Low serum osteocalcin level is a potential marker for metabolic syndrome: results from a Chinese male population survey
Introduction
Metabolic syndrome (MetS) is a cluster of abnormal metabolic conditions that increases the risk of cardiovascular disease [1] and type 2 diabetes mellitus [2]. Typically, it includes abdominal obesity, dyslipidemia, hyperglycemia, and elevated blood pressure [3]. Individuals with MetS are associated with approximately 5- and 2-fold increased risk for type 2 diabetes mellitus [4] and cardiovascular disease [5], respectively. In addition, MetS is a considerable public health issue in both developed and developing countries now [6], [7], [8].
On the other hand, osteocalcin has recently been recognized as a bone-derived hormone to regulate energy metabolism. In 2007, Lee et al [9] found that, compared with wild-type mice, osteocalcin−/− knockout mice had an abnormal amount of fat mass and an increase in serum triglycerides, and exhibited impaired insulin secretion, insulin resistance, and glucose intolerance. Expression of insulin target genes in liver and muscle (Fox a2, Mcad, Nrft, etc) and adiponectin gene in adipose all decreased. In vitro, insulin expression was induced when pancreatic β-cells were cocultured with bacterially produced recombinant osteocalcin (3 ng/mL) [9]. Furthermore, osteocalcin−/− mice had higher insulin and lower glucose levels when injected with recombinant osteocalcin [9]. Similar results also appear in a population-based study. In humans, significant inverse associations of osteocalcin with insulin resistance, blood glucose, adiposity, and triglycerides have been described [10], [11], [12], [13]. One recent study in blacks and non-Hispanic whites reported a negative relationship between serum osteocalcin and the presence of MetS [14]. However, this study was conducted in an older, predominantly hypertensive cohort, rather than younger and mainly normotensive adults. Besides, osteocalcin levels varied depending on ethnic background [15]. All these prompted us to perform the present study to examine the association of serum osteocalcin level with MetS in a Chinese male population.
Section snippets
Study population
The Fangchenggang Area Male Health and Examination Survey was a population-based study conducted among noninstitutionalized Chinese men aging from 17 to 88 years old in Guangxi, which was designed to investigate the effects of environmental and genetic factors and their interaction with the development of age-related chronic diseases. A comprehensive demographic and health survey was conducted among 4303 continuous men who participated in a large-scale physical examination in the Medical Centre
Results
The characteristics of the participants were shown in Table 1. Data were presented for participants divided into MetS (n = 297) and non-MetS (n = 2047). Among all individuals, the prevalence of MetS was 12.7%. Compared with participants with non-MetS, men with MetS had lower serum osteocalcin levels (−3.76, P < .001) (Table 1).
The mean concentration of serum osteocalcin was 23.57 ng/mL in the study population, with a standard deviation of 1.38 ng/mL. A trend of decreased osteocalcin associated
Discussion
This is the first large cross-sectional study to highlight the important relationship between osteocalcin levels and MetS in a Chinese male population. Consistent with the previous study[19], osteocalcin levels decreased with age. The prevalence of MetS (12.7%) in Fangchenggang area of Guangxi was similar to the prevalence of MetS in China in 2000-2001 (13.6%) based on the modified Adult Treatment Panel III criteria [7].
Our study revealed that serum osteocalcin levels were significantly
Acknowledgment
The work described in this article is supported by grants from Guangxi Graduate Education Innovation Program (2010105981002M175), the National Natural Science Foundation of China (30945204, 81060029) and the Guangxi Provincial Department of Finance and Education (2009GJCJ150). We express our sincere thanks to the local research teams from Fangchenggang First People's Hospital, Fangchenggang, China, for their contribution to the survey.
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Author contribution statement: AT, YG, XY, HZ, NX, and ZM designed the study. LM, AT, and YG collected samples and conducted the osteocalcin measurement. XQ and TP supervised the laboratory work. XY and HZ conducted the statistical analyses. AT wrote the first draft of the paper. NX, YG, and ZM revised the manuscript for important intellectual content.