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He D, Cheng S, Wei W, Zhao Y, Cai Q, Chu X, Shi S, Zhang N, Qin X, Liu H, Jia Y, Cheng B, Wen Y, Zhang F. Body shape from birth to adulthood is associated with skeletal development: A Mendelian randomization study. Bone 2024; 187:117191. [PMID: 38969278 DOI: 10.1016/j.bone.2024.117191] [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: 01/25/2024] [Revised: 05/21/2024] [Accepted: 07/01/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Observational studies have shown that childhood obesity is associated with adult bone health but yield inconsistent results. We aimed to explore the potential causal association between body shape and skeletal development. METHODS We used two-sample Mendelian randomization (MR) to estimate causal relationships between body shape from birth to adulthood and skeletal phenotypes, with exposures including placental weight, birth weight, childhood obesity, BMI, lean mass, fat mass, waist circumference, and hip circumference. Independent genetic instruments associated with the exposures at the genome-wide significance level (P < 5 × 10-8) were selected from corresponding large-scale genome-wide association studies. The inverse-variance weighted analysis was chosen as the primary method, and complementary MR analyses included the weighted median, MR-Egger, weighted mode, and simple mode. RESULTS The MR analysis shows strong evidence that childhood (β = -1.29 × 10-3, P = 8.61 × 10-5) and adulthood BMI (β = -1.28 × 10-3, P = 1.45 × 10-10) were associated with humerus length. Tibiofemoral angle was negatively associated with childhood BMI (β = -3.60 × 10-1, P = 3.00 × 10-5) and adolescent BMI (β = -3.62 × 10-1, P = 2.68 × 10-3). In addition, genetically predicted levels of appendicular lean mass (β = 1.16 × 10-3, P = 1.49 × 10-13), whole body fat mass (β = 1.66 × 10-3, P = 1.35 × 10-9), waist circumference (β = 1.72 × 10-3, P = 6.93 × 10-8) and hip circumference (β =1.28 × 10-3, P = 4.34 × 10-6) were all associated with tibia length. However, we found no causal association between placental weight, birth weight and bone length/width. CONCLUSIONS This large-scale MR analysis explores changes in growth patterns in the length/width of major bone sites, highlighting the important role of childhood body shape in bone development and providing insights into factors that may drive bone maturation.
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Affiliation(s)
- Dan He
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shiqiang Cheng
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Wenming Wei
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yijing Zhao
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Qingqing Cai
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoge Chu
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Sirong Shi
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Na Zhang
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiaoyue Qin
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Huan Liu
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yumeng Jia
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Bolun Cheng
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
| | - Feng Zhang
- NHC Key Laboratory of Trace Elements and Endemic Diseases, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Health Science Center, Xi'an Jiaotong University, Xi'an, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
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Rojo-Trejo ME, Robles-Osorio ML, Rangel B, García OP, Becerra-Hernández MF, Cárdenas-Rodríguez L, Sabath E. Appendicular Muscle Mass Index as the Most Important Determinant of Bone Mineral Content and Density in Small for Gestational Age Children. Clin Pediatr (Phila) 2024:99228241242515. [PMID: 38581300 DOI: 10.1177/00099228241242515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
Preterm small for gestational age (SGA) children are at increased risk for low bone mineral content later in life; however, data on SGA children born at term are scarce. We included 44 SGA and 57 adequate for gestational age (AGA) children aged 6 to 11 years to compare bone mineral density (BMD) and bone mineral content (BMC) and to identify which anthropometric and biochemical values influence bone mineralization in these children. Fat mass, appendicular skeletal muscle mass index (ASMMI), BMC, and BMD were significantly lower in SGA children than in AGA (P ≤ .005). Appendicular muscle mass index correlated with BMC(TBLH,FN,L1-L4) and BMD(TBLH,FN,L1-L4) in both groups (r2 = 0.7, P < .05). In multivariate analysis, ASMMI was strongly associated with BMC and BMD in both groups. There were no differences in clinical biomarkers, calcium intake, and physical activity between the groups. Achieving adequate muscle mass contributes to adequate bone mineralization and a lower risk for low BMC and BMD in SGA children.
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Affiliation(s)
| | | | - Beatriz Rangel
- Nutrition School, Universidad Autónoma de Querétaro, Querétaro, México
| | - Olga P García
- Nutrition School, Universidad Autónoma de Querétaro, Querétaro, México
| | | | | | - Ernesto Sabath
- Nutrition School, Universidad Autónoma de Querétaro, Querétaro, México
- Renal Division and Metabolic Unit, Hospital General de Querétaro, Queretaro, México
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McGrath C, Little-Letsinger SE, Pagnotti GM, Sen B, Xie Z, Uzer G, Uzer GB, Zong X, Styner MA, Rubin J, Styner M. Diet-Stimulated Marrow Adiposity Fails to Worsen Early, Age-Related Bone Loss. Obes Facts 2024; 17:145-157. [PMID: 38224679 PMCID: PMC10987189 DOI: 10.1159/000536159] [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: 07/25/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024] Open
Abstract
INTRODUCTION Longitudinal effect of diet-induced obesity on bone is uncertain. Prior work showed both no effect and a decrement in bone density or quality when obesity begins prior to skeletal maturity. We aimed to quantify long-term effects of obesity on bone and bone marrow adipose tissue (BMAT) in adulthood. METHODS Skeletally mature, female C57BL/6 mice (n = 70) aged 12 weeks were randomly allocated to low-fat diet (LFD; 10% kcal fat; n = 30) or high-fat diet (HFD; 60% kcal fat; n = 30), with analyses at 12, 15, 18, and 24 weeks (n = 10/group). Tibial microarchitecture was analyzed by µCT, and volumetric BMAT was quantified via 9.4T MRI/advanced image analysis. Histomorphometry of adipocytes and osteoclasts, and qPCR were performed. RESULTS Body weight and visceral white adipose tissue accumulated in response to HFD started in adulthood. Trabecular bone parameters declined with advancing experimental age. BV/TV declined 22% in LFD (p = 0.0001) and 17% in HFD (p = 0.0022) by 24 weeks. HFD failed to appreciably alter BV/TV and had negligible impact on other microarchitecture parameters. Both dietary intervention and age accounted for variance in BMAT, with regional differences: distal femoral BMAT was more responsive to diet, while proximal femoral BMAT was more attenuated by age. BMAT increased 60% in the distal metaphysis in HFD at 18 and 24 weeks (p = 0.0011). BMAT in the proximal femoral diaphysis, unchanged by diet, decreased 45% due to age (p = 0.0002). Marrow adipocyte size via histomorphometry supported MRI quantification. Osteoclast number did not differ between groups. Tibial qPCR showed attenuation of some adipose, metabolism, and bone genes. A regulator of fatty acid β-oxidation, cytochrome C (CYCS), was 500% more abundant in HFD bone (p < 0.0001; diet effect). CYCS also increased due to age, but to a lesser extent. HFD mildly increased OCN, TRAP, and SOST. CONCLUSIONS Long-term high fat feeding after skeletal maturity, despite upregulation of visceral adiposity, body weight, and BMAT, failed to attenuate bone microarchitecture. In adulthood, we found aging to be a more potent regulator of microarchitecture than diet-induced obesity.
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Affiliation(s)
- Cody McGrath
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah E. Little-Letsinger
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gabriel M. Pagnotti
- Department of Endocrine, Neoplasia and Hormonal Disorders, MD Anderson Cancer Center, Houston, TX, USA
| | - Buer Sen
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Zhihui Xie
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gunes Uzer
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Guniz B. Uzer
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Xiaopeng Zong
- Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Martin A. Styner
- Departments of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Janet Rubin
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Maya Styner
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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White CA, Serrat MA. Dysregulation of insulin-like growth factor-1 signaling in postnatal bone elongation. Biochem Cell Biol 2023; 101:388-393. [PMID: 37246759 DOI: 10.1139/bcb-2023-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Insulin-like growth factor-1 (IGF-1) is a critical modulator of cell growth and survival, making it a central part of maintaining essentially every biological system in the body. Knowledge of the intricate mechanisms involved in activating IGF-1 signaling is not only key to understanding basic processes of growth and development, but also for addressing diseases, such as cancer and diabetes. This brief review explores how dysregulation of normal IGF-1 signaling can impact growth by examining its role in postnatal bone elongation. IGF-1 actions are dysregulated in autoimmune diseases, such as juvenile idiopathic arthritis and chronic kidney disease, which results in growth stunting. Conversely, childhood obesity results in growth acceleration, premature growth cessation, and ultimately, diminished bone quality, while systemic IGF-1 levels remain normal. Understanding the role of IGF-1 signaling in normal and dysregulated growth can add to other studies that address how this system regulates chronic diseases.
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Affiliation(s)
- Cassaundra A White
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755, USA
| | - Maria A Serrat
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755, USA
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Lee J, Yoon I, Cha H, Kim HJ, Ryu OH. Inverted U-Shaped Relationship between Obesity Parameters and Bone Mineral Density in Korean Adolescents. J Clin Med 2023; 12:5869. [PMID: 37762810 PMCID: PMC10532009 DOI: 10.3390/jcm12185869] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
As the association between obesity and bone health remains controversial in children and adolescents, we investigate the effects of obesity parameters on bone mineral density (BMD) in 2060 Korean adolescents who participated in the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). Multiple regression analysis and analysis of covariance (ANCOVA) were conducted to examine both the linear and non-linear associations between total-body-less-head (TBLH) BMD and four obesity parameters: body mass index, waist circumference, waist-to-height ratio, and total-body fat mass (FM). In a multiple linear regression analysis adjusted for age, menarcheal status (in females only), and total-body lean mass, there was no significant linear association between obesity parameters and TBLH BMD, except for total-body FM in males. However, upon adding a second-order polynomial term for each obesity parameter, a significant quadratic relationship between all obesity parameters and TBLH BMD was observed, with the corresponding quadratic term being negative. The results of ANCOVA also revealed an inverted U-shaped relationship between each obesity parameter and TBLH BMD. Our findings suggest the existence of an optimal range of obesity parameters for developing or maintaining optimal bone health in Korean Adolescents. Deviation from this range, in either direction (being underweight or having obesity), may compromise bone health.
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Affiliation(s)
- Jongseok Lee
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Insang Yoon
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Hwajung Cha
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Ho-Jung Kim
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Ohk-Hyun Ryu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea
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Power GM, Tobias JH, Frayling TM, Tyrrell J, Hartley AE, Heron JE, Davey Smith G, Richardson TG. Age-specific effects of weight-based body size on fracture risk in later life: a lifecourse Mendelian randomisation study. Eur J Epidemiol 2023; 38:795-807. [PMID: 37133737 PMCID: PMC10276076 DOI: 10.1007/s10654-023-00986-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/02/2023] [Indexed: 05/04/2023]
Abstract
Musculoskeletal conditions, including fractures, can have severe and long-lasting consequences. Higher body mass index in adulthood is widely acknowledged to be protective for most fracture sites. However, sources of bias induced by confounding factors may have distorted previous findings. Employing a lifecourse Mendelian randomisation (MR) approach by using genetic instruments to separate effects at different life stages, this investigation aims to explore how prepubertal and adult body size independently influence fracture risk in later life.Using data from a large prospective cohort, univariable and multivariable MR were conducted to simultaneously estimate the effects of age-specific genetic proxies for body size (n = 453,169) on fracture risk (n = 416,795). A two-step MR framework was additionally applied to elucidate potential mediators. Univariable and multivariable MR indicated strong evidence that higher body size in childhood reduced fracture risk (OR, 95% CI: 0.89, 0.82 to 0.96, P = 0.005 and 0.76, 0.69 to 0.85, P = 1 × 10- 6, respectively). Conversely, higher body size in adulthood increased fracture risk (OR, 95% CI: 1.08, 1.01 to 1.16, P = 0.023 and 1.26, 1.14 to 1.38, P = 2 × 10- 6, respectively). Two-step MR analyses suggested that the effect of higher body size in childhood on reduced fracture risk was mediated by its influence on higher estimated bone mineral density (eBMD) in adulthood.This investigation provides novel evidence that higher body size in childhood reduces fracture risk in later life through its influence on increased eBMD. From a public health perspective, this relationship is complex since obesity in adulthood remains a major risk factor for co-morbidities. Results additionally indicate that higher body size in adulthood is a risk factor for fractures. Protective effect estimates previously observed are likely attributed to childhood effects.
