The Relationship Between Bone Morphogenic Protein-4 and Visceral-Central Adiposity

Excessive fat accumulation can adversely affect vital organs, primarily because of energy imbalance. Hepatosteatosis is characterized by visceral fat accumulation, whereas obesity is associated with central fat deposition. This study aimed to determine the differences in bone morphogenetic protein 4 (BMP-4) levels according to the presence of obesity and hepatosteatosis.

A total of 84 volunteers evaluated at the Erciyes University Faculty of Medicine Child Health and Diseases Polyclinic were included. Pediatric radiological assessments were conducted for hepatosteatosis, and BMP-4 gene expression analysis was performed at the Erciyes University Genome and Stem Cell Center, using patient records and RNA extracted from peripheral blood samples. Subsequently, groups were formed based on obesity and hepatosteatosis status, and BMP-4 expression levels were compared between groups.

The mean BMP-4 expression coefficient in the entire cohort was 1.3. Based on the BMI percentile groups, BMP-4 expression was highest in normal-weight individuals and lowest in overweight individuals, showing a statistically significant difference (p=0.024). In children with obesity, a weak positive correlation was noted between BMP-4 and glucose levels (r=0.315) and between BMP-4 and gamma-glutamyl transpeptidase levels (r=0.328).

BMP-4 may play a role in the modulation of obesity and hepatosteatosis. These findings suggest that BMP-4 expression decreases during initial weight gain, but increases in obese individuals. This suggests that BMP-4 increases with the onset of obesity. An increase in BMP-4 levels at the onset of obesity initiates the activation of resistance mechanisms.