The Effect of a Comprehensive Life-Style Intervention Program of Diet and Exercise on Four Bone-Derived Proteins, FGF-23, Osteopontin, NGAL and Sclerostin, in Overweight or Obese Children and Adolescents

Nutrients. 2022 Sep 13;14(18):3772. doi: 10.3390/nu14183772.

Abstract

The adipose and bone tissues demonstrate considerable interconnected endocrine function. In the present study, we determined the concentrations of fibroblast growth factor-23 (FGF-23), osteopontin, neutrophil gelatinase-associated lipocalin (NGAL) and sclerostin in 345 children and adolescents who were overweight or obese (mean age ± SD mean: 10.36 ± 0.16 years; 172 males, 173 females; 181 prepubertal; and 164 pubertal) before and after their participation in a comprehensive life-style intervention program of diet and exercise for one year. Following the one-year life-style interventions, there was a significant decrease in BMI (p < 0.01), FGF-23 (p < 0.05), osteopontin (p < 0.01) and NGAL (p < 0.01), and an increase in sclerostin (p < 0.01) concentrations. BMI z-score (b = 0.242, p < 0.05) and fat mass (b = 0.431, p < 0.05) were the best positive predictors and waist-to-height ratio (WHtR) (b = −0.344, p < 0.05) was the best negative predictor of the change of osteopontin. NGAL concentrations correlated positively with HbA1C (b = 0.326, p < 0.05), WHtR (b = 0.439, p < 0.05) and HOMA-IR (b = 0.401, p < 0.05), while BMI (b = 0.264, p < 0.05), fat mass (b = 1.207, p < 0.05), HDL (b = 0.359, p < 0.05) and waist circumference (b = 0.263, p < 0.05) were the best positive predictors of NGAL. These results indicate that FGF-23, osteopontin, NGAL and sclerostin are associated with being overweight or obese and are altered in relation to alterations in BMI. They also indicate a crosstalk between adipose tissue and bone tissue and may play a role as potential biomarkers of glucose metabolism. Further studies are required to delineate the physiological mechanisms underlying this association in children and adolescents.

Keywords: FGF-23; NGAL; adolescence; bone; childhood; obesity; osteopontin; overweight; sclerostin.

MeSH terms

  • Adaptor Proteins, Signal Transducing / metabolism
  • Adolescent
  • Biomarkers
  • Body Mass Index
  • Bone and Bones / metabolism
  • Child
  • Diet
  • Exercise
  • Female
  • Fibroblast Growth Factors / metabolism
  • Glucose
  • Glycated Hemoglobin / metabolism
  • Humans
  • Lipocalin-2
  • Male
  • Osteopontin / metabolism
  • Overweight* / complications
  • Overweight* / therapy
  • Pediatric Obesity* / complications
  • Pediatric Obesity* / therapy

Substances

  • Adaptor Proteins, Signal Transducing
  • Biomarkers
  • Glycated Hemoglobin A
  • Lipocalin-2
  • SOST protein, human
  • Osteopontin
  • Fibroblast Growth Factors
  • Glucose