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Affiliation(s)
- Grace Marion Power
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | - Jonathan H Tobias
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Timothy M Frayling
- Genetics of Complex Traits, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jessica Tyrrell
- Genetics of Complex Traits, College of Medicine and Health, University of Exeter, Exeter, UK
| | - April E Hartley
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jon E Heron
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
- NIHR Bristol Biomedical Research Centre Bristol, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Tom G Richardson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
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Yao W, Luo J, Ao L, Cheng H, Lu S, Liu J, Lu K, Mi J, Yang Y, Liu L. Association of total body fat and fat distribution with bone mineral density among children and adolescents aged 6-17 years from Guangzhou, China. Eur J Pediatr 2023; 182:1115-1126. [PMID: 36580174 DOI: 10.1007/s00431-022-04727-x] [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: 06/18/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 12/30/2022]
Abstract
This study aimed to assess the associations of total body fat and fat distribution with bone mineral density (BMD) among children and adolescents in this cross-sectional study. A total of 1032 boys and 897 girls aged 6-17 years were enrolled between May 2019 and June 2019 in Guangzhou, China. BMD, total body fat (fat mass index [FMI] and body fat percentage [BF%]), and fat distribution (trunk-to-limb and android-to-gynoid ratios) were measured by dual-energy X-ray absorptiometry. Inverse probability of treatment weighting regression was used to explore the association between fat and BMD. Traditional regression of covariate adjustment was applied as sensitivity analysis. Regression with inverse probability weighting suggested BF% and android-to-gynoid ratio were negatively associated with BMD in boys (β = - 0.12 and - 0.16, respectively; P < 0.05). Android-to-gynoid ratio was also inversely associated with BMD in girls (β = - 0.08, P < 0.05). When stratified by age, the negative associations were retained in boys aged 12-17 years (β = - 0.23 and - 0.25, respectively; P < 0.001). But for girls, it showed a positive association of FMI with BMD in the 6-9 years group (β = 0.33, P < 0.001) and a negative association between the android-to-gynoid ratio and BMD in the 10-17 years group (β = - 0.10, P < 0.05). Traditional regression supported the robustness of the results. Conclusion: Total body fat is positively associated with BMD in younger girls but inversely associated in older boys. As for abdominal adipose, it is associated with lower BMD in both older boys and girls. What is Known: • The lean mass has been consistently positively associated with bone mineral density (BMD) among children and adolescents. However, the impact of fat mass on BMD remained controversial. • Beyond total body fat, site-specific fat mass, especially abdominal adiposity, might impede bone formation. What is New: • The associations of total body fat and fat distribution with BMD in children and adolescents were gender- and age-specific. • More attention should be paid to the abdominal fat accumulation to promote bone health in older children.
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Affiliation(s)
- Wanwen Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Jiepeng Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Liping Ao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Shuang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Keyuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Jie Mi
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
- Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China.
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China.
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8
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GAO X, SHEN S, NIU Q, MIAO W, HAN Y, HAO Z, AN N, YANG Y, ZHANG Y, ZHANG H, STOREY KB, CHANG H. Differential bone metabolism and protein expression in mice fed a high-fat diet versus Daurian ground squirrels following natural pre-hibernation fattening. J Zhejiang Univ Sci B 2022; 23:1042-1056. [PMID: 36518056 PMCID: PMC9758712 DOI: 10.1631/jzus.b2100798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This study compared the effects on bone metabolism and morphology of pathological obesity induced by excessive fat intake in a non-hibernator (mice) versus healthy obesity due to pre-hibernation fattening in a hibernator (ground squirrels). Kunming mice were fed a high-fat diet to provide a model of pathological obesity (OB group). Daurian ground squirrels fattened naturally in their pre-hibernation season (PRE group) were used as a healthy obesity model. Micro-computed tomography (micro-CT) and three-point bending tests were used to determine the microstructure and mechanical properties of bone. Western blots were used to analyze protein expression levels related to bone metabolism (Runt-related transcription factor 2 (RunX2), osteocalcin (OCN), alkaline phosphatase (ALP), osteoprotegerin (OPG), receptor activator of nuclear factor-κB ligand (RANKL), cathepsin K, matrix metallopeptidase 9 (MMP9), patched protein homolog 1 (Ptch1), phosphorylated β-catenin (P-β-catenin), and glycogen synthase kinase-3β (GSK-3β)). Compared with controls, there was no obvious bone loss in the OB mice, and the stiffness of the femur was increased significantly. Compared with summer active squirrels, bone formation was enhanced but the mechanical properties did not change in the PRE group squirrels. In OB mice, western blots showed significantly increased expression levels of all proteins except RunX2, OPG, and Ptch1. PRE ground squirrels showed significantly increased expression of most proteins except OCN and Ptch1, which decreased significantly, and P-β-catenin and OPG, which did not change. In conclusion, for non-hibernating mice, moderate obesity had a certain protective effect on bones, demonstrating two-way regulation, increasing both bone loss and bone formation. For pre-hibernating ground squirrels, the healthy obesity acquired before hibernation had a positive effect on the microstructure of bones, and also enhanced the expression levels of proteins related to bone formation, bone resorption, and Wnt signaling.
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Affiliation(s)
- Xuli GAO
- Shaanxi Key Laboratory for Animal Conservation, Northwest University, Xi’an710069, China,Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Shenyang SHEN
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Qiaohua NIU
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Weilan MIAO
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Yuting HAN
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Ziwei HAO
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Ning AN
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Yingyu YANG
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Yu ZHANG
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Han ZHANG
- Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China
| | - Kenneth B. STOREY
- Department of Biology, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Hui CHANG
- Shaanxi Key Laboratory for Animal Conservation, Northwest University, Xi’an710069, China,Key Laboratory of Resource Biology and Biotechnology in Western China (College of Life Sciences, Northwest University), Ministry of Education, Xi’an710069, China,Hui CHANG,
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9
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Blomberg A, Mortensen J, Weihe P, Grandjean P. Bone mass density following developmental exposures to perfluoroalkyl substances (PFAS): a longitudinal cohort study. Environ Health 2022; 21:113. [PMID: 36402982 PMCID: PMC9675242 DOI: 10.1186/s12940-022-00929-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Environmental exposures to industrial chemicals, including perfluoroalkyl substances (PFAS), may play a role in bone development and future risk of osteoporosis. However, as prospective evidence is limited, the role of developmental PFAS exposures in bone density changes in childhood is unclear. The objective of this study was to estimate associations between serum-PFAS concentrations measured in infancy and early childhood and areal bone mineral density (aBMD) measured at age 9 years in a birth cohort of children from the Faroe Islands. METHODS We prospectively measured concentrations of five PFAS in cord serum and serum collected at 18 months, 5 years and 9 years, and conducted whole-body DXA scans at the 9-year clinical visit. Our study included 366 mother-child pairs with DXA scans and at least one PFAS measurement. We estimated covariate-adjusted associations of individual PFAS concentrations with age-, sex- and height-adjusted aBMD z-scores using multivariable regression models and applied formal mediation analysis to estimate the possible impact of by several measures of body composition. We also evaluated whether associations were modified by child sex. RESULTS We found PFAS exposures in childhood to be negatively associated with aBMD z-scores, with the strongest association seen for perfluorononanoic acid (PFNA) at age 5 years. A doubling in age-5 PFNA was associated with a 0.15 decrease in aBMD z-score (95% CI: - 0.26, - 0.039). The PFNA-aBMD association was significantly stronger in males than females, although effect modification by sex was not significant for other PFAS exposures. Results from the mediation analysis suggested that any potential associations between aBMD and 18-month PFAS concentrations may be mediated by total body fat and BMI, although most estimated total effects for PFAS exposures at age 18 months were non-significant. PFAS exposures at age 9 were not associated with age-9 aBMD z-scores. CONCLUSIONS The PFAS-aBMD associations identified in this and previous studies suggest that bone may be a target tissue for PFAS. Pediatric bone density has been demonstrated to strongly track through young adulthood and possibly beyond; therefore, these prospective results may have important public health implications.
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Affiliation(s)
- Annelise Blomberg
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- Division of Occupational and Environmental Medicine, Lund University, Scheelevägen 2, 22363, Lund, Sweden.
| | - Jann Mortensen
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Medicine, The Faroese National Hospital, Torshavn, Faroe Islands
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, Faroese Hospital System, Torshavn, Faroe Islands
- Center of Health Science, University of the Faroe Islands, Torshavn, Faroe Islands
| | - Philippe Grandjean
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
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10
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Shultz SJ, Cruz MR, Casey E, Dompier TP, Ford KR, Pietrosimone B, Schmitz RJ, Taylor JB. Sex-Specific Changes in Physical Risk Factors for Anterior Cruciate Ligament Injury by Chronological Age and Stages of Growth and Maturation From 8 to 18 Years of Age. J Athl Train 2022; 57:830-876. [PMID: 36638346 PMCID: PMC9842121 DOI: 10.4085/1062-6050-0038.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To critically assess the literature focused on sex-specific trajectories in physical characteristics associated with anterior cruciate ligament (ACL) injury risk by age and maturational stage. DATA SOURCES PubMed, CINAHL, Scopus, and SPORTDiscus databases were searched through December 2021. STUDY SELECTION Longitudinal and cross-sectional studies of healthy 8- to 18-year-olds, stratified by sex and age or maturation on ≥1 measure of body composition, lower extremity strength, ACL size, joint laxity, knee-joint geometry, lower extremity alignment, balance, or lower extremity biomechanics were included. DATA EXTRACTION Extracted data included study design, participant characteristics, maturational metrics, and outcome measures. We used random-effects meta-analyses to examine sex differences in trajectory over time. For each variable, standardized differences in means between sexes were calculated. DATA SYNTHESIS The search yielded 216 primary and 22 secondary articles. Less fat-free mass, leg strength, and power and greater general joint laxity were evident in girls by 8 to 10 years of age and Tanner stage I. Sex differences in body composition, strength, power, general joint laxity, and balance were more evident by 11 to 13 years of age and when transitioning from the prepubertal to pubertal stages. Sex differences in ACL size (smaller in girls), anterior knee laxity and tibiofemoral angle (greater in girls), and higher-risk biomechanics (in girls) were observed at later ages and when transitioning from the pubertal to postpubertal stages. Inconsistent study designs and data reporting limited the number of included studies. CONCLUSIONS Critical gaps remain in our knowledge and highlight the need to improve our understanding of the relative timing and tempo of ACL risk factor development.
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Affiliation(s)
- Sandra J. Shultz
- Department of Kinesiology, University of North Carolina, Greensboro
| | | | | | | | | | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Randy J. Schmitz
- Department of Kinesiology, University of North Carolina, Greensboro
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11
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Kawai M, Etani Y, Ida S. Subcutaneous adipose tissue is a positive predictor for bone mineral density in prepubertal children with Prader-Willi syndrome independent of lean mass. J Pediatr Endocrinol Metab 2022; 35:603-609. [PMID: 35286052 DOI: 10.1515/jpem-2021-0749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Emerging evidence suggests a fat depot-specific relationship with bone mineral density (BMD) in children, particularly in those who are overweight/obese. However, this has not yet been investigated in detail in children with Prader-Willi syndrome (PWS), a genetic syndrome characterized by a decreased lean mass (LM) and increased fat mass (FM). The objective of this study is to investigate the relationships of LM and FM, particularly fat distribution, with bone mineral parameters. METHODS This is a retrospective and cross-sectional study. Forty-seven prepubertal Japanese children with PWS (22 males, mean age: 6.86 years) were included. No subjects had type 2 diabetes mellitus or osteoporotic medications. LM, FM, and BMD and bone mineral content in the total body less head and the lumbar spine were measured using dual-energy x-ray absorptiometry, in addition to subcutaneous/visceral adipose tissue (SAT/VAT), and the ratio of VAT to SAT (V/S) by computed tomography at the umbilical level. Bone mineral apparent density was calculated to correct for bone size. RESULTS LM positively correlated with bone mineral parameters after controlling for age, sex, growth hormone (GH) treatment, and FM. Although FM did not correlate with bone mineral parameters, compartment-specific analysis revealed that SAT positively and V/S negatively correlated with bone mineral parameters after controlling for age, sex, GH treatment and LM. CONCLUSIONS A compartment-specific effect of FM on bone mineral parameters was noted such that SAT was a positive predictor for BMD independent of LM in prepubertal children with PWS.
