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Journal of Pediatric Endocrinology and Metabolism

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Volume 29, Issue 8


Decreased undercarboxylated osteocalcin in children with type 2 diabetes mellitus

Junji Takaya
  • Corresponding author
  • Department of Pediatrics, Kawachi General Hospital, 1-31 Yokomakura, Higashi-Osaka, Osaka 578-0954, Japan
  • Department of Pediatrics, Kansai Medical University, Osaka, Japan
  • Email
  • Other articles by this author:
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/ Yuko Tanabe / Yuichi Kuroyanagi / Kazunari Kaneko
Published Online: 2016-07-06 | DOI: https://doi.org/10.1515/jpem-2015-0417



Osteocalcin (OC) is a bone-specific protein secreted by osteoblasts and often used as a bone formation biomarker. OC undergoes post-translational carboxylation to yield carboxylated osteocalcin (Gla-OC) and undercarboxylated osteocalcin (uc-OC) molecules. The aim of this study was to explore the association between bone and glucose metabolism by evaluating OC, ionized cations, and markers of glucose metabolism in children with obesity and type 2 diabetes mellitus (DM2).


The subjects were nine children with DM2 [six males, three females; age 15.7±4.1 years; duration of disease 3.2±1.2 years], 18 children with simple obesity [12 males, six females; age 12.6±4.1 years], and 12 controls [eight males, four females; age 12.3±3.2 years]. Serum Gla-OC and uc-OC levels were determined using an enzyme-linked immunosorbent assay (ELISA).


Patients with DM2 (0.65±0.46 ng/mL), but not with obesity (1.11±0.55 ng/mL), had lower uc-OC levels than controls (1.25±0.49 ng/mL). Serum uc-OC was negatively correlated with mean serum glucose levels (r=–0.447, p=0.013) and hemoglobin A1c (HbA1c) (r=–0.455, p=0.012) in all subjects. Serum Gla-OC was correlated with serum alkaline phosphatase (r=0.601, p<0.001) and inorganic phosphorus (r=0.686, p<0.001), yet negatively correlated with age (r=–0.383, p=0.030). Mean serum ionized magnesium was lower in DM2 subjects than in controls. Mean serum ionized calcium was higher in obese subjects than in controls. In all subjects, mean serum ionized magnesium was negatively correlated with mean serum glucose levels.


Osteoblast-derived protein OC, especially uc-OC, may have a role in the pathophysiology of diabetes by being associated with blood glucose homeostasis.

Keywords: calcium; magnesium; obesity


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About the article

Corresponding author: Junji Takaya, MD, Department of Pediatrics, Kawachi General Hospital, 1-31 Yokomakura, Higashi-Osaka, Osaka 578-0954, Japan, Phone: +81-72-965-0731, Fax: +81-72-965-2022

Received: 2015-10-23

Accepted: 2016-04-27

Published Online: 2016-07-06

Published in Print: 2016-08-01

Author contributions: JT and KK conceived and designed the study and obtained funding. JT, YT, and YO collected and analyzed the data. YT and YK recruited patients. JT wrote the draft, with critical revision from all authors. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: Part of this study was supported by a Grant-in-Aid for Scientific Research (C) from the Japanese Society for the Promotion of Science (No. 24591614).

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 29, Issue 8, Pages 879–884, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2015-0417.

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