1
|
Singhal V, Kaur S, Haidar LA, Lee H, Bredella MA, Misra M. Differences in bone accrual over one year in young girls with obesity compared to Normal weight controls. Bone 2023; 172:116757. [PMID: 37030498 PMCID: PMC10198942 DOI: 10.1016/j.bone.2023.116757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/14/2023] [Accepted: 03/31/2023] [Indexed: 04/10/2023]
Abstract
Despite higher bone mineral density (BMD), women with obesity are at an increased risk of fracture compared to normal-weight women. Optimal adolescent bone accrual is critical for normal peak bone mass acquisition and future bone health. Whereas several studies have examined the impact of low body weight on bone accrual in youth, data are lacking regarding the impact of obesity on bone accrual. We examined bone accrual over one year in young women with moderate to severe obesity (OB) (n = 21) versus normal-weight controls (NWC) (n = 50). Participants were 13-25 years old. We used dual-energy X-ray absorptiometry to assess areal BMD (aBMD) and high resolution peripheral quantitative computed tomography (distal radius and tibia) to assess volumetric BMD (vBMD), bone geometry, and microarchitecture. Analyses were controlled for age and race. The mean age was 18.7 ± 2.7 years. OB and NWC were similar for age, race, height, and physical activity. OB had a higher BMI (p < 0.0001) and younger menarchal age (p = 0.022) than NWC. Over one year, OB did not demonstrate the increase in total hip BMD observed in NWC (p = 0.03). Increases in percent cortical area and cortical thickness, and cortical and total vBMD at the radius were lower in OB than in NWC (p ≤ 0.037). Groups did not differ for tibial bone accrual. We demonstrate that longitudinal bone accrual is impaired at the total hip and radial cortex in young women with obesity, raising concerns regarding their future bone health.
Collapse
Affiliation(s)
- Vibha Singhal
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; MGH Weight Center, Boston, MA, United States of America; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America.
| | - Snimarjot Kaur
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Lea Abou Haidar
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Hang Lee
- MGH Biostatistics Center and Harvard Medical School, Boston, MA, United States of America; Department of Medicine and Harvard Medical School, Boston, MA, United States of America
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Madhusmita Misra
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| |
Collapse
|
2
|
Mengel E, Tamme R, Remmel L, Purge P, Mäestu E, Jürimäe J, Tillmann V. Pubertal increment in insulin resistance is negatively related to lumbar bone mineral density in 18-year-old males. Osteoporos Int 2023; 34:161-170. [PMID: 36367566 DOI: 10.1007/s00198-022-06591-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022]
Abstract
UNLABELLED Transient insulin resistance seen during puberty is expected to favour body growth, but our results show that increment in insulin resistance even in physiological ranges during puberty might compromise lumbar spine bone mineral density accrual independently of body composition parameters, and therefore adult bone quality might be challenged. INTRODUCTION Insulin resistance (IR) might have a compromising effect on growing bone, and therefore adult bone quality might be challenged. The aim of the present study was to identify whether increases in IR during puberty contribute to bone mineral characteristics in males independently of body composition parameters. METHODS This is a retrospective cohort-based longitudinal observational study. Data from 85 subjects were included. Boys were studied annually during their pubertal years (12 years at baseline) and at follow-up at the age of 18 years. Anthropometry, bone age, fasting blood samples, body composition, total body, and lumbar spine bone mineral characteristics were measured. Insulin resistance was determined by homeostatic model assessment of IR (HOMA-IR). Multiple regression analysis was performed to determine the effect of changes in HOMA-IR during pubertal years as a longitudinal predictor to fixed bone mineral outcome variables at the age of 18 years. All models were adjusted to potential clinically justified confounding variables. RESULTS After adjustment to baseline bone indices and body composition-related predictors, the pubertal increment in the HOMA-IR was a negative independent predictor of lumbar spine bone mineral areal density (β = - 0.202, p = 0.005) and lumbar spine bone mineral apparent density (β = - 0.235, p = 0.005) in 18-year-old males. CONCLUSIONS Pubertal increment in IR has a potential diminishing effect on lumbar spine bone mineral density accrual independently of body composition parameters. Further studies are needed to clarify whether monitoring HOMA-IR during puberty may identify subjects at increased risk of low peak bone mass and possible osteoporosis in the future.
Collapse
Affiliation(s)
- Eva Mengel
- Institute of Clinical Medicine, University of Tartu, 51007, Tartu, Estonia.