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Affiliation(s)
- Masanobu Kawai
- Department of Gastroenterology, Nutrition, and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Japan.,Department of Bone and Mineral Research, Research Institute, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Yuri Etani
- Department of Gastroenterology, Nutrition, and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Shinobu Ida
- Department of Gastroenterology, Nutrition, and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Japan.,Department of Clinical Laboratory, Osaka Women's and Children's Hospital, Izumi, Japan
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12
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Baronio F, Baptista F. Editorial: Bone health and development in children and adolescents. Front Endocrinol (Lausanne) 2022; 13:1101403. [PMID: 36578952 PMCID: PMC9791941 DOI: 10.3389/fendo.2022.1101403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022] Open
Affiliation(s)
- Federico Baronio
- Department Hospital of Woman and Child, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- *Correspondence: Federico Baronio,
| | - Fátima Baptista
- Department of Sport and Health, CIPER - Centro Interdisciplinar do Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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13
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Constable AM, Vlachopoulos D, Barker AR, Moore SA, Soininen S, Haapala EA, Väistö J, Jääskeläinen J, Voutilainen R, Auriola S, Häkkinen MR, Laitinen T, Lakka TA. The Mediating Role of Endocrine Factors in the Positive Relationship Between Fat Mass and Bone Mineral Content in Children Aged 9-11 Years: The Physical Activity and Nutrition in Children Study. Front Endocrinol (Lausanne) 2022; 13:850448. [PMID: 35399927 PMCID: PMC8987010 DOI: 10.3389/fendo.2022.850448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION We aimed to investigate whether the relationship between fat mass and bone mineral content (BMC) is mediated by insulin, leptin, adiponectin, dehydroepiandrosterone sulphate, testosterone and estradiol in children aged 9-11 years. MATERIALS AND METHODS We utilised cross-sectional data from the Physical Activity and Nutrition in Children study (n = 230 to 396; 112 to 203 girls). Fat mass and BMC were assessed with dual-energy X-ray absorptiometry. Endocrine factors were assessed from fasted blood samples. We applied the novel 4-way decomposition method to analyse associations between fat mass, endocrine factors, and BMC. RESULTS Fat mass was positively associated with BMC in girls (ß = 0.007 to 0.015, 95% confidence interval (CI) 0.005 to 0.020) and boys (ß = 0.009 to 0.015, 95% CI 0.005 to 0.019). The relationship between fat mass and BMC was mediated by free leptin index in girls (ß = -0.025, 95% CI -0.039 to -0.010) and boys (ß = -0.014, 95% CI -0.027 to -0.001). The relationship between fat mass and BMC was partially explained by mediated interaction between fat mass and free leptin index in boys (ß = -0.009, 95% CI -0.013 to -0.004) and by interaction between fat mass and adiponectin in girls (ß = -0.003, 95% CI -0.006 to -0.000). CONCLUSION At greater levels of adiponectin and free leptin index, the fat mass and BMC relationship becomes less positive in girls and boys respectively. The positive association between fat mass with BMC was largely not explained by the endocrine factors we assessed. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/ct2/show/NCT01803776], identifier NCT01803776.
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Affiliation(s)
- Annie M. Constable
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- *Correspondence: Annie M. Constable,
| | - Dimitris Vlachopoulos
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom
| | - Alan R. Barker
- Children’s Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom
| | - Sarah A. Moore
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Sonja Soininen
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Social and Health Center, City of Varkaus, Finland
| | - Eero A. Haapala
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juuso Väistö
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Paediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Seppo Auriola
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | | | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Timo A. Lakka
- Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
- Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
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14
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Djafari F, Eslahi M, Zandi N, Pazoki B, Reza Amini M, Shab-Bidar S. The inverse association of body adiposity index and bone health in the older adults: A report from a developing country. Int J Clin Pract 2021; 75:e14718. [PMID: 34378289 DOI: 10.1111/ijcp.14718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 08/08/2021] [Indexed: 11/29/2022] Open
Abstract
The ageing process influences body composition and could be related to bone health. The current study was set out to evaluate the association between body adiposity index (BAI) and bone health in older adults. This is a cross-sectional study performed on 178 elderly persons (51 men and 127 women) with a mean age of 67.04 (range: 60-83) who was referred to the determined 25 health centres in Tehran. The anthropometric measurements were done. Further, serum 25-hydroxy vitamin D (25(OH)D), parathormone (PTH), high-sensitivity C-reactive protein (hs-CRP), osteocalcin and urine C-terminal telopeptide I (CTX-I) were collected. The mean of body mass index (P < .001), body weight (P = .002), body fat (P < .001), waist circumference (P < .001), hip circumference (P < .001), urine CTX-I concentration (P = .011), 25(OH)D (P = .030), was higher in the highest BAI category in comparison with the lowest one. BAI was negatively correlated with urine CTX-I concentration (r=-0.165, P = .028). Moreover, linear regression showed an inverse association between BAI with urine CTX-I (β = -0.165, P = .025) and 25(OH)D (β = -0.039, P = .029). Moreover, the percentage of body fat was positively associated with serum hs-CRP (β = 0.026, P = .002). Our study showed a significant inverse association between BAI with urinary CTX-I which shows the effect of obesity on bone health. This study suggests that more clinical and prospective studies for monitoring body fat may have some favourable impacts on bone health.
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Affiliation(s)
- Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Masoumeh Eslahi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Nadia Zandi
- Tehran University of Medical Science (TUMS), Tehran, Iran
| | | | - Mohammad Reza Amini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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15
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Koo HC, Lim GP, Kaur S, Chan KQ, Chan KE, Chung C, Wong M, Danaselvam U. Bone Health and Its Positive Relationships with Body Composition in Malaysian Schoolchildren: Findings from a Cross-Sectional Study. CHILDREN-BASEL 2021; 8:children8070569. [PMID: 34356548 PMCID: PMC8303397 DOI: 10.3390/children8070569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/14/2021] [Accepted: 06/30/2021] [Indexed: 01/02/2023]
Abstract
Background: Optimal bone health is vital in children to prevent osteoporosis later in life, and body composition plays a crucial role in it. However, the literature reports contradictory results when considering the relationship between body composition and bone health in children. This study aimed to examine the bone health and its relationship with body composition in Malaysian schoolchildren. Methods: In this cross sectional study, body composition data (weight, height, body fat percentage [% fat], fat mass, fat free mass, visceral fat, waist circumference [WC] and body mass index-for-age [BMI z-score]) and bone health data (Z-score and broadband ultrasound attenuation [BUA]) were collected from 415 schoolchildren aged 9–12 years, cluster sampled from randomly selected primary schools in Kuala Lumpur, Malaysia. Results: Girls generally had significantly higher height, body fat percentage, fat mass, visceral fat and Z-score as compared to boys. A steady increase of the mean BUA value was observed with increasing age in both sexes. The mean BUA value of the present study across the population was significantly higher than that of schoolchildren from Nigeria (p < 0.001), Colombia (p < 0.001) and Spain (p = 0.002). Significant positive correlations were found between all the body composition variables and bone outcome variables across the population. Further, BUA was significantly correlated with weight (β = 0.172; p = 0.001), height (β = 0.299; p < 0.001), % fat (β = 0.131; p = 0.007), fat mass (β = 0.130; p = 0.007), fat free mass (β = 0.209; p < 0.001), visceral fat (β = 0.127, p = 0.008), WC (β = 0.165; p = 0.001) and BMI z-score (β = 0.162; p = 0.001), after controlling for sex, age and ethnicity. Similarly, after confounders adjusted, Z-score was significantly predicted by weight (β = 0.160; p = 0.001), height (β = 0.310; p < 0.001), % fat (β = 0.104; p = 0.032), fat mass (β = 0.107; p = 0.026), fat free mass (β = 0.218; p < 0.001), visceral fat (β = 0.107, p = 0.026), WC (β = 0.145; p = 0.002) and BMI z-score (β = 0.150; p = 0.002). Conclusions: Our findings have revealed that body composition variables were positive correlated with bone outcome variables, suggesting that adipose tissue acts to stimulate bone growth. Further clinical and molecular studies in the future is recommended to fully illustrate the complex interactions between adiposity and bone health.
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Affiliation(s)
- Hui Chin Koo
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
- Correspondence:
| | - Geok Pei Lim
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Satvinder Kaur
- Faculty of Applied Sciences, UCSI University, Kuala Lumpur 56000, Malaysia;
| | - Kai Quin Chan
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Keh En Chan
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Casey Chung
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Michelle Wong
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
| | - Ugunesh Danaselvam
- Department of Bioscience, Faculty of Applied Sciences, Tunku Abdul Rahman University College, Kuala Lumpur 53300, Malaysia; (G.P.L.); (K.Q.C.); (K.E.C.); (C.C.); (M.W.); (U.D.)
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Analysis of the Association between Fat Mass Distribution and Bone Mass in Chinese Male Adolescents at Different Stages of Puberty. Nutrients 2021; 13:nu13072163. [PMID: 34202423 PMCID: PMC8308367 DOI: 10.3390/nu13072163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Bone mineral acquisition during adolescence is crucial for maximizing peak bone mass. Fat mass (FM) and bone mass are closely related. This study investigated the association of FM distribution with bone mass in Chinese male adolescents. Method: A total of 693 male adolescents aged 10–18 years were recruited from a secondary school in Jiangmen, China. Their bone mass and body composition were measured by quantitative ultrasound and bioelectrical impedance analysis, respectively. The associations of the measures of fat distribution with bone parameters, i.e., broadband ultrasound attenuation, speed of sound (SOS), and stiffness index (SI), were analyzed using multiple linear regression. Age, height, body mass index, stage of puberty, physical activity, sedentary behavior, dietary energy intake, and dietary calcium and vitamin D intake were adjusted in the model. Further subgroup analyses of prepubertal and pubertal participants were conducted. Results: The measures of fat distribution showed negative associations with SOS and SI in total subjects (p < 0.010). In prepubertal boys, the measures of fat distribution were only associated with SOS (β = −0.377 to −0.393, p < 0.050). In pubertal boys, the measures of fat distribution had associations with all bone parameters (β = −0.205 to −0.584, p < 0.050). The strongest association was between trunk FM and SOS (β = −0.584, p < 0.001). Conclusion: This study supported that the measures of fat distribution were negatively associated with bone parameters in Chinese male adolescents. Trunk FM had the strongest association with bone parameter. These associations appear to be stronger in pubertal boys than in prepubertal boys.
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Evaluation of Body Composition, Physical Activity, and Food Intake in Patients with Inborn Errors of Intermediary Metabolism. Nutrients 2021; 13:nu13062111. [PMID: 34202936 PMCID: PMC8233825 DOI: 10.3390/nu13062111] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 12/12/2022] Open
Abstract
Children with inborn errors of intermediary metabolism (IEiM) must follow special diets that restrict their intake of essential nutrients and may compromise normal growth and development. We evaluated body composition, bone mineral density, physical activity, and food intake in IEiM patients undergoing dietary treatment. IEiM patients (n = 99) aged 5–19 years and healthy age- and sex-matched controls (n = 98) were recruited and underwent dual-energy X-ray absorptiometry to evaluate anthropometric characteristics and body composition. Data on food intake and physical activity were also collected using validated questionnaires. The height z-score was significantly lower in IEiM patients than controls (−0.28 vs. 0.15; p = 0.008), particularly in those with carbohydrate and amino acid metabolism disorders. Significant differences in adiposity were observed between patients and controls for the waist circumference z-score (−0.08 vs. −0.58; p = 0.005), but not the body mass index z-score (0.56 vs. 0.42; p = 0.279). IEiM patients had a significantly lower total bone mineral density (BMD) than controls (0.89 vs. 1.6; p = 0.001) and a higher risk of osteopenia (z-score < −2, 33.3% vs. 20.4%) and osteoporosis (z-score < −2.5, 7.1% vs. 0%), but none presented fractures. There was a significant positive correlation between natural protein intake and BMD. Our results indicate that patients with IEiM undergoing dietary treatment, especially those with amino acid and carbohydrate metabolism disorders, present alterations in body composition, including a reduced height, a tendency towards overweight and obesity, and a reduced BMD.
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Jeddi M, Ardalan A, Heydari ST, Dabbaghmanesh MH. Non-linear association of body composition and its components with bone density in Iranian children and adolescents. Arch Osteoporos 2021; 16:77. [PMID: 33948735 DOI: 10.1007/s11657-021-00920-x] [Citation(s) in RCA: 1] [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: 07/22/2020] [Accepted: 03/25/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Peak bone mass is established during childhood. This study aimed to evaluate the associations of the components of overall body mass with areal bone mineral density Z-score in children. The findings of this study showed that children with greater overall body mass had higher aBMD Z-score. PURPOSE Peak bone mass is established during childhood and adolescence. One of the important factors influencing predicted bone mass tracking in childhood and adolescence is alteration in the body composition during this growth period. This study aimed to evaluate the associations of the components of overall body mass with areal bone mineral density Z-score in children and adolescents. METHODS In this cross-sectional study, 478 healthy Iranian children and adolescents (237 girls and 241 boys) who had DXA measures participated. We evaluated the linearity of associations using generalized additive models. RESULTS Children's mean age was14 years with a range of 9-18 years, and 49.6% were girls. We found an increase in aBMD Z-score with increasing overall body mass (r = 0.25, p < 0.001). We observed this association with fat-free mass and total fat mass up to the 60th (~30 Kg) and 75th percentile (~12.5 Kg) [0.051 (95% CI, 0.027-0.075) increase in aBMD Z-score per 1 Kg increase in fat-free mass and 0.079 (95% CI, 0.044-0.114) increase in aBMD Z-score per 1 Kg increase in the total fat mass]. The correlation between Z-score of overall body mass and its components with aBMD Z-score was strongly positive. (P value < 0.001 for all) CONCLUSION: The findings of this study showed that children with greater overall body mass had higher aBMD Z-score. In addition, this study adds to a growing literature, suggesting that the relationship between body composition and BMD may be influenced by the pattern of fat and fat-free mass distribution in population.
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Affiliation(s)
- Marjan Jeddi
- Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Postal Box, Shiraz, 71345-1414, Iran
| | - Arash Ardalan
- Department of Mathematics, Yasouj University, Yasouj, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Dabbaghmanesh
- Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Postal Box, Shiraz, 71345-1414, Iran.
