Abnormal Bone Turnover Observed in Obese Children based on Puberty Stage-Specific Bone Turnover Marker Reference

Area of Science:

• Pediatric Endocrinology
• Bone Metabolism Research
• Adolescent Health

Background:

• Childhood and adolescence are critical for lifelong bone health.
• The influence of obesity on bone health during these periods remains debated.
• Lack of standardized, age-, sex-, and puberty-specific bone turnover markers (BTMs) hinders accurate assessment of bone metabolism.

Purpose of the Study:

• To develop age-, sex-, and puberty stage-specific reference curves for BTMs in children and adolescents.
• To investigate the effects of obesity on bone metabolism within the Chinese pediatric population.

Main Methods:

• Utilized data from the Shenzhen School-based Nutrition and Growth study.
• Established BTM reference curves using 800 normal BMI participants (ages 6-18).
• Compared 200 obese participants (BMI > 95th percentile) with matched healthy controls, measuring bone mineral density, procollagen type 1 N-propeptide (P1NP), and β-C-telopeptide of type I collagen (CTX).

Main Results:

• BTMs showed significant variations based on age, sex, and puberty stage.
• Obese boys exhibited a higher prevalence of low P1NP levels (indicating reduced bone formation).
• Obese girls displayed a higher proportion of elevated CTX levels (indicating increased bone resorption).

Conclusions:

• Generated age-, sex-, and puberty stage-specific reference curves for P1NP and CTX.
• Obesity negatively affects bone formation in boys and bone resorption in girls.
• These findings provide essential benchmarks for assessing bone health in relation to obesity in pediatric populations.