- Tartu Health Care College, 50411, Tartu, Estonia.
| | - Reeli Tamme
- Institute of Clinical Medicine, University of Tartu, 51007, Tartu, Estonia
- Children's Clinic of Tartu University Hospital, 50406, Tartu, Estonia
| | - Liina Remmel
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Priit Purge
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Evelin Mäestu
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Jaak Jürimäe
- Institute of Sports Sciences and Physiotherapy, University of Tartu, 51007, Tartu, Estonia
| | - Vallo Tillmann
- Institute of Clinical Medicine, University of Tartu, 51007, Tartu, Estonia
- Children's Clinic of Tartu University Hospital, 50406, Tartu, Estonia
| |
Collapse
|
3
|
Zheng B, Zheng Y, Zhang Y, Huang L, Shen X, Zhao F, Yan S. Precedence of Bone Loss Accompanied with Changes in Body Composition and Body Fat Distribution in Patients with Type 2 Diabetes Mellitus. J Diabetes Res 2023; 2023:6753403. [PMID: 37102158 PMCID: PMC10125744 DOI: 10.1155/2023/6753403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 03/05/2023] [Accepted: 03/16/2023] [Indexed: 04/28/2023] Open
Abstract
Methods A total of 596 patients with T2DM, including 308 male and 288 female patients, were included in the follow-up study; the median follow-up time was 2.17 years. We calculated the difference between the endpoint and the baseline of each body composition index and the annual rate. The research participants were divided into the increased body mass index (BMI) group, stable BMI group, and decreased BMI group. Some confounding factors were adjusted, such as BMI, fat mass index (FMI), muscle mass index (MMI), muscle/fat mass ratio (M/F), trunk fat mass index (TFMI), appendicular skeletal muscle mass index (ASMI), and appendicular skeletal muscle mass/trunk fat mass ratio (A/T). Results The linear analysis showed that ΔFMI and ΔTFMI were negatively correlated with the change in femoral neck BMD (ΔFNBMD) and ΔMMI, ΔASMI, ΔM/F, and ΔA/T were positively correlated with ΔFNBMD. The risk of FNBMD reduction in patients with increased BMI was 56.0% lower than that in patients with decreased BMI; also, the risk in patients with stable M/F was 57.7% lower than that in patients with decreased M/F. The risk in the A/T increase group was 62.9% lower than that in the A/T decrease group. Conclusions A reasonable muscle/fat ratio is still beneficial to maintaining bone mass. Maintaining a certain BMI value is conducive to maintaining FNBMD. Simultaneously, increasing the proportion of muscle mass and reducing fat accumulation can also prevent FNBMD loss.
Collapse
Affiliation(s)
- Biao Zheng
- Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Yuxin Zheng
- Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Yongze Zhang
- Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Lingning Huang
- Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Ximei Shen
- Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Fengying Zhao
- Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Sunjie Yan
- Department of Endocrinology, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Department of Endocrinology, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, China
- Clinical Research Center for Metabolic Diseases of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Fujian Key Laboratory of Glycolipid and Bone Mineral Metabolism, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Diabetes Research Institute of Fujian Province, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
- Metabolic Diseases Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| |
Collapse
|
4
|
Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022; 14:nu14163260. [PMID: 36014768 PMCID: PMC9414751 DOI: 10.3390/nu14163260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022] Open
Abstract
Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant–juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.
Collapse
|
5
|
Zhang L, Ruan X, Ju R, Qin S, Wang B, Dou Z, Xu X, Mueck AO. Lumbar bone mineral density measured by quantitative computed tomography (QCT): association with abdominal adipose tissue in different menopausal periods of Chinese women. Gynecol Endocrinol 2021; 37:264-268. [PMID: 33084429 DOI: 10.1080/09513590.2020.1836147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To investigate the correlation between abdominal adipose tissue and lumbar bone mineral density (BMD) in different menopausal periods of Chinese women. METHODS 230 women were included in this cross-sectional study. Subjects were divided into a perimenopausal and postmenopausal group. Lumbar BMD was measured by QCT to assess total adipose tissue (TAT), visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). The concomitant variables age, body mass index (BMI), and endocrine hormones were also considered. Multiple linear regression was used to assess the relationship between abdominal adipose tissue and BMD. RESULTS In the perimenopausal group, Spearman correlation analysis showed that there was no significant association among TAT, SAT, VAT, and BMD (all p > .05). In the postmenopausal group, BMD was negatively correlated with TAT, SAT, and VAT. In both groups, after adjustment for age and BMI, multiple linear regression analysis showed that VAT was negatively correlated with BMD (p < .05). In contrast, there was no significant correlation with TAT, SAT, and BMD. CONCLUSIONS High VAT volume is associated with low lumbar BMD in both perimenopausal and postmenopausal women. TAT and SAT have no significant correlation with lumbar trabecular BMD.