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Twelve years of GWAS discoveries for osteoporosis and related traits: advances, challenges and applications. Bone Res 2021; 9:23. [PMID: 33927194 PMCID: PMC8085014 DOI: 10.1038/s41413-021-00143-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/21/2020] [Indexed: 02/03/2023] Open
Abstract
Osteoporosis is a common skeletal disease, affecting ~200 million people around the world. As a complex disease, osteoporosis is influenced by many factors, including diet (e.g. calcium and protein intake), physical activity, endocrine status, coexisting diseases and genetic factors. In this review, we first summarize the discovery from genome-wide association studies (GWASs) in the bone field in the last 12 years. To date, GWASs and meta-analyses have discovered hundreds of loci that are associated with bone mineral density (BMD), osteoporosis, and osteoporotic fractures. However, the GWAS approach has sometimes been criticized because of the small effect size of the discovered variants and the mystery of missing heritability, these two questions could be partially explained by the newly raised conceptual models, such as omnigenic model and natural selection. Finally, we introduce the clinical use of GWAS findings in the bone field, such as the identification of causal clinical risk factors, the development of drug targets and disease prediction. Despite the fruitful GWAS discoveries in the bone field, most of these GWAS participants were of European descent, and more genetic studies should be carried out in other ethnic populations to benefit disease prediction in the corresponding population.
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Abstract
UNLABELLED Insulin resistance may be linked to bone health in young people. This study is the first on adolescents that jointly examined the association of bone health with insulin resistance and body composition. Our results revealed significant negative association between bone parameters and insulin resistance, even after adjustment for confounding factors. PURPOSE Previous studies are suggestive of the protective role of insulin on bone in adults. Whether this association exists in younger individuals is not clear, yet. This investigation aimed to evaluate the association between insulin resistance, bone parameters, and body composition amongst Iranian adolescents᾽ population. METHODS A cross-sectional study was conducted on 423 participants (224 girls and 199 boys) aged 9-19 years old. Insulin resistance was assessed, using a homeostatic model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Bone mineral density (BMD), bone mineral content (BMC), total body fat mass (TBFM), and total body lean mass (TBLM) were measured, using dual energy X-ray absorptiometry (DXA), and bone mineral apparent density (BMAD) was calculated. RESULTS In multiple regression analyses adjusted for potential confounders, the HOMA-IR showed statistically significant negative association with most of the bone parameters (β = - 1.1 to - 0.002, P = 0.004 to 0.036). On the subject of QUICKI index, this relationship was detected only for lumbar spine (LS) parameters (β = 0.062 to 37.21, P = 0.0001 to 0.026) and femoral neck bone mineral content (FNBMC) (β = 1.297, P = 0.013). CONCLUSION Our results suggest that insulin resistance may be inversely and independently associated with the bone indices in younger individuals. Whether high insulin levels have detrimental effects on growing bone is still unclear and has to be answered.
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Dong H, Zhao X, Cheng H, Mi J. Childhood adiposity, adult adiposity, and bone health. Pediatr Investig 2021; 5:6-11. [PMID: 33778421 PMCID: PMC7984010 DOI: 10.1002/ped4.12244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/05/2021] [Indexed: 11/19/2022] Open
Abstract
IMPORTANCE Childhood and adolescence are critical periods for lifelong bone mineral accrual, but few studies have determined the impact of childhood adiposity on adult bone density. OBJECTIVE To determine the long-term impact of childhood adiposity on adult areal bone mineral density (aBMD) and the effect of adult adiposity on this relationship. METHODS We conducted a longitudinal study of 1156 adults (56.3% men), for whom skinfold thickness (SFT) had been measured during childhood (6-18 years) and fat mass percentage (FMP) and aBMD were measured during adulthood (29-43 years). Adult aBMD in the lumbar spine (LS), femoral neck (FN), arms, and legs was measured using dual-energy X-ray absorptiometry. The direct effect of childhood SFT and its indirect effect through adult FMP on adult aBMD were estimated using general linear regression and a causal steps approach. RESULTS Significant positive associations between childhood SFT and adult aBMD were found in the LS in men (β = 0.089, P = 0.044) and in all the skeletal sites in women. With respect to the adult fat-bone relationship, high adult FMP was associated with low aBMD in most of the sites in men, but with high FN aBMD in women (β = 0.144, P = 0.002). Moreover, suppressive effects of adult FMP on the associations between childhood SFT and adult aBMD in the LS (-34.8%) and legs (-67.1%) of men, and a positive effect on the FN aBMD in women (17.0%) were identified. INTERPRETATION Childhood adiposity appears to have a positive long-term effect on adult aBMD, which may be reduced by adiposity in adult men but reinforced by adiposity in adult women.
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Affiliation(s)
- Hongbo Dong
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xiaoyuan Zhao
- Department of EpidemiologyCapital Institute of PediatricsBeijingChina
| | - Hong Cheng
- Department of EpidemiologyCapital Institute of PediatricsBeijingChina
| | - Jie Mi
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Department of EpidemiologyCapital Institute of PediatricsBeijingChina
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Abstract
Bone mass is a key determinant of osteoporosis and fragility fractures. Epidemiologic studies have shown that a 10% increase in peak bone mass (PBM) at the population level reduces the risk of fracture later in life by 50%. Low PBM is possibly due to the bone loss caused by various conditions or processes that occur during adolescence and young adulthood. Race, gender, and family history (genetics) are responsible for the majority of PBM, but other factors, such as physical activity, calcium and vitamin D intake, weight, smoking and alcohol consumption, socioeconomic status, age at menarche, and other secondary causes (diseases and medications), play important roles in PBM gain during childhood and adolescence. Hence, the optimization of lifestyle factors that affect PBM and bone strength is an important strategy to maximize PBM among adolescents and young people, and thus to reduce the low bone mass or osteoporosis risk in later life. This review aims to summarize the available evidence for the common but important factors that influence bone mass gain during growth and development and discuss the advances of developing high PBM.
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Affiliation(s)
- Xiaowei Zhu
- Disease & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, 310024, China
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, 310024, China
- School of Life Sciences, Fudan University, Shanghai, 200433, China
| | - Houfeng Zheng
- Disease & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, 310024, China.
- Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Westlake University, Hangzhou, 310024, China.
- School of Life Sciences, Fudan University, Shanghai, 200433, China.
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Bone Mineral Density in Adolescent Boys: Cross-Sectional Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010245. [PMID: 33396391 PMCID: PMC7795160 DOI: 10.3390/ijerph18010245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/21/2020] [Accepted: 12/28/2020] [Indexed: 01/10/2023]
Abstract
Physical inactivity of children can be a precursor of reduced bone mineral density, considered to be a typical problem only in old age. The aim of this study was to evaluate bone mineral density in 96 Polish boys aged 14–17 years with varied physical activity (swimmers, track and field athletes, non-athletes) and the effect of bone composition, birth weight and breastfeeding during infancy on bone parameters. Anthropometric and body composition measurements were performed according to the kinanthropometric standards. Bone parameters of the forearm were measured by means of dual-energy X-ray absorptiometry. Data on the infant’s birth weight and the length of breastfeeding were collected during direct interviews with mothers. The strongest links with bone parameters were found for the type of physical activity and birth weight. Regardless of birth weight, track and field athletes had the most advantageous bone parameters (mainly sT-score prox values). Swimmers with normal or low birth weight had less favourable sT-score prox values than non-athletes. The type of physical activity proved to be an important determinant of bone parameters. Childhood and adolescence are important periods of bone development and increasing the content of bone mineral components, and the bone status in later years of life depends to a large extent on this period. The perinatal period, especially the correct birth weight of the child, not only has a significant effect on general health, but also on bone status.
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Baradaran Mahdavi S, Daniali SS, Farajzadegan Z, Bahreynian M, Riahi R, Kelishadi R. Association between maternal smoking and child bone mineral density: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:23538-23549. [PMID: 32314283 DOI: 10.1007/s11356-020-08740-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
Maternal smoking during pregnancy has detrimental effects on fetal development. The current review examined the differences in offspring's bone mineral density (BMD) between mothers smoked during pregnancy and those who did not. A systematic review and meta-analysis on the studies investigating the influence of maternal smoking during pregnancy on children or neonates' bone measures published up to October 30, 2018, was performed. BMD results measured at different body sites were pooled and then fixed or random effect models were used based on the presence of heterogeneity. The desired pooled effect size was the offspring's BMD mean difference with 95% confidence interval between smoker and non-smoker mothers. Sensitivity analysis was performed for birth weight and current weight, two important mediator/confounders causing heterogeneity. Overall, eight studies consisting of 17,931 participants aged from infancy to 18 years were included. According to the fixed effect model, the mean of BMD in offspring whose mothers smoked during pregnancy was 0.01 g/cm2 lower than those with non-smoker mothers (95% CI = - 0.02 to - 0.002). However, subgroup meta-analysis adjusted for birth weight and current weight demonstrated no significant mean difference between BMD of children with smoker and non-smoker mothers (d = 0.06, 95% CI = -0.04 to 0.16, p value = 0.25 and d = - 0.005, 95% CI = - 0.01 to 0.004, p value = 0.28, respectively). According to available studies, it is suggested that maternal smoking during pregnancy does not have direct effect on the offspring's BMD. Instead, this association might be confounded by other factors such as placental weight, birth weight, and current body size of children.
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Affiliation(s)
- Sadegh Baradaran Mahdavi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Student Research Committee, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyede Shahrbanoo Daniali
- Pediatric Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ziba Farajzadegan
- Department of Community Medicine, Faculty of Medicine, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Bahreynian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran
| | - Roya Riahi
- Biostatistics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical science, Isfahan, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran.
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Cheng L, Pohlabeln H, Ahrens W, Russo P, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, De Henauw S, Moreno L, Page A, Hebestreit A. Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents. Bone 2020; 131:115162. [PMID: 31760215 DOI: 10.1016/j.bone.2019.115162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/20/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
Abstract
Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | | | - Luis Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009 Zaragoza, Spain
| | - Angie Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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Fintini D, Cianfarani S, Cofini M, Andreoletti A, Ubertini GM, Cappa M, Manco M. The Bones of Children With Obesity. Front Endocrinol (Lausanne) 2020; 11:200. [PMID: 32390939 PMCID: PMC7193990 DOI: 10.3389/fendo.2020.00200] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
Excess adiposity in childhood may affect bone development, ultimately leading to bone frailty. Previous reports showing an increased rate of extremity fractures in children with obesity support this fear. On the other hand, there is also evidence suggesting that bone mineral content is higher in obese children than in normal weight peers. Both adipocytes and osteoblasts derive from multipotent mesenchymal stem cells (MSCs) and obesity drives the differentiation of MSCs toward adipocytes at the expense of osteoblast differentiation. Furthermore, adipocytes in bone marrow microenvironment release a number of pro-inflammatory and immunomodulatory molecules that up-regulate formation and activation of osteoclasts, thus favoring bone frailty. On the other hand, body adiposity represents a mechanical load, which is beneficial for bone accrual. In this frame, bone quality, and structure result from the balance of inflammatory and mechanical stimuli. Diet, physical activity and the hormonal milieu at puberty play a pivotal role on this balance. In this review, we will address the question whether the bone of obese children and adolescents is unhealthy in comparison with normal-weight peers and discuss mechanisms underlying the differences in bone quality and structure. We anticipate that many biases and confounders affect the clinical studies conducted so far and preclude us from achieving robust conclusions. Sample-size, lack of adequate controls, heterogeneity of study designs are the major drawbacks of the existing reports. Due to the increased body size of children with obesity, dual energy absorptiometry might overestimate bone mineral density in these individuals. Magnetic resonance imaging, peripheral quantitative CT (pQCT) scanning and high-resolution pQCT are promising techniques for the accurate estimate of bone mineral content in obese children. Moreover, no longitudinal study on the risk of incident osteoporosis in early adulthood of children and adolescents with obesity is available. Finally, we will address emerging dietary issues (i.e., the likely benefits for the bone health of polyunsaturated fatty acids and polyphenols) since an healthy diet (i.e., the Mediterranean diet) with balanced intake of certain nutrients associated with physical activity remain the cornerstones for achieving an adequate bone accrual in young individuals regardless of their adiposity degree.
