Ankara University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey
Ankara University Faculty of Medicine, Department of Pediatric Endocrinology, Ankara, Turkey
J Clin Res Pediatr Endocrinol. 2022 Dec 1;14(4):433-443. doi: 10.4274/jcrpe.galenos.2022.2022-1-15. Epub 2022 Jul 21.
The harmful or beneficial effect of obesity on bone mineral density (BMD) remains controversial in children and adolescents. Fibroblast growth factor 21 (FGF21) is a metabolic factor that plays a specific role in the regulation of carbohydrate and lipid metabolism. However, the role of FGF21 in bone metabolism appears paradoxical and is complex. To determine whether serum FGF21 level was associated with BMD in obese children and adolescents.
The study was conducted with the participation of children and adolescents aged 8-18 years. Ninety-eight obese children were included in the study group and 44 children were included in the control group. BMD, in addition to the routine obesity workup, which includes fasting blood glucose, fasting insulin levels, lipid profile, and liver enzymes; serum FGF21 levels have been analyzed.
The mean age of the obese group (n=98) was 13.34±2.24 years and the mean age of controls (n=44) was 13.48±2.87 years. Based on International Diabetes Federation criteria, 15 of 98 (15.3%) patients were metabolically unhealthy. FGF21 levels were 193.54±139.62 mg/dL in the obese group and 158.69±151.81 mg/dL in the control group (p=0.06). There was no difference between the FGF21 and BMD z-score values of girls and boys in the obese and control groups (p>0.05).
BMD-z-score was increased in obese children compared to healthy control. Moreover, BMD-z-score tended to be higher when more metabolic risk factors were present. However, there was no significant relationship between FGF21 levels and BMD z-score values in obese children.
肥胖对骨密度（BMD）的有害或有益影响在儿童和青少年中仍存在争议。成纤维细胞生长因子 21（FGF21）是一种代谢因子，在调节碳水化合物和脂质代谢方面发挥着特殊作用。然而，FGF21 在骨代谢中的作用似乎存在矛盾且复杂。本研究旨在确定肥胖儿童和青少年的血清 FGF21 水平是否与 BMD 相关。
本研究纳入了 8-18 岁的儿童和青少年。研究组纳入 98 例肥胖儿童，对照组纳入 44 例儿童。除了常规的肥胖检查（包括空腹血糖、空腹胰岛素水平、血脂谱和肝酶）外，还分析了 BMD 和血清 FGF21 水平。
肥胖组（n=98）的平均年龄为 13.34±2.24 岁，对照组（n=44）的平均年龄为 13.48±2.87 岁。根据国际糖尿病联合会的标准，98 例患者中有 15 例（15.3%）代谢不健康。肥胖组的 FGF21 水平为 193.54±139.62mg/dL，对照组为 158.69±151.81mg/dL（p=0.06）。肥胖组和对照组的女孩和男孩的 FGF21 和 BMD z 评分值之间没有差异（p>0.05）。
与健康对照组相比，肥胖儿童的 BMD-z 评分增加。此外，当存在更多的代谢危险因素时，BMD-z 评分倾向于更高。然而，肥胖儿童的 FGF21 水平与 BMD z 评分值之间没有显著关系。
