Serum leptin, parathyroid hormone, 1,25-dihydroxyvitamin D, fibroblast growth factor 23, bone alkaline phosphatase, and sclerostin relationships in obesity
Open accessAbstract
BACKGROUND: Obesity is associated with hyperparathyroidism and increased bone mass and turnover, but their pathogeneses are unclear. AIMS: Our aim was to determine in obesity interrelationships among serum levels of leptin, the mineral-regulating hormones, bone turnover markers, and sclerostin. METHODS: This case-control study was performed in 20 women having bariatric surgery and 20 control women matched for race and age. Anthropometrics and fasting serum biochemistries were measured in controls and in bariatric patients the morning of surgery. RESULTS: Body mass index (48.9 vs. 25.4 kg/m(2)), weight (128.6 vs. 71.9 kg), serum leptin (74.6 vs. 25.2 ng/ml), PTH (44.5 vs. 28.8 pg/ml), fibroblast growth factor 23 (FGF23) (42.4 vs. 25.9 pg/ml), and bone alkaline phosphatase (BAP) (25.8 vs. 17.5 U/liter) were higher, but height (162.3 vs. 167.7 cm) and 1,25-dihydroxyvitamin D (1,25D) (39.2 vs. 48.7 pg/ml) were lower in bariatric surgery patients than controls. There was no difference in serum sclerostin, amino-terminal collagen cross-links, 25-hydroxyvitamin D (25D), calcium, phosphate, and creatinine between groups. In the combined sample, leptin was positively related to PTH, FGF23, and BAP but not to 1,25D or sclerostin. Multiple regression analysis demonstrated that PTH was predicted by leptin and Ca (R(2) = 0.39); 1,25D by 25D, FGF23, and phosphate (R(2) = 0.43); FGF23 by leptin and 1,25D (R(2) = 0.27); BAP by leptin, PTH, and Ca (R(2) = 0.39); and sclerostin by leptin and PTH (R(2) = 0.20). CONCLUSIONS: Women having bariatric surgery had higher leptin, PTH, FGF23, and BAP and lower 1,25D than controls. Leptin predicted the serum levels of PTH, 1,25D, and FGF23, the mineral-regulating hormones, and BAP, a bone formation marker, in women with body mass index ranging from 13.9-65.8 kg/m(2). The results suggest that leptin has an endocrine or paracrine effect on PTH and FGF23 production and that PTH may be one of the signals in obesity that leads to increased bone mass.
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Emerging data support a direct relationship between bone and fat.
“Emerging data also support a direct relationship between bone and fat16, 17.”
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Hip BMD declines after RYGB range between 8% and 11%.
“Declines in hip BMD range between 8-11%17, 52-54, 62, 67-69.”
From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [17]
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- Authors
- Grethen, E., Hill, K. M., Jones, R., Cacucci, B. M., Gupta, C. E., Acton, A., Considine, R. V., & Peacock, M.
- Affiliations
- Indiana University Indianapolis (US)
- St. Vincent Carmel Hospital (US)
- Corresponding author
- Peacock, Munro
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2012-05
- Volume
- 97
- Issue
- 5
- Pages
- 1655-1662
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC3339883
- OpenAlex
- W2016377710
- Cited by
- 136
- References
- 53
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 7 · 2022: 8 · 2021: 13 · 2020: 13 · 2019: 6 · 2018: 11 · 2017: 16 · 2016: 12 · 2015: 8 · 2014: 14 · 2013: 15 · 2012: 5
- FWCI
- 10.61
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK089070)
- National Center for Research Resources (UL1RR025761)
- Topics
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- obesity, leptin, parathyroid hormone, 1,25-dihydroxyvitamin D, fibroblast growth factor 23, sclerostin, bone-specific alkaline phosphatase, bone turnover markers, hyperparathyroidism, bariatric surgery, vitamin D, mineral metabolism, women, body mass index, phosphate, calcium
- MeSH terms
- Fibroblast Growth Factor-23, Adult, Alkaline Phosphatase, Bone and Bones, Female, Fibroblast Growth Factors, Genetic Markers, Humans, Middle Aged, Obesity, Parathyroid Hormone, Vitamin D, Gastric Bypass, Biomarkers, Case-Control Studies, Bone Morphogenetic Proteins, Leptin, Adaptor Proteins, Signal Transducing
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