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Affiliation(s)
- Danilo Fintini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
- *Correspondence: Danilo Fintini
| | - Stefano Cianfarani
- Diabetes and Growth Disorders Unit, Dipartimento Pediatrico Universitario Ospedaliero Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Marta Cofini
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Angela Andreoletti
- Pediatric Resident, Pediatric Clinic, University of Brescia, Brescia, Italy
| | - Grazia Maria Ubertini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Marco Cappa
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Bambino Gesù Children's Hospital, Rome, Italy
- Melania Manco
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The impact of diet, body composition, and physical activity on child bone mineral density at five years of age-findings from the ROLO Kids Study. Eur J Pediatr 2020; 179:121-131. [PMID: 31673780 PMCID: PMC6942579 DOI: 10.1007/s00431-019-03465-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 09/05/2019] [Accepted: 09/06/2019] [Indexed: 12/11/2022]
Abstract
Bone health is extremely important in early childhood because children with low bone mineral density (BMD) are at a greater risk of bone fractures. While physical activity and intake of both calcium and vitamin D benefit BMD in older children, there is limited research on the determinants of good bone health in early childhood. The aim of this cross-sectional study was to investigate the impact of diet, physical activity, and body composition on BMD at five years of age. Dietary intakes and physical activity levels were measured through questionnaires. Whole body BMD was measured by dual-energy X-ray absorptiometry in 102 children. Child weight, height, circumferences, skinfolds and serum 25-hydroxyvitamin D (25OHD) concentrations were assessed. There was no association between BMD and dietary calcium, dietary vitamin D, 25OHD, physical activity, or sedentary behaviour. Several measures of body composition were significantly positively associated with BMD; however, neither fat mass nor lean body mass was associated with BMD.Conclusion: Although we found no association between self-reported dietary and lifestyle factors and bone health in early years, increased body size was linked with higher BMD. These findings are important as identifying modifiable factors that can improve bone health at a young age is of utmost importance.What is Known:• Bone health is extremely important in early childhood, as children with low bone mineral density (BMD) are at greater risk of bone fractures.• Physical activity has been found to be beneficial for bone health in adolescents, and body composition has also been associated with BMD in teenage years.• Limited research on the determinants of good bone health in early childhood.What is New:• No association between self-reported lifestyle and dietary factors with bone health in early childhood.• Increased body size was associated with higher BMD at five years of age.
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Li Y, Liu Y, He J, Ma P, Yu L, Sun G. The association of wrist circumference with hypertension in northeastern Chinese residents in comparison with other anthropometric obesity indices. PeerJ 2019; 7:e7599. [PMID: 31523521 PMCID: PMC6717503 DOI: 10.7717/peerj.7599] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/31/2019] [Indexed: 12/12/2022] Open
Abstract
Background Wrist circumference (WrC) is an easily obtained measure in estimating the body frame and regional fat distribution, and has increasingly used as an obesity index. The aim of our study is to estimate the association of WrC with elevated blood pressure (BP) among northeastern Chinese community-dwelling residents, and compare the strength of this association to other anthropometric obesity indices. Methods A total of 2,331 adult participants (761 male participants, and 1,570 female participants) were included. WrC and other five generally used obesity indices, including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and neck circumference (NC) were measured. Hypertension was defined as systolic blood pressure (SBP)/diastolic blood pressure (DBP) ≥140/90 mmHg or anti-hypertensive medication use. Multivariable linear and logistic regression models were performed to identify associations of BP and hypertension with per standard deviation (SD) increase of obesity indices. Areas under receiver operative characteristic curves (AUC) were calculated to compare the predicting capacity of WrC and other obesity indices on hypertension. Results All of the six obesity indices were positively associated with both SBP and DBP after adjustment for age and gender (P-values of associations of SBP with obesity indices were 0.043 for WrC, and <0.001 for other five indices; P-values of associations of DBP with obesity indices were 0.011 for WrC, 0.031 for WHR, and <0.001 for other four indices), while the association between SBP and WrC showed no statistically significant after further adjusted for life-style and metabolic risk factors (P-value was 0.062). The increases of both SBP and DBP per SD increase of BMI were the largest. The positive associations of five obesity indices but WHR with hypertension were observed after adjustment for all risk factors (P-values were 0.024 for WrC, 0.064 for WHR and <0.001 for other four indices). However, the odd ratios (OR) of WrC was the smallest, while BMI was the largest. Consistently, the AUC of BMI was the largest and statistically larger than that observed for WrC (P-value <0.001). Conclusions WrC was associated with hypertension among northeastern Chinese populations. However, the association was not stronger than the other generally used indices, particularly BMI.
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Affiliation(s)
- Yongfang Li
- Research Center of Environmental and Non-communicable Disease, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yuyan Liu
- Department of Clinical Epidemiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jing He
- Department of Non-Communicable Disease, Shenhe Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Ping Ma
- Department of Non-Communicable Disease, Shenhe Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Luyang Yu
- Department of Non-Communicable Disease, Shenhe Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Guifan Sun
- Research Center of Environmental and Non-communicable Disease, School of Public Health, China Medical University, Shenyang, Liaoning, China
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Mak IL, Lavery P, Agellon S, Rauch F, Murshed M, Weiler HA. Arachidonic acid exacerbates diet-induced obesity and reduces bone mineral content without impacting bone strength in growing male rats. J Nutr Biochem 2019; 73:108226. [PMID: 31520815 DOI: 10.1016/j.jnutbio.2019.108226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/28/2019] [Accepted: 08/09/2019] [Indexed: 12/30/2022]
Abstract
Long-chain polyunsaturated fatty acids modulate bone mass and adipocyte metabolism. Arachidonic acid (AA, C20:4 n-6) is elevated in obesity and postulated to stimulate bone resorption. This study aimed to determine the effect of AA on bone mass, quality, and adiposity in diet-induced obesity during growth. Male Sprague-Dawley rats (n=42, 4-week) were randomized into groups fed a control diet (CTRL, AIN-93G), high-fat diet (HFD, 35% kcal fat) or HFD + AA (1% w/w diet) for 6 weeks. Body composition, bone mineral density and microarchitecture were measured using dual-energy X-ray absorptiometry and micro-computed tomography. Red blood cell fatty acid profile was measured with gas chromatography. Group differences were evaluated using repeated measures two-way analysis of variance with Tukey-Kramer post hoc testing. Total energy intake did not differ among diet groups. At week 6, HFD + AA had significantly greater body fat % (12%), body weight (6%) and serum leptin concentrations (125%) than CTRL, whereas visceral fat (mass and %, assessed with micro-computed tomography) was increased in both HFD and HFD + AA groups. HFD + AA showed reduced whole body bone mineral content and femur mid-diaphyseal cortical bone cross-sectional area than HFD and CTRL, without impairment in bone strength. Contrarily, HFD + AA had greater femur metaphyseal trabecular vBMD (35%) and bone volume fraction (5%) compared to controls. Inclusion of AA elevated leptin concentrations in male rats. The early manifestations of diet-induced obesity on bone mass were accelerated with AA. Studies of longer duration are needed to clarify the effect of AA on peak bone mass following growth cessation.
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Affiliation(s)
- Ivy L Mak
- School of Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC, Canada H9X 3V9
| | - Paula Lavery
- School of Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC, Canada H9X 3V9
| | - Sherry Agellon
- School of Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC, Canada H9X 3V9
| | - Frank Rauch
- Shriners' Hospital for Children, 1003 Decarie Boulevard, Montreal, QC, Canada H4A 0A9
| | - Monzur Murshed
- Shriners' Hospital for Children, 1003 Decarie Boulevard, Montreal, QC, Canada H4A 0A9; Faculty of Dentistry, McGill University, 3640 rue University, Montreal, QC, Canada H3A 0C7
| | - Hope A Weiler
- School of Human Nutrition, McGill University, 21111 Lakeshore Road, Ste-Anne-de-Bellevue, QC, Canada H9X 3V9.
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Kemp JP, Sayers A, Fraser WD, Davey Smith G, Ala-Korpela M, Evans DM, Tobias JH. A Metabolic Screen in Adolescents Reveals an Association Between Circulating Citrate and Cortical Bone Mineral Density. J Bone Miner Res 2019; 34:1306-1313. [PMID: 30882941 DOI: 10.1002/jbmr.3697] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 01/10/2019] [Accepted: 02/03/2019] [Indexed: 12/29/2022]
Abstract
Observations that insulin and adiponectin levels are related to cortical bone size in adolescents, independently of body composition, suggest factors related to fat metabolism directly influence skeletal development. To explore this question, we examined associations between a metabolic screen focusing on fat metabolism, and peripheral quantitative computed tomography (pQCT) measures of the mid-tibia, in 15-year-olds from the Avon Longitudinal Study of Parents and Children. Metabolic profiles were generated by proton nuclear magnetic resonance spectroscopy, from blood samples obtained at the same time as pQCT scans. Ordinary least squares linear regression was used to investigate relationships between metabolic measures and periosteal circumference (PC), cortical thickness (CT), and cortical bone mineral density (BMDC ). Metabolic profiles yielded 22 independent components following principal component analysis (PCA), giving a Bonferroni-adjusted threshold for statistical significance of p = 0.002. Data were available in 1121 subjects (487 males), mean age 15 years. Several metabolites related to lipid and cholesterol metabolism were associated with PC, CT, and BMDC after adjustment for age, sex, and Tanner stage. After additional adjustment for height, fat, and lean mass, only the association between citrate and BMDC remained below the Bonferroni-significant threshold (β = -0.14 [-0.18, -0.09]) (β represents a standardized coefficient). Citrate also showed evidence of association with PC (β = 0.06 [0.03, 0.10]) and strength strain index (SSI; β = 0.04 [0.01, 0.08]). Subsequently, we investigated whether these relationships were explained by increased bone resorption. Citrate was strongly related to serum β-C-telopeptides of type I collagen (β-CTX) (β = 0.20 [0.16, 0.23]). After additional adjustment for β-CTX the above associations between citrate and BMDC (β = -0.04 [-0.08, 0.01]), PC (β = 0.03 [-0.01, 0.07]) and SSI (β = 0.03 [-0.01, 0.07]) were no longer observed. We conclude that in adolescents, circulating levels of citrate are inversely related to BMDC and positively related to PC, reflecting associations with higher bone turnover. Further studies are justified to elucidate possible contributions of citrate, a constituent of bone matrix, to bone resorption and cortical density. © 2019 American Society for Bone and Mineral Research.
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Affiliation(s)
- John P Kemp
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Adrian Sayers
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Mika Ala-Korpela
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Systems Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Computational Medicine, Faculty of Medicine, University of Oulu and Biocenter Oulu, Oulu, Finland
- NMR Metabolomics Laboratory, School of Pharmacy, University of Eastern Finland, Kuopio, Finland
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, The Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - David M Evans
- University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jonathan H Tobias
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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White Z, White S, Dalvie T, Kruger MC, Van Zyl A, Becker P. Bone Health, Body Composition, and Vitamin D Status of Black Preadolescent Children in South Africa. Nutrients 2019; 11:nu11061243. [PMID: 31159206 PMCID: PMC6627122 DOI: 10.3390/nu11061243] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 12/14/2022] Open
Abstract
Optimal bone health is important in children to reduce the risk of osteoporosis later in life. Both body composition and vitamin D play an important role in bone health. This study aimed to describe bone health, body composition, and vitamin D status, and the relationship between these among a group of conveniently sampled black preadolescent South African children (n = 84) using a cross-sectional study. Body composition, bone mineral density (BMD), and bone mineral content (BMC) were assessed using dual x-ray absorptiometry. Levels of 25-hydroxyvitamin D (25(OH)D) (n = 59) were assessed using dried blood spots. A quarter (25%) of children presented with low bone mass density for their chronological age (BMD Z-score < -2) and 7% with low BMC-for-age (BMC Z-score < -2), while only 34% of the children had sufficient vitamin D status (25(OH)D ≥ 30 ng/mL). Lean mass was the greatest body compositional determinant for variances observed in bone health measures. Body composition and bone health parameters were not significantly different across vitamin D status groups (p > 0.05), except for lumbar spine bone mineral apparent density (LS-BMAD) (p < 0.01). No association was found between bone parameters at all sites and levels of 25(OH)D (p > 0.05). Further research, using larger representative samples of South African children including all race groups is needed before any conclusions and subsequent recommendation among this population group can be made.
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Affiliation(s)
- Zelda White
- Department Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
| | - Samantha White
- Department Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
| | - Tasneem Dalvie
- Department Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
| | - Marlena C Kruger
- School of Health Sciences, Massey University, Private Bag 11029, Palmerston North 4442, New Zealand.
| | - Amanda Van Zyl
- Department Human Nutrition, Faculty of Health Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
| | - Piet Becker
- Faculty of Health Sciences, University of Pretoria, Private Bag X20, Hatfield 0028, South Africa.
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Dimitri P. The Impact of Childhood Obesity on Skeletal Health and Development. J Obes Metab Syndr 2019; 28:4-17. [PMID: 31089575 PMCID: PMC6484936 DOI: 10.7570/jomes.2019.28.1.4] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 01/24/2019] [Accepted: 02/18/2019] [Indexed: 12/26/2022] Open
Abstract
Increased risk of fracture identified in obese children has led to a focus on the relationship between fat, bone, and the impact of obesity during skeletal development. Early studies have suggested that despite increased fracture risk, obese children have a higher bone mass. However, body size corrections applied to account for wide variations in size between children led to the finding that obese children have a lower total body and regional bone mass relative to their body size. Advances in skeletal imaging have shifted the focus from quantity of bone in obese children to evaluating the changes in bone microarchitecture that result in a change in bone quality and strength. The findings suggest that bone strength in the appendicular skeleton does not appropriately adapt to an increase in body size which results in a mismatch between bone strength and force from falls. Recent evidence points to differing influences of fat compartments on skeletal development-visceral fat may have a negative impact on bone which may be related to the associated adverse metabolic environment, while marrow adipose tissue may have an independent effect on trabecular bone development in obese children. The role of brown fat has received recent attention, demonstrating differences in the influence on bone mass between white and brown adipose tissues. Obesity results in a shift in growth and pubertal hormones as well as influences bone development through the altered release of adipokines. The change in the hormonal milieu provides an important insight into the skeletal changes observed in childhood obesity.
