title: Independent Relationship of Osteocalcin Circulating Levels with Obesity, Type 2 Diabetes, Hypertension, and HDL Cholesterol.
abstract: BACKGROUND
  Osteocalcin, a protein synthesized by osteoblasts during the bone formation phase of bone remodeling, is used as a biomarker for the bone production process, and its serum levels are positively correlated with bone mineral density during treatment with anabolic bone drugs for osteoporosis. Higher fat mass has been shown to be a risk factor for osteoporosis and fragility fractures and body fat and bone interplay through several adipokines and bone-derived molecules, regulating bone remodeling, adipogenesis, body weight control, and glucose homeostasis.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the relationship between total osteocalcin levels and obesity, hypertension and type 2 diabetes.
  
  
  METHODS
  The present study was performed in a cohort of 298 patients including a) 121 overweight and obese patients, unaffected by hypertension or type 2 diabetes, b) 129 subjects affected by hypertension and not by type 2 diabetes, and c) 48 subjects affected by both hypertension and type 2 diabetes. No subject of the group of overweight and obese patients was taking any kind of drug. All patients affected by hypertension, with or without type 2 diabetes, were taking drugs for hypertension. Examining only patients affected by type 2 diabetes (n: 48), 43 (90% of all) were taking drugs to reduce blood glucose levels, 26 (54% of all) were taking drugs to reduce cholesterol levels (statins and/or ezetimide, etc), and 4 (8% of all) were taking ω-3 for hypertriglyceridemia. Each patient was evaluated for anthropometric measurements as well as for serum osteocalcin and uric acid, and plasma glucose, HbA1c, and lipid determination.
  
  
  RESULTS
  Osteocalcin levels were significantly and negatively associated with BMI, waist circumference, and HbA1c, and significantly and positively correlated with HDL-cholesterol and systolic blood pressure in the whole population. Osteocalcin levels did maintain an independent negative association with BMI, and HbA1c, and positive association with HDL cholesterol and systolic blood pressure when a multiple regression analyses was performed by considering osteocalcin levels as the dependent variable and BMI, systolic blood pressure, HbA1c, and HDL cholesterol as independent variables. When age was included in the analyses among the independent variables, osteocalcin levels maintained an independent association with BMI, systolic blood pressure, HbA1c, and HDL cholesterol, but not with age.
  
  
  CONCLUSIONS
  The results of the present study seem to suggest that patients with obesity and type 2 diabetes are at higher risk of lower osteocalcin levels and bone formation, whereas higher HDLcholesterol levels and systolic blood pressure seem to be associated to higher osteocalcin production.
authors.affiliation: Clinical Nutrition Unit, Medical Oncology, Department of Internal Medicine and Clinical Oncology, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: De Pergola
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Triggiani
authors.forename: Nicola
authors.initials: N
authors.lastname: Bartolomeo
authors.forename: Adele
authors.initials: A
authors.lastname: Nardecchia
authors.forename: Vito Angelo
authors.initials: VA
authors.lastname: Giagulli
authors.forename: Irene
authors.initials: I
authors.lastname: Bruno
authors.forename: Domenico
authors.initials: D
authors.lastname: Caccavo
authors.forename: Franco
authors.initials: F
authors.lastname: Silvestris
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D015675:Osteocalcin / Q000097:blood*; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D015675:Osteocalcin
keywords: Bone formation; hypertension; obesity; osteocalcin; type 2 diabetes.