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In youths with obesity, sclerostin may influence insulin resistance
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The glycoprotein sclerostin, a negative regulator of bone formation, is associated with a measure of insulin resistance in children and adolescents, with the association much stronger in youths with obesity, according to study findings published in Bone.
Anna Wedrychowicz, MD, PhD, of the department of pediatric and adolescent endocrinology at the Polish American Children’s Institute, Jagiellonian University, Cracow, and colleagues analyzed data from 55 children and adolescents with obesity recruited from an outpatient clinic (mean age, 13 years; mean BMI, 28.89 kg/m²) and 26 healthy age-, sex- and Tanner stage-matched controls between 2015 and 2017. Researchers calculated participants’ BMI and collected fasting blood samples to measure serum sclerostin, osteocalcin, receptor activator of nuclear factor kappa B ligand (RANKL), leptin and adiponectin, vitamin D, lipid profile, glucose, C-peptide, insulin and HbA1c. Insulin resistance was calculated using homeostatic model assessment of insulin resistance. Researchers used analysis of covariance to evaluate the differences of sclerostin levels between children with obesity and controls.
In both children with obesity and controls, researchers observed a positive association between serum sclerostin levels and osteocalcin (r = 0.417; P = .027) and a negative correlation between sclerostin and HOMA-IR (r = –0.24; P = .045) and age (r = –0.23; P = .037). After adjustment for age, BMI standard deviation of samples (SDS) and Tanner stage, the association between sclerostin and HOMA-IR persisted (r = –0.3; P = .01).
Among participants with obesity, researchers observed a negative association between sclerostin levels and insulin, HOMA-IR, age, height and body mass; however, after adjusting for age, BMI SDS and Tanner stage of development, only the association between sclerostin and insulin and HOMA-IR persisted (r = –0.39; P = .005 and r = –0.39; P = .006, respectively).
“The correlation between sclerostin and HOMA-IR was much stronger in the obese patients than in the whole group,” the researchers wrote.
Among controls, researchers observed a negative association between sclerostin and C-peptide, persisting after adjustment for age, BMI SDS and Tanner stage.
“In young patients, the cross talk between bone-derived sclerostin and carbohydrate metabolism appear to be independent of other fat and bone-derived factors,” the researchers wrote. “In young patients who are obese, sclerostin’s action could be associated with decreasing insulin resistance. This observation is a novel finding, which demands further investigation due to important implications in the aspect of the risk of cardiovascular diseases in the future of this patient population.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
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