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Affiliation(s)
- Paul Dimitri
- Academic Unit of Child Health, The University of Sheffield, Sheffield, UK
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Sanjeevi N, Lipsky LM, Nansel TR. Greater inflammation and adiposity are associated with lower bone mineral density in youth with type 1 diabetes. Diabetes Res Clin Pract 2018; 144:10-16. [PMID: 30114458 PMCID: PMC6202251 DOI: 10.1016/j.diabres.2018.07.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 06/22/2018] [Accepted: 07/30/2018] [Indexed: 01/20/2023]
Abstract
AIMS The objectives of this study were to investigate relationships of inflammation and adiposity with bone mineral density (BMD) in youth with type 1 diabetes followed prospectively for 18 months. METHODS Participants were youth with type 1 diabetes (n = 136, 8-16.9 years) enrolled in an 18-month behavioral nutrition intervention trial. BMD of the total body, subtotal, lumbar spine, pelvis leg, arm and rib, percent body fat and percent trunk fat (by dual energy x-ray absorptiometry) and C-reactive protein (CRP), a marker of inflammation, were assessed at baseline, 12 and 18 months. Linear mixed-effects models estimated associations of time-varying BMD with time-varying CRP, and with percent body and trunk fat. RESULTS CRP was inversely associated with BMD of the total body, pelvis and leg (n = 136). Percent body fat was inversely associated with BMD of the total body and pelvis; whereas percent trunk fat was related only to total body BMD. CONCLUSIONS Greater inflammation and adiposity were related to lower BMD in youth with type 1 diabetes. Investigating the impact of inflammation and adiposity on bone turnover markers could provide insights on mechanisms that contribute to this relationship.
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Affiliation(s)
- Namrata Sanjeevi
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, United States.
| | - Leah M Lipsky
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, United States
| | - Tonja R Nansel
- Social and Behavioral Sciences Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, United States
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Kaur H, Joshee P, Franquemont S, Baumgartner A, Thurston J, Pyle L, Nadeau KJ, Shah VN. Bone mineral content and bone density is lower in adolescents with type 1 diabetes: A brief report from the RESISTANT and EMERALD studies. J Diabetes Complications 2018; 32:931-933. [PMID: 29980432 PMCID: PMC6908302 DOI: 10.1016/j.jdiacomp.2018.06.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/04/2018] [Accepted: 06/06/2018] [Indexed: 10/28/2022]
Abstract
To understand the effect of type 1 diabetes (T1D) on bone mineral content (BMC) and bone density (BMD), we studied 125 T1D adolescents and 80 pubertal stage matched controls. T1D was associated with lower whole-body BMC and BMD compared to controls, even when adjusted for age, sex and sex hormones.
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Affiliation(s)
- Harsahiba Kaur
- Barbara Davis Center for Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, 1775 Aurora Ct, Aurora, CO 80045, United States of America
| | - Prakriti Joshee
- Barbara Davis Center for Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, 1775 Aurora Ct, Aurora, CO 80045, United States of America
| | - Stephanie Franquemont
- Rocky Vista University College of Osteopathic Medicine, 8401 S Chambers Rd, Parker, CO 80134, United States of America
| | - Amy Baumgartner
- University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America
| | - Jessica Thurston
- Department of Pediatrics, School of Medicine, Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17th Place Mail Stop B119, Aurora, CO 80045, United States of America
| | - Laura Pyle
- Department of Pediatrics, School of Medicine, Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17th Place Mail Stop B119, Aurora, CO 80045, United States of America
| | - Kristen J Nadeau
- University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America; Division of Pediatric Endocrinology, Department of Pediatrics, Children's Hospital Colorado, Aurora, CO, United States of America
| | - Viral N Shah
- Barbara Davis Center for Diabetes, School of Medicine, University of Colorado Anschutz Medical Campus, 1775 Aurora Ct, Aurora, CO 80045, United States of America; University of Colorado School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, United States of America.
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Zulfarina MS, Sharif R, Syarifah-Noratiqah SB, Sharkawi AM, Aqilah-SM ZSM, Mokhtar SA, Nazrun SA, Naina-Mohamed I. Modifiable factors associated with bone health in Malaysian adolescents utilising calcaneus quantitative ultrasound. PLoS One 2018; 13:e0202321. [PMID: 30106982 PMCID: PMC6091955 DOI: 10.1371/journal.pone.0202321] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 08/01/2018] [Indexed: 12/02/2022] Open
Abstract
Maximizing bone mineral accrual to attain an optimal peak bone mass (PBM), particularly during adolescence, appears to be an effective protective strategy in the prevention of osteoporosis. This study aimed to evaluate the influence of physical activity (PA), fat mass (FM), lean mass (LM), body mass index (BMI), calcium, or combination of vitamin D supplement intake, smoking and alcohol drinking status on bone health assessed by calcaneus quantitative ultrasound (QUS) in a healthy adolescent population. The participants comprised of 920 male and female secondary school adolescents aged 15–17 years old. Quantitative ultrasound measurements of the left heel were performed using Lunar Achilles EX II, which included results of broadband ultrasound attenuation (BUA), speed of sound (SOS), and a calculated stiffness index (SI). Multivariable linear regression analyses revealed that—PA was positively associated with all three QUS indices in both genders; BMI was positively associated with SI and SOS in females; LM was positively associated with BUA in both genders; and FM was negatively associated with SI in females. These variables accounted for 32.1%, 21.2% and 29.4% of females’ SOS, BUA and SI variances (p<0.001), respectively and 23.6%, 15.4% and 17.2% of males’ SOS, BUA and SI variances (p<0.001), respectively. Promoting health benefits from physical activity could influence bone status and consequently improve PBM, which is a potent protective determinant against osteoporosis in adulthood.
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Affiliation(s)
- Mohamed S. Zulfarina
- Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Razinah Sharif
- Nutritional Sciences Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Syed-Badrul Syarifah-Noratiqah
- Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Ahmad M. Sharkawi
- Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Zaris-SM Aqilah-SM
- Department of Orthopaedic, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Sabarul-Afian Mokhtar
- Department of Orthopaedic, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Shuid A. Nazrun
- Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Isa Naina-Mohamed
- Pharmacoepidemiology and Drug Safety Unit, Department of Pharmacology, Faculty of Medicine, UKM Medical Centre, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- * E-mail:
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Hetherington-Rauth M, Bea JW, Blew RM, Funk JL, Hingle MD, Lee VR, Roe DJ, Wheeler MD, Lohman TG, Going SB. Relative contributions of lean and fat mass to bone strength in young Hispanic and non-Hispanic girls. Bone 2018; 113:144-150. [PMID: 29800691 PMCID: PMC6008243 DOI: 10.1016/j.bone.2018.05.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/16/2018] [Accepted: 05/20/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND With the high prevalence of childhood obesity, especially among Hispanic children, understanding how body weight and its components of lean and fat mass affect bone development is important, given that the amount of bone mineral accrued during childhood can determine osteoporosis risk later in life. The aim of this study was to assess the independent contributions of lean and fat mass on volumetric bone mineral density (vBMD), geometry, and strength in both weight-bearing and non-weight-bearing bones of Hispanic and non-Hispanic girls. METHODS Bone vBMD, geometry, and strength were assessed at the 20% distal femur, the 4% and 66% distal tibia, and the 66% distal radius of the non-dominant limb of 326, 9- to 12-year-old girls using peripheral quantitative computed tomography (pQCT). Total body lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). Multiple linear regression was used to assess the independent relationships of fat and lean mass with pQCT bone measures while adjusting for relevant confounders. Potential interactions between ethnicity and both fat and lean mass were also tested. RESULTS Lean mass was a significant positive contributor to all bone outcomes (p < 0.05) with the exception of vBMD at diaphyseal sites. Fat mass was a significant contributor to bone strength at weight bearing sites, but did not significantly contribute to bone strength at the non-weight bearing radius and was negatively associated with radius cortical content and thickness. Bone measures did not significantly differ between Hispanic and non-Hispanic girls, although there was a significant interaction between ethnicity and fat mass with total bone area at the femur (p = 0.02) and 66% tibia (p = 0.005) as well as bone strength at the femur (p = 0.03). CONCLUSION Lean mass is the main determinant of bone strength for appendicular skeletal sites. Fat mass contributes to bone strength in the weight-bearing skeleton but does not add to bone strength in non-weight-bearing locations and may potentially be detrimental. Bone vBMD, geometry, and strength did not differ between Hispanic and non-Hispanic girls; fat mass may be a stronger contributor to bone strength in weight-bearing bones of Hispanic girls compared to non-Hispanic.
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Affiliation(s)
| | - Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA; Department of Medicine, University of Arizona, Tucson, AZ 85721, USA; Arizona Cancer Center, Tucson, AZ 85724, USA.
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
| | - Janet L Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA; Department of Medicine, University of Arizona, Tucson, AZ 85721, USA.
| | - Melanie D Hingle
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
| | - Vinson R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
| | - Denise J Roe
- Arizona Cancer Center, Tucson, AZ 85724, USA; Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ 85721, USA.
| | - Mark D Wheeler
- Department of Pediatric Endocrinology, University of Arizona, Tucson, AZ 85724, USA.
| | - Timothy G Lohman
- Department of Physiology, University of Arizona, Tucson, AZ 85721, USA
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA.
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Üstyol A, Atabek ME. Prediyabeti olan obez çocukların kemik mineral dansitometreleri. EGE TIP DERGISI 2018. [DOI: 10.19161/etd.414976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Hetherington-Rauth M, Bea JW, Blew RM, Funk JL, Lee VR, Varadi TC, Roe DJ, Wheeler MD, Going SB. Effect of cardiometabolic risk factors on the relationship between adiposity and bone mass in girls. Int J Obes (Lond) 2018; 42:1185-1194. [PMID: 29892038 PMCID: PMC6195820 DOI: 10.1038/s41366-018-0134-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/07/2018] [Accepted: 05/10/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND/OBJECTIVE Childhood obesity has been separately associated with cardiometabolic risk factors (CMRs) and increased risk of fracture. However, both augmented and compromised bone mass have been reported among overweight/obese children. Metabolic dysfunction, often co-existing with obesity, may explain the discrepancy in previous studies. The aim of this study was to examine whether the relationship between adiposity and dual-energy X-ray absorptiometry (DXA) derived bone mass differed in young girls with and without CMR(s). SUBJECTS/METHODS Whole-body bone and body composition measures by DXA and measures of CMR (fasting glucose, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), systolic and diastolic blood pressure, waist circumference (WC)) were obtained from 307, 9- to 12-year-old girls. Girls with 1 or ≥ 2 CMR(s) were considered to be at risk (vs. no CMR). Multiple linear regression was used to test the relationship of total fat mass with total body bone mineral content (BMC) after controlling for height, lean mass, CMR risk, and other potential confounders. RESULTS There was a significant interaction between CMR risk and total body fat mass. When girls were stratified by CMR group, all groups had a significant positive relationship between fat mass and BMC (p < 0.05), however, girls with ≥ 2 CMRs had a lower BMC for a given level of body fat. Total body fat was not significantly related to bone mineral density (p > 0.05). CONCLUSION Fat mass has a positive relationship with BMC even after controlling for lean mass. However, the positive relationship of fat mass with BMC may be attenuated if multiple CMRs are present.