Collapse
Affiliation(s)
- Luping Zhang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Shuang Qin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Binhong Wang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Zhuli Dou
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xin Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Alfred Otto Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| |
Collapse
|
6
|
Inflammatory markers and bone mass in children with overweight/obesity: the role of muscular fitness. Pediatr Res 2020; 87:42-47. [PMID: 31493774 DOI: 10.1038/s41390-019-0572-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/02/2019] [Accepted: 08/16/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine which inflammatory markers are associated with bone mass and whether this association varies according to muscular fitness in children with overweight/obesity. METHODS Plasma interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), epidermal growth factor, vascular endothelial growth factor A (VEGF), and C-reactive protein were analyzed in 55 children aged 8-11 years. A muscular fitness score was computed. Bone mineral content (BMC) of the total body-less head (TBLH) and lumbar spine (LS) were assessed using dual-energy x-ray absorptiometry. RESULTS IL-6 (β = -0.136) and VEGF (β = -0.099) were associated with TBLH BMC, while TNF-α (β = -0.345) and IL-1β (β = 0.212) were associated with LS BMC (P < 0.05). The interaction effect of muscular fitness showed a trend in the association of VEGF with TBLH BMC (P = 0.122) and TNF-α with LS BMC (P = 0.057). Stratified analyses by muscular fitness levels showed an inverse association of VEGF with TBLH BMC (β = -0.152) and TNF-α with LS BMC (β = -0.491) in the low-fitness group, while no association was found in the high-fitness group. CONCLUSION IL-6, VEGF, TNF-α, and IL-1β are significantly associated with bone mass. Higher muscular fitness may attenuate the adverse effect of high VEGF and TNF-α on bone mass.
Collapse
|
7
|
Nilsen OA, Ahmed LA, Winther A, Christoffersen T, Thrane G, Evensen E, Furberg AS, Grimnes G, Dennison E, Emaus N. Body Weight and Body Mass Index Influence Bone Mineral Density in Late Adolescence in a Two-Year Follow-Up Study. The Tromsø Study: Fit Futures. JBMR Plus 2019; 3:e10195. [PMID: 31667452 PMCID: PMC6808229 DOI: 10.1002/jbm4.10195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/15/2019] [Accepted: 03/02/2019] [Indexed: 01/01/2023] Open
Abstract
Determinants of bone acquisition in late adolescence and early adulthood are not well‐described. This 2‐year follow‐up study explored the associations of body weight (BW), body mass index (BMI), and changes in weight status with adolescent bone accretion in a sample of 651 adolescents (355 girls and 296 boys) between 15 and 19 years of age from The Tromsø Study: Fit Futures. This Norwegian population‐based cohort study was conducted from 2010 to 2011 and was repeated from 2012 to 2013. We measured femoral neck, total hip, and total body bone mineral content and areal bone mineral density (aBMD) by dual‐energy X‐ray absorptiometry. We measured height, BW, calculated BMI (kg/m
2), and collected information on lifestyle at both surveys. Mean BMI (SD) at baseline was 22.17 (3.76) and 22.18 (3.93) in girls and boys, respectively. Through multiple linear regression, baseline BW and BMI were positively associated with ∆aBMD over 2 years of follow‐up at all skeletal sites in boys (
