kjhp Korean Journal of Health Promotion Korean J Health Promot 2234-2141 2093-5676 The Korean Society of Health Promotion and Disease Prevention 10.15384/kjhp.2017.17.3.145 kjhp-17-145 Original Article Association of Serum Osteocalcin with Metabolic Syndrome in Korean Adult Women KangJee-Hyun Department of Family Medicine, College of Medicine, Konyang University, Daejeon, Korea Corresponding author : Jee-Hyun Kang, MD, PhD Department of Family Medicine, College of Medicine, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: +82-42-600-9240, Fax: +82-42-600-9095 E-mail: jeehyunkang@yahoo.co.kr 012017 19012017 173145 151 30052017 29082017 Copyright © 2017 The Korean Society of Health Promotion and Disease Prevention 2017 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:

Serum osteocalcin level has been widely used as a bone turnover marker in clinical setting. In this study, we analyzed the relationship between serum osteocalcin concentration and metabolic syndrome as a cardiovascular risk factor in adult women.

 Methods:

We retrospectively reviewed the medical records of 89 adult women (29 premenopausal, 60 postmenopausal) who voluntarily measured serum osteocalcin concentration and lumbar spine bone mineral density (BMD) for the purpose of screening. The definition of metabolic syndrome was used National Cholesterol Education Program's Adult Treatment Panel III criteria except waist circumference which was adopted the Korean standard.

 Results:

The serum osteocalcin concentration with metabolic syndrome was significantly lower than those without metabolic syndrome (15.4±8.0 ng/mL vs. 22.4±12.2 ng/mL; P=0.001). The osteocalcin level was significantly lower in the groups with more than 4 risk factors for metabolic syndrome (10.1±6.7 ng/mL) than the groups with more than 3 (18.0±7.6 ng/mL) or 2 (23.6±7.1 ng/mL) risk factors. As a result of logistic regression analysis using serum osteocalcin, age, menopausal status, lumbar spine BMD and body mass index as independent variables, the presence of metabolic syndrome was independently associated with the serum osteocalcin level (β =-0.151, P=0.018).

 Conclusions:

The serum osteocalcin levels in adult women were significantly lower in the metabolic syndrome group, and also lower in the group with higher clustering of individual risk factors of metabolic syndrome.

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Serum osteocalcin level according to presence of metabolic syndrome (mean±SE).

Serum osteocalcin level according to number of components of metabolic syndrome (mean±SE).

General characteristics of the subjects

Variables Total (n=89) Without MS (n=77) With MS (n=12) P
Mean SD Mean SD Mean SD
Age, y 54.0 9.3 53.5 9.5 57.3 7.2 0.197
Height, cm 156.9 5.8 156.9 6.0 157.5 4.9 0.740
Weight, kg 59.5 9.3 58.2 8.2 68.1 12.0 0.001
Body mass index, kg/m2 24.1 3.4 23.6 3.1 27.3 3.7 <0.001
Waist circumference, cm 77.7 9.4 76.3 8.8 86.3 8.4 <0.001
Osteocalcin, ng/mL 21.5 12.0 22.4 12.2 15.4 8.0 0.001
Bone mineral density, g/cm2 1.107 0.177 1.101 0.176 1.146 0.185 0.415
Alkaline phosphatase, IU/L 64.0 24.4 64.6 26.0 59.6 8.8 0.506
Calcium, mg/dL 9.1 0.4 9.1 0.4 9.1 0.4 0.924
Phosphate, mg/dL 3.7 0.5 3.8 0.5 3.4 0.4 0.030
Systolic blood pressure, mmHg 116.0 16.4 114.7 16.8 124.4 10.5 0.056
Diastolic blood pressure, mmHg 75.4 10.4 75.0 10.7 77.7 7.6 0.416
Glucose, mg/dL 101.4 30.4 97.7 21.0 125.0 60.3 0.003
Total cholesterol, mg/dL 207.4 39.9 210.3 39.4 188.8 40.0 0.083
HDL-cholesterol, mg/dL 59.9 15.8 62.4 15.2 43.8 8.8 <0.001
LDL-cholesterol, mg/dL 136.7 31.9 138.4 31.5 126.1 33.6 0.218
Triglyceride, mg/dL 117.4 59.0 105.3 42.1 195.3 89.3 <0.001
Diabetes medication 7 7.9% 3 3.9% 4 33.3% 0.001
Hypertension medication 17 19.1% 9 11.7% 8 66.7% <0.001
Menopause 60 67.4% 50 64.9% 10 83.3% 0.209

Abbreviations: MS, metabolic syndrome; SD, standard deviation; HDL, high density lipoprotein; LDL, low-density lipoprotein.

Comparison of osteocalcin levels according to each component of metabolic syndrome

Component of metabolic syndrome Number Osteocalcin P
    Mean SD
Waist circumference       　
<85 cm 70 22.0 12.8 0.196
≥85 cm 18 20.0 8.4 　
Blood pressure       　
<130/85 mmHg 54 22.7 14.1 0.207
≥130/85 mmHg or hypertension medication 35 19.5 7.3 　
Glucose       　
<110 mg/dL 74 21.9 12.7 0.691
≥110 mg/dL or hypertension medication 15 19.1 7.4 　
Triglyceride       　
<150 mg/dL ≥150 mg/dL 72 17 21.8 20.1 11.8 13.0 0.071 　
HDL cholesterol       　
<50 mg/dL 23 20.8 10.0 0.627
≥50 mg/dL 66 23.2 16.5 　
Metabolic syndrome       　
<3 components 77 22.4 12.2 0.001
≥3 components 12 15.4 8.0 　

Abbreviations: SD, standard deviation; HDL, high density lipoprotein.

Logistic regression analysis for metabolic syndrome

Independent variables Coefficient (β) P
Model 1a    
Age, y -0.005 0.936
Menopause 2.184 0.088
Bone mineral density 2.363 0.241
Osteocalcin -0.154 0.014
Model 2b 　 　
Age, y -0.001 0.863
Menopause 1.861 0.191
Bone mineral density 1.256 0.567
Body mass index 0.254 0.013
Osteocalcin -0.151 0.018

Dependent variable: presence of metabolic syndrome.

Model 1 indepedent variables: age, menopause, bone mineral density, osteocalcin.

Model 2 independent variables: model 1+body mass index.