adolescents

Bingyan Cao; Meijuan Liu; Qipeng Luo; Qiao Wang; Min Liu; Xuejun Liang; Di Wu; Wenjing Li; Chang Su; Jiajia Chen; Chunxiu Gong

doi:10.3389/fendo.2022.880418

The Effect of BMI, Age, Gender, and Pubertal Stage on Bone Turnover Markers in Chinese Children and Adolescents

Front Endocrinol (Lausanne). 2022 Jun 13:13:880418. doi: 10.3389/fendo.2022.880418. eCollection 2022.

Authors

Bingyan Cao¹, Meijuan Liu¹, Qipeng Luo², Qiao Wang¹, Min Liu¹, Xuejun Liang¹, Di Wu¹, Wenjing Li¹, Chang Su¹, Jiajia Chen¹, Chunxiu Gong¹

Affiliations

¹ Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
² Department of Pain Medicine, Peking University Third Hospital, Beijing, China.

Abstract

Objectives: To ascertain the associations of serum bone turnover markers (BTMs) levels with body mass index (BMI) in Chinese children and adolescents, and whether the influence of BMI, age, pubertal stage on BTMs varied by gender.

Methods: A total of 500 students (180 controls and 320 children and adolescents with overweight/obesity) aged 9-14 years were randomly selected from the Chinese National Survey on Students Constitution and Health Cohort. Serum levels of BTMs, including bone formation marker bone alkaline phosphatase (BAP), collagen type 1 C-terminal propeptide (CICP), and bone resorption markers C-terminal telopeptide of type-I collagen (CTX) were determined by commercial enzyme-linked immunosorbent assay kits. The associations among BMI, age, gender, pubertal stage, and BTMs were analyzed.

Results: Serum levels of CICP and CTX in overweight/obese children and adolescents were lower than those in controls (p<0.05). Moreover, after subgroup analysis stratified by gender, the decreased serum CICP and CTX levels in overweight/obese children and adolescents were observed only in boys (p<0.05). After adjustment of age and pubertal stage, there was a negative correlation between serum BAP and BMI in both boys and girls (p<0.05). However, the correlations between serum CICP, CTX levels, and BMI were significant in boys but not in girls. Serum BAP and CICP levels were independently correlated with BMI, age, gender, and pubertal stage, while CTX levels were independently correlated with BMI, age, and gender (p<0.05). BAP, CICP, and CTX levels showed a clear age, gender, and pubertal stage dependence with significantly higher values in boys (p<0.05).

Conclusions: Our findings support the associations between serum BTMs levels and BMI in Chinese children and adolescents, and suggest age, gender, and pubertal stage differences in this relationship that warrant future studies.

Keywords: age; body mass index (BMI); bone turnover markers (BTMs); children; gender; pubertal stage.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Biomarkers
Body Mass Index
Bone Remodeling
Child
China / epidemiology
Collagen Type I
Female
Humans
Male
Overweight* / epidemiology
Pediatric Obesity* / epidemiology

Substances

Biomarkers
Collagen Type I