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The adipose and bone tissues demonstrate considerable interconnected endocrine function. In the present study, we determined the concentrations of fibroblast growth factor-23 (FGF-23), osteopontin, neutrophil gelatinase-associated lipocalin (NGAL) and sclerostin in 345 children and adolescents who were overweight or obese (mean age ± SD mean: 10.36 ± 0.16 years; 172 males, 173 females; 181 prepubertal; and 164 pubertal) before and after their participation in a comprehensive life-style intervention program of diet and exercise for one year. Following the one-year life-style interventions, there was a significant decrease in BMI (p &lt; 0.01), FGF-23 (p &lt; 0.05), osteopontin (p &lt; 0.01) and NGAL (p &lt; 0.01), and an increase in sclerostin (p &lt; 0.01) concentrations. BMI z-score (b = 0.242, p &lt; 0.05) and fat mass (b = 0.431, p &lt; 0.05) were the best positive predictors and waist-to-height ratio (WHtR) (b = −0.344, p &lt; 0.05) was the best negative predictor of the change of osteopontin. NGAL concentrations correlated positively with HbA1C (b = 0.326, p &lt; 0.05), WHtR (b = 0.439, p &lt; 0.05) and HOMA-IR (b = 0.401, p &lt; 0.05), while BMI (b = 0.264, p &lt; 0.05), fat mass (b = 1.207, p &lt; 0.05), HDL (b = 0.359, p &lt; 0.05) and waist circumference (b = 0.263, p &lt; 0.05) were the best positive predictors of NGAL. These results indicate that FGF-23, osteopontin, NGAL and sclerostin are associated with being overweight or obese and are altered in relation to alterations in BMI. They also indicate a crosstalk between adipose tissue and bone tissue and may play a role as potential biomarkers of glucose metabolism. Further studies are required to delineate the physiological mechanisms underlying this association in children and adolescents.

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The Effect of a Comprehensive Life-Style Intervention Program of Diet and Exercise on Four Bone-Derived Proteins, FGF-23, Osteopontin, NGAL and Sclerostin, in Overweight or Obese Children and Adolescents