الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Obesity has become a growing public health problem in both developed and developing countries, with about one third of the world‘s population being obese (Forse et al., 2020). Pediatric obesity leads to adult obesity and many serious complications with estimated prevalence of about 125 million children being obese (Kyler et al., 2019; Triantafyllidis et al., 2020). Osteoporosis represents one of the serious health consequences of obesity. Osteoblasts were found to release that hormone called osteocalcin which maintains glucose metabolism and homeostasis. In case of osteoporosis, there would be defective osteocalcin release. This in turn decreases insulin sensitivity and thus metabolic syndrome develops. In pediatrics, obesity is considered to be an important inducer for insulin resistance and metabolic syndrome which are responsible for the adverse problems of obesity exerted on bone; as insulin promotes osteoblasts for bone development (Giudici et al., 2017; Liu et al., 2015). So it‘s a kind of vicious circle with complex interplay between adipose tissue, glucose homeostasis and bone health. So this work aimed to measure serum level of osteocalcin in obese children and adolescents with and without metabolic syndrome and to assess its relation to insulin resistance and duration of breastfeeding during infancy period. This study included 50 obese children with criteria of metabolic syndrome, 22 males and 28 females; their ages ranged from 10 to 17 years with mean of 12.13 ± 2.01 years, 50 obese children without criteria of metabolic syndrome, 21 males and 29 females; their ages ranged from 10 to 15.5 years with mean of 11.53 ± 1.43 years and 50 healthy children of matched age and sex who weren‘t obese and had no criteria of metabolic syndrome enrolled as controls. All Subjects included in this study were subjected to the following: • Complete History Taking: emphasizing on breastfeeding duration. • Through Clinical Examination including chest, abdomen and heart beside blood pressure measurement, pubertal staging using the method of Tanner and anthropometric measurements including weight, height, BMI, waist circumference and hip circumference. • Laboratory Investigations: including CBC, liver functions, renal functions, fasting blood glucose, fasting serum insulin, lipid profile and osteocalcin. The results of this study were as follows: • Birth weight and acanthosis nigricans were statistically significantly higher in group Ⅰ than group Ⅱ and Ⅲ. • Weight, BMI and BMI Z-score were statistically significantly lower in group Ⅲ than group Ⅰ and Ⅱ. • Waist circumference, hip circumference, SBP and DBP were statistically significantly higher in group I than group Ⅱ and Ⅲ. • Total cholesterol, triglycerides, fasting blood glucose, fasting serum insulin and HOMA-IR were statistically significantly higher in group I than group Ⅱ and Ⅲ. • There was insignificant difference between the studied groups as regards age, sex, breastfeeding duration and pubertal development. • Serum osteocalcin levels were statistically significantly lower in group I and Ⅱ than group Ⅲ. • Osteocalcin was statistically significantly higher in males than females of group I. • HOMA-IR Index was statistically significantly higher in males than females of group I. • Serum osteocalcin levels were statistically significantly lower in the presence of acanthosis nigricans in patients of group I. • Serum osteocalcin levels were statistically significantly higher in patients of group I who had pubertal signs. • HOMA-IR Index was statistically significantly higher among patients of group I who had pubertal signs. • HOMA-IR Index was statistically significantly higher in patients of group I who received short duration of breastfeeding. • Osteocalcin was statistically significantly higher in males than females of group Ⅱ. • Significant positive correlation between serum osteocalcin levels BMI and waist circumference in group Ⅰ. • Significant positive correlation between serum osteocalcin levels and birth weight in group Ⅱ. • Significant negative correlation between serum osteocalcin, fasting blood glucose and cholesterol levels in group Ⅰ. • Significant negative correlation between serum osteocalcin levels, waist circumference and BMI in group Ⅱ. • Significant positive correlation between HOMA-IR Index and BMI Z-score in group I. • Significant positive correlation between HOMA-IR Index with fasting blood glucose and serum insulin levels in group I and II. • Significant positive correlation between HOMA-IR Index and birth weight in group Ⅱ.