p < 0.05), but not in girls. ∆BW and ∆BMI predicted ∆aBMD and ∆BMC in both sexes, but the strength of the associations was moderate. Individuals who lost weight during follow‐up demonstrated a slowed progression of aBMD accretion compared with those gaining weight, but loss of BW or reduction of BMI during 2 years was not associated with net loss of aBMD. In conclusion, our results confirm that adequate BW for height in late adolescence is important for bone health. Associations between change in weight status and bone accretion during follow‐up were moderate and unlikely to have any clinical implication on adolescents of normal weight. Underweight individuals, particularly boys, are at risk of not reaching optimal peak bone mass and could benefit from an increase in BMI. © 2019 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Ole Andreas Nilsen
- Department of Health and Care Sciences The Arctic University of Norway Tromsø Norway
| | - Luai Awad Ahmed
- Department of Health and Care Sciences The Arctic University of Norway Tromsø Norway
| | - Anne Winther
- Division of Neurosciences, Orthopedics and Rehabilitation Services University Hospital of North Norway Tromsø Norway
| | - Tore Christoffersen
- Department of Health and Care Sciences The Arctic University of Norway Tromsø Norway.,Department of Health and Care Sciences Finnmark Hospital Trust, Alta Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences The Arctic University of Norway Tromsø Norway
| | - Elin Evensen
- Department of Clinical Research University Hospital of North Norway, Tromsø, Norway, and Department of Health and Care Sciences, The Arctic University of Norway Tromsø Norway
| | - Anne-Sofie Furberg
- Department of Community Medicine The Arctic University of Norway Tromsø Norway.,Department of Microbiology and Infection Control Division of Internal Medicine University Hospital of North Norway Tromsø Norway
| | - Guri Grimnes
- Division of Internal Medicine University Hospital of North Norway, Tromsø, Norway, and Endocrine Research Group, Department of Clinical Medicine, The Arctic University of Norway Tromsø Norway
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, Southampton UK and Victoria University Wellington New Zealand
| | - Nina Emaus
- Department of Health and Care Sciences The Arctic University of Norway Tromsø Norway
| |
Collapse
|
8
|
Laakso S, Viljakainen H, Lipsanen-Nyman M, Turpeinen U, Ivaska KK, Anand-Ivell R, Ivell R, Mäkitie O. Testicular Function and Bone in Young Men with Severe Childhood-Onset Obesity. Horm Res Paediatr 2018; 89:442-449. [PMID: 29961074 DOI: 10.1159/000489818] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/29/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Previous studies suggest increased risk for hypoandrogenism and fractures in men with obesity. We aimed to describe the effects of severe childhood-onset obesity on the cross talk between metabolic state, testes, and skeleton at late puberty. METHODS A cohort of adolescent and young adult males with severe childhood-onset obesity (n = 21, mean age 18.5 years) and an age-matched control group were assessed for testicular hormones and X-ray absorptiometry-derived bone mass. RESULTS Current median body mass indexes for the obese and control subjects were 37.4 and 22.9. Severe early-onset obesity manifested with lower free testosterone (median [interquartile range] 244 [194-332] vs. 403 [293-463] pmol/L, p = 0.002). Lower insulin-like 3 (1.02 [0.82-1.23] vs. 1.22 [1.01-1.46] ng/mL, p = 0.045) and lower ratio of testosterone to luteinizing hormone (2.81 [1.96-3.98] vs. 4.10 [3.03-5.83] nmol/IU, p = 0.008) suggested disrupted Leydig cell function. The degree of current obesity inversely correlated with free testosterone (τ = -0.516, p = 0.003), which in turn correlated positively with bone area at all measurement sites in males with childhood-onset obesity. CONCLUSIONS Severe childhood-onset obesity is associated with impaired Leydig cell function in young men and lower free testosterone may contribute to impaired skeletal characteristics.
