title: [Assessment of anthropometric parameters and serum leptin and fetuin-A levels in children and adolescents with osteosarcoma after anticancer treatment].
abstract: Cancer and the use of a comprehensive anti-cancer treatment are unfavorable factors, which have a significant impact on bone mass accumulation, bone mineralization and consequently the occurrence of osteoporosis. Bone turnover is regulated by complex mechanisms, among which an important role play OPG/RANK/RANKL signaling pathway, adipokines, and fetuin-A. The aim of the study was to evaluate bone mineral density and concentrations of leptin and fetuin-A in patients with osteosarcoma after anti-cancer treatment.
  
  
  METHODS
  The study included 50 children and adolescents aged 10-21 years. The study group consisted of 25 patients with osteosarcoma and 25 healthy counterparts as a control group. The examination was conducted 2 months after the last course of postoperative chemotherapy and included densitometric measurements: bone mineral content (BMC), bone mineral density (BMD), fat mass, lean mass and biochemical measurements: serum concentrations of calcium, magnesium, phosphate, 25-hydroksyvitamin D, alkaline phosphatase, leptin and fetuin-A. Concentrations of leptin and fetuin-A were determined by immunoenzymatic methods.
  
  
  RESULTS
  In patients with osteosarcoma after anti-cancer treatment, we observed significantly reduced bone mineral content, bone mineral density and lean body mass compared with the healthy children (p < 0.05, p < 0.01, p < 0.05, respectively). Mean values of z-score of the whole body BMD and z-score of the lumbar BMD L1-L4 were significantly lower in patients than in the controls (p < 0.001). The serum concentrations of phosphate, magnesium, and alkaline phosphatase in both studied groups were similar, while calcium was significantly lower (p < 0.05) in patients than in the healthy children. The concentration of 25-hydroxyvitamin D was about two-fold lower, while leptin approximately 2.5-fold higher in patients than in the controls. The mean value of fetuin-A was similar in both studied groups. Statistically significant positive correlations between body composition parameters and the values of BMD, as well as between anthropometric parameters and leptin and fetuin-A were observed.
  
  
  CONCLUSIONS
  The deficit in bone mass observed in patients with malignant bone tumors after anti-cancer treatment might be the result of decreased serum calcium and vitamin D concentrations. The observed correlation between anthropometric and biochemical parameters may indicate the link between bone and adipose tissue metabolism.
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Ambroszkiewicz
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rychłowska-Pruszyńska
authors.forename: Magdalena
authors.initials: M
authors.lastname: Chełchowska
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Rogowska
authors.forename: Grazyna
authors.initials: G
authors.lastname: Rowicka
authors.forename: Teresa
authors.initials: T
authors.lastname: Klepacka
authors.forename: Joanna
authors.initials: J
authors.lastname: Gajewska
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D000886:Anthropometry; D015519:Bone Density; D001859:Bone Neoplasms / Q000378:metabolism* / Q000628:therapy*; D001842:Bone and Bones / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008274:Magnesium / Q000097:blood; D008297:Male; D012516:Osteosarcoma / Q000378:metabolism* / Q000628:therapy*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D055815:Young Adult; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*
chemical_list: D020738:Leptin; D060749:alpha-2-HS-Glycoprotein; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D000469:Alkaline Phosphatase; D008274:Magnesium; D002118:Calcium