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Affiliation(s)
| | - Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721, USA.,Departments of Medicine, University of Arizona, Tucson, AZ, 85721, USA.,Arizona Cancer Center, Tucson, AZ, 85724, USA
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721, USA
| | - Janet L Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721, USA.,Departments of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Vinson R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721, USA
| | - Tiffany C Varadi
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721, USA
| | - Denise J Roe
- Arizona Cancer Center, Tucson, AZ, 85724, USA.,Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, 85721, USA
| | - Mark D Wheeler
- Department of Pediatric Endocrinology, University of Arizona, Tucson, AZ, 85724, USA
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, Arizona, 85721, USA
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Evensen E, Skeie G, Wilsgaard T, Christoffersen T, Dennison E, Furberg AS, Grimnes G, Winther A, Emaus N. How Is Adolescent Bone Mass and Density Influenced by Early Life Body Size and Growth? The Tromsø Study: Fit Futures-A Longitudinal Cohort Study From Norway. JBMR Plus 2018; 2:268-280. [PMID: 30283908 PMCID: PMC6139726 DOI: 10.1002/jbm4.10049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/13/2018] [Accepted: 03/26/2018] [Indexed: 01/21/2023] Open
Abstract
The effect of birth weight and childhood body mass index (BMI) on adolescents’ bone parameters is not established. The aim of this longitudinal, population‐based study was to investigate the association of birth weight, childhood BMI, and growth, with adolescent bone mass and bone density in a sample of 633 adolescents (48% girls) from The Tromsø Study: Fit Futures. This population‐based cohort study was conducted in 2010–2011 and 2012–2013 in Tromsø, Norway. Bone mineral content (BMC) and areal BMD (aBMD) were measured at total hip (TH) and total body (TB) by dual‐energy X‐ray absorptiometry (DXA) and converted to internal Z‐scores. Birth weight and childhood anthropometric measurements were retrospectively obtained from the Medical Birth Registry of Norway and childhood health records. Associations between birth weight, BMI, and growth were evaluated by fitting linear mixed models with repeated measures of BMC and aBMD at ages 15 to 17 and 18 to 20 years as the outcome. In crude analysis, a significant positive association (p < 0.05) with TB BMC was observed per 1 SD score increase in birth weight, observed in both sexes. Higher rate of length growth, conditioned on earlier size, from birth to age 2.5 years, and higher rate of weight gain from ages 6.0 to 16.5 years, conditioned on earlier size and concurrent height growth, revealed stronger associations with bone accrual at ages 15 to 20 years compared with other ages. Compared with being normal weight, overweight/obesity at age 16.5 years was associated with higher aBMD Z‐scores: β coefficient (95% confidence interval [CI]) of 0.78 (0.53, 1.03) and 1.08 (0.85, 1.31) in girls, 0.63 (0.42, 0.85) and 0.74 (0.54, 0.95) in boys at TH and TB, respectively. Similar associations were found for BMC. Being underweight was consistently negatively associated with bone parameters in adolescence. In conclusion, birth weight influences adolescent bone mass but less than later growth and BMI in childhood and adolescence. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research
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Affiliation(s)
- Elin Evensen
- Department of Clinical Research University Hospital of North Norway Tromsø Norway.,Department of Health and Care Sciences Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
| | - Guri Skeie
- Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
| | - Tom Wilsgaard
- Department of Clinical Research University Hospital of North Norway Tromsø Norway.,Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
| | - Tore Christoffersen
- Department of Health and Care Sciences Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway.,Finnmark Hospital Trust Alta Norway
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit Southampton UK.,Victoria University Wellington New Zealand
| | - Anne-Sofie Furberg
- Department of Community Medicine Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway.,Department of Microbiology and Infection Control University Hospital of North Norway Tromsø Norway
| | - Guri Grimnes
- Endocrinology Research Group Institute of Clinical Medicine UiT The Arctic University of Norway Tromsø Norway.,Division of Internal Medicine University Hospital of North Norway Tromsø Norway
| | - Anne Winther
- Division of Neurosciences Orthopedics, and Rehabilitation Services University Hospital of North Norway Tromsø Norway
| | - Nina Emaus
- Department of Health and Care Sciences Faculty of Health Sciences UiT The Arctic University of Norway Tromsø Norway
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40
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Dimitri P. Fat and bone in children - where are we now? Ann Pediatr Endocrinol Metab 2018; 23:62-69. [PMID: 29969876 PMCID: PMC6057021 DOI: 10.6065/apem.2018.23.2.62] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/19/2018] [Indexed: 12/16/2022] Open
Abstract
The risk of fracture secondary to low-impact trauma is greater in obese children, suggesting obese children are at risk of skeletal fragility. However, despite this finding, there is a lack of agreement about the impact of excessive adiposity on skeletal development. The combination of poor diet, sedentary lifestyle, greater force generated on impact through falls, and greater propensity to falls may in part explain the increased risk of fracture in obese children. To date, evidence suggests that in early childhood years, obesity confers a structural advantage to the developing skeleton. However, in time, this relationship attenuates and then reverses, such that there is a critical period during skeletal development when obesity has a detrimental effect on skeletal structure and strength. Fat mass may be important to the developing cortical and trabecular bone compartments, provided that gains in fat mass are not excessive. However, when fat accumulation reaches excessive levels, unfavorable metabolic changes may impede skeletal development. Evidence from studies examining bone microstructure suggests skeletal adaption to excessive load fails, and bone strength is relatively diminished in relation to body size in obese children. Mechanisms that may explain these changes include changes in the hormonal environment, particularly in relation to alterations in adipokines and fat distribution. Given the concomitant rise in the prevalence of childhood obesity and fractures, as well as adult osteoporosis, further work is required to understand the relationship between obesity and skeletal development.
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Affiliation(s)
- Paul Dimitri
- Address for correspondence: Paul Dimitri The Academic Unit of Child Health, Sheffield Children’s NHS Foundation Trust, Western Bank, Sheffield S10 2TH, United Kingdom Tel: +44-271-7118 Fax: +44-275-5364 E-mail:
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41
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Soininen S, Sidoroff V, Lindi V, Mahonen A, Kröger L, Kröger H, Jääskeläinen J, Atalay M, Laaksonen DE, Laitinen T, Lakka TA. Body fat mass, lean body mass and associated biomarkers as determinants of bone mineral density in children 6-8years of age - The Physical Activity and Nutrition in Children (PANIC) study. Bone 2018; 108:106-114. [PMID: 29307776 DOI: 10.1016/j.bone.2018.01.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 11/24/2017] [Accepted: 01/03/2018] [Indexed: 11/23/2022]
Abstract
Lean body mass (LM) has been positively associated with bone mineral density (BMD) in children and adolescents, but the relationship between body fat mass (FM) and BMD remains controversial. Several biomarkers secreted by adipose tissue, skeletal muscle, or bone may affect bone metabolism and BMD. We investigated the associations of LM, FM, and such biomarkers with BMD in children. We studied a population sample of 472 prepubertal Finnish children (227 girls, 245 boys) aged 6-8years. We assessed BMD, LM, and FM using whole-body dual-energy x-ray absorptiometry and analysed several biomarkers from fasting blood samples. We studied the associations of LM, FM, and the biomarkers with BMD of the whole body excluding the head using linear regression analysis. LM (standardized regression coefficient β=0.708, p<0.001), FM (β=0.358, p<0.001), and irisin (β=0.079, p=0.048) were positive correlates for BMD adjusted for age, sex, and height in all children. These associations remained statistically significant after further adjustment for LM or FM. The positive associations of dehydroepiandrosterone sulphate (DHEAS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), leptin, free leptin index, and high-sensitivity C-reactive protein and the negative association of leptin receptor with BMD were explained by FM. The positive associations of DHEAS and HOMA-IR with BMD were also explained by LM. Serum 25-hydroxyvitamin D was a positive correlate for BMD adjusted for age, sex, and height and after further adjustment for FM but not for LM. LM and FM were positive correlates for BMD also in girls and boys separately. In girls, insulin, HOMA-IR, leptin, and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height, and FM, none of the biomarkers was associated with BMD. In boys, leptin and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height and FM, 25(OH)D was positively and IGF-1 and leptin were negatively associated with BMD. FM strongly modified the association between leptin and BMD. LM but also FM were strong, independent positive correlates for BMD in all children, girls, and boys. Irisin was positively and independently associated with BMD in all children. The associations of other biomarkers with BMD were explained by LM or FM.
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Affiliation(s)
- Sonja Soininen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Institute of Dentistry, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Social and Health Center, City of Varkaus, Savontie 55, 78300 Varkaus, Finland.
| | - Virpi Sidoroff
- Department of Pediatrics, North-Karelia Central Hospital, Tikkamäentie 16, 80210 Joensuu, Finland.
| | - Virpi Lindi
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Anitta Mahonen
- Institute of Biomedicine, Medical Biochemistry, School of Medicine, University of Eastern Finland, PO Box 1627, Kuopio, Finland.
| | - Liisa Kröger
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Heikki Kröger
- Department of Orthopedics and Traumatology, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Mustafa Atalay
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - David E Laaksonen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Internal Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Timo A Lakka
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland.
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42
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Kouda K, Ohara K, Nakamura H, Fujita Y, Jaalkhorol M, Iki M. Fat mass is positively associated with bone mass acquisition in children with small or normal lean mass: A three-year follow-up study. Bone 2018; 107:222-227. [PMID: 29313815 DOI: 10.1016/j.bone.2017.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/14/2017] [Accepted: 12/02/2017] [Indexed: 11/27/2022]
Abstract
The independent impact of fat mass (FM) on bone health is difficult to assess, as FM is correlated with lean soft tissue mass (LSTM). In a previous cross-sectional study, FM was suggested to help promote high bone mass acquisition in adolescents with small LSTM. The present prospective cohort study investigated the effects of FM on bone in pubertal children after stratification by height-normalized index of LSTM (LSTMI). The source population was all 5th grade children enrolled in either one of the two public elementary schools in Hamamatsu, Japan. Of these, 545 children who participated in both baseline (at age 11) and follow-up (at age 14) surveys were included in the present analysis. Body composition and whole body areal bone mineral density (aBMD) were measured using dual-energy X-ray absorptiometry. From baseline to follow-up, significant (P<0.05) differences were observed in changes in aBMD among tertiles of change in FM in both sexes after adjusting for confounding factors including LSTMI. After stratification by tertiles of sex-specific LSTMI, adjusted means of changes in aBMD according to tertiles of change in FM within the lowest and second lowest tertiles of LSTMI in both sexes showed a significant increase from the lower tertiles to the highest tertile of change in FM. In the highest tertile of LSTMI, changes in FM showed no significant association with changes in aBMD. These findings suggest that adipose tissue might help promote high bone mass acquisition in pubertal children with small or normal LSTMI.
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Affiliation(s)
- Katsuyasu Kouda
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan.
| | - Kumiko Ohara
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe 657-8501, Japan
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe 657-8501, Japan
| | - Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan
| | - Myadagmaa Jaalkhorol
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan
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43
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Winther A, Jørgensen L, Ahmed LA, Christoffersen T, Furberg AS, Grimnes G, Jorde R, Nilsen OA, Dennison E, Emaus N. Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromsø Study, Fit Futures. BMC Musculoskelet Disord 2018; 19:21. [PMID: 29351755 PMCID: PMC5775543 DOI: 10.1186/s12891-018-1933-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 01/10/2018] [Indexed: 12/20/2022] Open
Abstract
Background Positive association between body weight and bone mass is well established, and the concept of body mass index (BMI) is associated with higher areal bone mineral density (aBMD) and reduced fracture risk. BMI, that comprises both fat mass (FM) and lean mass (LM) may contribute to peak bone mass achievement in different ways. This study explored the influence of body composition in terms of total body LM and FM on hip aBMD-values in adolescence. Methods In 2010/2011, 93% of the region’s first-year upper-secondary school students (15–17 years old) in Tromsø, Norway attended the Tromsø Study, Fit Futures. Areal BMD at femoral neck (aBMDFN) and total hip (aBMDTH) (g/cm2), total body LM and FM (g) were measured by dual energy X-ray absorptiometry (DXA). Height and weight were measured, and BMI calculated. Lifestyle variables were collected by self-administered questionnaires and interviews, including questions on time spent on leisure time physical activity. Stratified analyses of covariance and regression models included 395 girls and 363 boys. Crude results were adjusted for age, height, sexual maturation, physical activity levels, vitamin D levels, calcium intake, alcohol consumption and smoking habits. Results Unadjusted distribution indicated higher aBMD-levels at higher LM-levels in both genders (p < 0.001), but higher aBMD at higher FM-levels were found only in girls (p < 0.018). After multiple adjustments, aBMDFN-levels in girls were associated by 0.053 g/cm2 and 0.032 g/cm2 per standard deviation (SD) change in LM and FM (p < 0.001). Corresponding values in boys were 0.072 and 0.025 (p < 0.001). The high LM groups accounted for the highest aBMD-levels, while aBMD-levels at the LM/FM-combinations indicated different patterns in girls compared to boys. The adjusted odds ratio (95% CI) for low levels of aBMDFN was 6.6 (3.4,13.0) in boys, compared to 2.8 (1.6,4.9) in girls per SD lower LM. Conclusions LM and FM should be regarded as strong predictors for bone mass and hence bone strength in adolescents. A gender specific difference indicated that high lean mass is of crucial importance prominently in boys. In adolescents with low lean mass, especially in girls, high fat mass may partially ameliorate the effect of deficient lean mass levels.