Collapse
Affiliation(s)
- Saila Laakso
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Heli Viljakainen
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Biomedicum, Helsinki, Finland
| | - Marita Lipsanen-Nyman
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Kaisa K Ivaska
- Department of Cell Biology and Anatomy, University of Turku, Turku, Finland
| | | | - Richard Ivell
- School of Biosciences, University of Nottingham, Nottingham, United Kingdom
| | - Outi Mäkitie
- Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Biomedicum, Helsinki, Finland.,Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
9
|
Mengel E, Tillmann V, Remmel L, Kool P, Purge P, Lätt E, Jürimäe J. The associations between the changes in serum inflammatory markers and bone mineral accrual in boys with overweight and obesity during pubertal maturation: a 3-year longitudinal study in Estonian boys. Osteoporos Int 2018; 29:2069-2078. [PMID: 29858631 DOI: 10.1007/s00198-018-4580-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 05/16/2018] [Indexed: 01/20/2023]
Abstract
UNLABELLED Adipose tissue produces different inflammatory cytokines which compromise bone mineral accrual during puberty. Vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), interleukin (IL)-8, and interferon-gamma (IFN-γ) are significantly related to bone mineral accrual during pubertal maturation in boys with different BMI values. INTRODUCTION This longitudinal study aims to identify the inflammatory markers that most strongly associate with pubertal bone mineral density (BMD) increment in boys with overweight and obesity (OWB). METHODS Twenty-six OWB and 29 normal-weight boys were followed yearly for 3 years to measure changes in 12 serum inflammatory markers, BMD (by DXA), and apparent volumetric BMD. The OWB group was further divided into two subgroups according to their BMI gain during the 3-year period. Data through time points presented as slopes were used to calculate correlation coefficients to explore the possible relationships between variables of interest. In the whole study group, linear mixed effects (LME) models were also used. RESULTS Increment in serum VEGF concentration was inversely associated with an increase in total body (TB) BMD (r = - 0.82, P = 0.02) and TB bone mineral content (BMC)/height (r = - 0.82, P = 0.02) in those OWB whose BMI gain was higher during pubertal years. In the whole study group, the LME model confirmed the inverse association between VEGF and TB BMC/height (P < 0.05). EGF was inversely associated with LS BMD and LS BMAD (P < 0.05), whereas there was a positive association between IL-8 and TB BMAD and between IFN-γ and LS BMD (P < 0.05). CONCLUSIONS Lower increment in BMD in OWB with higher BMI gain is associated with increasing serum VEGF concentration during pubertal maturation. VEGF, EGF, IL-8, and IFN-γ are significantly associated with BMD during pubertal maturation in boys with different BMI values.
Collapse
Affiliation(s)
- E Mengel
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Jakobi 5, 50411, Tartu, Estonia.
- Children's Clinic of Tartu University Hospital, Tartu, Estonia.
| | - V Tillmann
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
- Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - L Remmel
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Jakobi 5, 50411, Tartu, Estonia
| | - P Kool
- Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - P Purge
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Jakobi 5, 50411, Tartu, Estonia
| | - E Lätt
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Jakobi 5, 50411, Tartu, Estonia
| | - J Jürimäe
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Jakobi 5, 50411, Tartu, Estonia
| |
Collapse
|
10
|
Jürimäe J, Lätt E, Remmel L, Purge P, Tillmann V. Longitudinal changes in bone-testis axis and their associations with insulin resistance in 11- to 12-year-old boys. Bone 2018; 108:115-120. [PMID: 29309847 DOI: 10.1016/j.bone.2018.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 01/03/2018] [Accepted: 01/04/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Associations between osteocalcin (OCN), an osteoblast-specific hormone, and different markers of energy metabolism and insulin resistance have been reported in adults, but few studies have investigated this in children. The aim of the current study was to investigate serum OCN levels during pubertal development in normal weight (NW) and overweight (OW) boys, and to evaluate possible associations of OCN with body composition, testosterone, insulin resistance and adipocytokine values during puberty. METHODS Ninety 11- to 12-year-old boys were investigated at 12-month intervals over the next 2years. Boys were divided by their BMI into NW (n=60) and OW (n=30) groups. Serum OCN, testosterone, leptin, adiponectin, insulin, HOMA-IR score, and body composition were measured. RESULTS Pubertal development over the 2-year period was similar in both groups. Serum OCN was not different at the beginning of the study and increased similarly in both groups. However, at the end of the study, NW had higher OCN than OW (142.9±5.2 vs. 124.0±7.4ng/ml; p<0.05). OW had higher leptin, insulin and HOMA-IR compared to NW, and these differences remained significant through the 2-year period. Testosterone, insulin and HOMA-IR increased through the study period in both groups. In multiple regression analyses increment in OCN was associated with the increase in testosterone in NW (p<0.001) and OW (p=0.049) boys. Increment in OCN was also associated with the increase in insulin (p=0.019) and HOMA-IR (p=0.012) over the 2-year period in NW boys. CONCLUSION Serum OCN concentration increases in puberty and the increment is positively associated with the rise in testosterone level in both NW and OW boys. The positive association between the rise in OCN and insulin in NW boys would suggest that OCN may have a role in the development of insulin resistance.
Collapse
Affiliation(s)
- Jaak Jürimäe
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia.
| | - Evelin Lätt
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Liina Remmel
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Priit Purge
- Institute of Sport Sciences and Physiotherapy, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Vallo Tillmann
- Department of Paediatrics, Faculty of Medicine, University of Tartu, Tartu, Estonia
| |
Collapse
|