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Affiliation(s)
- Anne Winther
- Division of Neurosciences, Orthopedics and Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway. .,Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway. .,Victoria University, Wellington, New Zealand.
| | - Lone Jørgensen
- Division of Neurosciences, Orthopedics and Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Luai Awad Ahmed
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Tore Christoffersen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Finnmark Hospital Trust, Alta, Norway
| | - Anne-Sofie Furberg
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Guri Grimnes
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.,Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Rolf Jorde
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.,Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Andreas Nilsen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, Southampton, UK.,Victoria University, Wellington, New Zealand
| | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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44
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Kelley JC, Stettler-Davis N, Leonard MB, Hill D, Wrotniak BH, Shults J, Stallings VA, Berkowitz R, Xanthopoulos MS, Prout-Parks E, Klieger SB, Zemel BS. Effects of a Randomized Weight Loss Intervention Trial in Obese Adolescents on Tibia and Radius Bone Geometry and Volumetric Density. J Bone Miner Res 2018; 33:42-53. [PMID: 28884881 PMCID: PMC8527854 DOI: 10.1002/jbmr.3288] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/31/2017] [Accepted: 09/06/2017] [Indexed: 01/06/2023]
Abstract
Obese adolescents have increased fracture risk, but effects of alterations in adiposity on bone accrual and strength in obese adolescents are not understood. We evaluated 12-month changes in trabecular and cortical volumetric bone mineral density (vBMD) and cortical geometry in obese adolescents undergoing a randomized weight management program, and investigated the effect of body composition changes on bone outcomes. Peripheral quantitative computed tomography (pQCT) of the radius and tibia, and whole-body dual-energy X-ray absorptiometry (DXA) scans were obtained at baseline, 6 months, and 12 months in 91 obese adolescents randomized to standard care versus behavioral intervention for weight loss. Longitudinal models assessed effects of body composition changes on bone outcomes, adjusted for age, bone length, and African-American ancestry, and stratified by sex. Secondary analyses included adjustment for physical activity, maturation, vitamin D, and inflammatory biomarkers. Baseline body mass index (BMI) was similar between intervention groups. Twelve-month change in BMI in the standard care group was 1.0 kg/m2 versus -0.4 kg/m2 in the behavioral intervention group (p < 0.01). Intervention groups were similar in bone outcomes, so they were combined for subsequent analyses. For the tibia, BMI change was not associated with change in vBMD or structure. Greater baseline lean body mass index (LBMI) associated with higher cortical vBMD in males, trabecular vBMD in females, and polar section modulus (pZ) and periosteal circumference (Peri-C) in both sexes. In females, change in LBMI positively associated with gains in pZ and Peri-C. Baseline visceral adipose tissue (VFAT) was inversely associated with pZ in males and cortical vBMD in females. Change in VFAT did not affect bone outcomes. For the radius, BMI and LBMI changes positively associated with pZ in males. Thus, in obese adolescents, weight loss intervention with modest changes in BMI was not detrimental to radius or tibia bone strength, and changes in lean, but not adiposity, measures were beneficial to bone development. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Jennifer C Kelley
- Division of Endocrinology and Diabetes, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | | | - Mary B Leonard
- Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Douglas Hill
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Pediatric Advanced Care Team, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Brian H Wrotniak
- Department of Physical Therapy, D'Youville College, Buffalo, NY, USA
| | - Justine Shults
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Biostatistics and Data Management, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Virginia A Stallings
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Robert Berkowitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Melissa S Xanthopoulos
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elizabeth Prout-Parks
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Sarah B Klieger
- Biostatistical and Data Management Core, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Babette S Zemel
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadephia, Philadelphia, PA, USA
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45
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Piasecki J, McPhee JS, Hannam K, Deere KC, Elhakeem A, Piasecki M, Degens H, Tobias JH, Ireland A. Hip and spine bone mineral density are greater in master sprinters, but not endurance runners compared with non-athletic controls. Arch Osteoporos 2018; 13:72. [PMID: 29971503 PMCID: PMC6028830 DOI: 10.1007/s11657-018-0486-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/05/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED We examined bone density in older athletes and controls. Sprinters had greater hip and spine bone density than endurance athletes and controls, whereas values were similar in the latter two groups. These results could not be explained by differences in impact, muscle size or power between sprint and endurance athletes. PURPOSE We examined the relationship between prolonged participation in regular sprint or endurance running and skeletal health at key clinical sites in older age, and the factors responsible for any associations which we observed. METHODS We recruited 38 master sprint runners (28 males, 10 females, mean age 71 ± 7 years), 149 master endurance runners (111 males, 38 females, mean age 70 ± 6 years) and 59 non-athletic controls (29 males, 30 females, mean age 74 ± 5 years). Dual X-ray absorptiometry was used to assess hip and spine bone mineral density (BMD), body composition (lean and fat mass), whilst jump power was assessed with jumping mechanography. In athletes, vertical impacts were recorded over 7 days from a waist-worn accelerometer, and details of starting age, age-graded performance and training hours were recorded. RESULTS In ANOVA models adjusted for sex, age, height, body composition, and jump power, sprinter hip BMD was 10 and 14% greater than that of endurance runners and controls respectively. Sprinter spine BMD was also greater than that of both endurance runners and controls. There were no differences in hip or spine BMD between endurance runners and controls. Stepwise regression showed only discipline (sprint/endurance), sex, and age as predictors of athlete spine BMD, whilst these variables and starting age were predictive of hip BMD. CONCLUSIONS Regular running is associated with greater BMD at the fracture-prone hip and spine sites in master sprinters but not endurance runners. These benefits cannot be explained by indicators of mechanical loading measured in this study including vertical impacts, body composition or muscular output.
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Affiliation(s)
- J. Piasecki
- Sport, Health and Performance Enhancement Research Centre, Nottingham Trent University, Nottingham, UK
| | - J. S. McPhee
- Department for Sports and Exercise Sciences, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK
| | - K. Hannam
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - K. C. Deere
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - A. Elhakeem
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - M. Piasecki
- MRC/ARUK Centre of Excellence for Musculoskeletal Ageing Research Centre, School of Medicine, University of Nottingham, Derby, UK
| | - H. Degens
- Department for Sports and Exercise Sciences, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK ,Institute of Sport Science and Innovations, Lithuanian Sports University, Lithuania, Lithuania
| | - J. H. Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - A. Ireland
- Department for Sports and Exercise Sciences, Manchester Metropolitan University, John Dalton Building, Chester Street, Manchester, M1 5GD UK
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46
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Investigating associations between child bone mineral density and vitamin D status, diet, physical activity, and body composition at 5 years of age – Findings from the ROLO Kids Study. Proc Nutr Soc 2018. [DOI: 10.1017/s0029665118000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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47
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48
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Cohen TR, Hazell TJ, Vanstone CA, Rodd C, Weiler HA. Bone Health is Maintained, While Fat Mass is Reduced in Pre-pubertal Children with Obesity Participating in a 1-Year Family-Centered Lifestyle Intervention. Calcif Tissue Int 2017; 101:612-622. [PMID: 28866763 DOI: 10.1007/s00223-017-0318-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/23/2017] [Indexed: 12/18/2022]
Abstract
Diet and physical activity (PA) influence bone health in children. This study tested whether increasing milk and milk products and weight-bearing types of PA favorably changed bone outcomes assessed by dual-energy X-ray absorptiometry (DXA) and bone biomarkers in children with obesity participating in a 1-year family-centered lifestyle intervention. Children were randomized to one of three groups: Control (Ctrl; no intervention), Standard treatment (StnTx: two servings milk and milk products/day; meet PA guidelines plus weight-bearing PA three times/week), or Modified treatment (ModTx: four servings milk and milk products/day; meet PA guidelines plus daily weight-bearing PA). Baseline and 12-month measurements included DXA scans for whole body (WB), lumbar spine (LS), lumbar lateral spine (LLS), and ultra-distal (UD) ulna + radius for bone mineral content (BMC), areal bone mineral density (aBMD) and BMD z-scores. Fat mass index (FMI), fat-free mass index (FFMI), and biomarkers of bone metabolism were assessed. Seventy-eight children 6-8 years old were recruited (mean body mass index for-age z-score: 3.3 ± 1.2). Compared to baseline, all groups increased BMC of WB, LS, and LLS (p < 0.001), whereas only StnTx increased UD ulna + radius BMC at 12 months (p < 0.05). At 12 months, WB-BMD z-scores were significantly lower in Ctrl (p < 0.05), whereas WB and LLS aBMD increased in StnTx and ModTx (p < 0.001) but not in Ctrl. All groups increased FFMI (p < 0.001), while only Ctrl increased FMI (p < 0.001). Bone biomarkers did not change over time. Participating in a family-centered lifestyle intervention based on Canadian diet and PA guidelines maintained bone health in obese children.
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Affiliation(s)
- Tamara R Cohen
- School of Human Nutrition, Macdonald Campus, McGill University, 21,111 Lakeshore Rd, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada
| | - Tom J Hazell
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, 75 University Avenue West, Waterloo, ON, N2L 3C5, Canada
| | - Catherine A Vanstone
- School of Human Nutrition, Macdonald Campus, McGill University, 21,111 Lakeshore Rd, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada
| | - Celia Rodd
- Children's Hospital, University of Manitoba, FW302-685 William Ave, Winnipeg, MB, R3E 0Z2, Canada
| | - Hope A Weiler
- School of Human Nutrition, Macdonald Campus, McGill University, 21,111 Lakeshore Rd, Sainte-Anne-de-Bellevue, QC, H9X 3V9, Canada.
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49
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Khwanchuea R, Punsawad C. Association between Anthropometric Indices, Body Composition and Bone Parameters in Thai Female Adolescents. Indian J Pediatr 2017; 84:908-914. [PMID: 28799060 DOI: 10.1007/s12098-017-2422-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 07/05/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To investigate correlations between anthropometrics and body composition with bone parameters of the whole-body and lumbar spine in non-obese and obese Thai female adolescents. METHODS This study was performed in 135 female adolescents aged 15 to 18 y enrolled in secondary schools in southern Thailand. Subjects were grouped into non-obesity (underweight and normal-to-overweight) (BMI < 25) and obesity (BMI ≥ 25) groups. Anthropometric indices for obesity [body weight (BW), waist circumference (WC), and body mass index (BMI)] were recorded. Bone parameters (BMC, BMD, and Z-scores) of the whole-body and lumbar spine (L1-L4) and body composition (LBM, BFM, %fat, %lean, and %bone) were assessed by dual-energy X-ray absorptiometry (DXA). Correlations between anthropometrics, body composition, and bone parameters were evaluated and compared between subject groups. RESULTS The obesity group had significantly higher means of whole-body BMD, BMC and Z-score than non-obese group (p < 0.05). BMI and BW were positively associated with BFM and %fat (p < 0.05) for non-obese subjects. Obese subjects had greater lumbar spine BMC compared to non-obese subjects. BFM was correlated with whole-body BMC in obese group. BW was a positive determinant of BMC at both sites in all subject groups, particularly for obese subjects; BW had positive associations with all bone parameters at the lumbar spine. CONCLUSIONS BW can be used as a determinant of all bone parameters at lumbar spine, and BFM had a positive effect on whole-body BMC in Thai obese female adolescent subjects.
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Affiliation(s)
- Rapheeporn Khwanchuea
- School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand.
| | - Chuchard Punsawad
- School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand
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50
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Styner M, Pagnotti GM, McGrath C, Wu X, Sen B, Uzer G, Xie Z, Zong X, Styner MA, Rubin CT, Rubin J. Exercise Decreases Marrow Adipose Tissue Through ß-Oxidation in Obese Running Mice. J Bone Miner Res 2017; 32:1692-1702. [PMID: 28436105 PMCID: PMC5550355 DOI: 10.1002/jbmr.3159] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 03/17/2017] [Accepted: 04/20/2017] [Indexed: 12/23/2022]
Abstract
The relationship between marrow adipose tissue (MAT) and bone health is poorly understood. We used running exercise to ask whether obesity-associated MAT can be attenuated via exercise and whether this correlates with gains in bone quantity and quality. C57BL/6 mice were divided into diet-induced obesity (DIO, n = 14) versus low-fat diet (LFD, n = 14). After 3 months, 16-week-old mice were allocated to an exercise intervention (LFD-E, DIO-E) or a control group (LFD, DIO) for 6 weeks (4 groups, n = 7/group). Marrow adipocyte area was 44% higher with obesity (p < 0.0001) and after exercise 33% lower in LFD (p < 0.0001) and 39% lower in DIO (p < 0.0001). In LFD, exercise did not affect adipocyte number; however, in DIO, the adipocyte number was 56% lower (p < 0.0001). MAT was 44% higher in DIO measured by osmium-μCT, whereas exercise associated with reduced MAT (-23% in LFD, -48% in DIO, p < 0.05). MAT was additionally quantified by 9.4TMRI, and correlated with osmium-µCT (r = 0.645; p < 0.01). Consistent with higher lipid beta oxidation, perilipin 3 (PLIN3) rose with exercise in tibial mRNA (+92% in LFD, +60% in DIO, p < 0.05). Tibial µCT-derived trabecular bone volume (BV/TV) was not influenced by DIO but responded to exercise with an increase of 19% (p < 0.001). DIO was associated with higher cortical periosteal and endosteal volumes of 15% (p = 0.012) and 35% (p < 0.01), respectively, but Ct.Ar/Tt.Ar was lower by 2.4% (p < 0.05). There was a trend for higher stiffness (N/m) in DIO, and exercise augmented this further. In conclusion, obesity associated with increases in marrow lipid-measured by osmium-μCT and MRI-and partially due to an increase in adipocyte size, suggesting increased lipid uptake into preexisting adipocytes. Exercise associated with smaller adipocytes and less bone lipid, likely invoking increased ß-oxidation and basal lipolysis as evidenced by higher levels of PLIN3. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Maya Styner
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Gabriel M Pagnotti
- Department of Biomedical Engineering, State University of New York, Stony Brook, Stony Brook, NY, USA
| | - Cody McGrath
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Xin Wu
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Buer Sen
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Gunes Uzer
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
- Department of Mechanical and Biomedical Engineering, Boise State University, Boise, ID, USA
| | - Zhihui Xie
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Xiaopeng Zong
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, USA
| | - Martin A Styner
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Clinton T Rubin
- Department of Biomedical Engineering, State University of New York, Stony Brook, Stony Brook, NY, USA
| | - Janet Rubin
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
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