Adolescent Obesity, Bone Mass, and Cardiometabolic Risk Factors

• Published in: The Journal of pediatrics Vol. 158; no. 5; pp. 727 - 734
• Main Authors: Pollock, Norman K., PhD, Bernard, Paul J., MD, Gutin, Bernard, PhD, Davis, Catherine L., PhD, Zhu, Haidong, MD, PhD, Dong, Yanbin, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01-05-2011
• Subjects: Absorptiometry, Photon - methods; adipose tissue; Adipose Tissue - anatomy & histology; Adipose Tissue - metabolism; adiposity; Adiposity - physiology; Adolescent; adolescents; blood pressure; Body Mass Index; Bone and Bones - metabolism; bone density; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - metabolism; dual-energy X-ray absorptiometry; fasting; Female; Georgia - epidemiology; glucose; high density lipoprotein cholesterol; homeostasis; Humans; insulin resistance; linear models; Magnetic Resonance Imaging; Male; metabolic syndrome; obesity; Obesity - complications; Obesity - epidemiology; Obesity - metabolism; Pediatrics; Prevalence; Risk Factors; triacylglycerols; waist circumference; Georgia; FFST; Physical activity; MRI; Subcutaneous abdominal adipose tissue; VAT; HDL; LDL; Cardiometabolic risk factors; Homeostasis model assessment of insulin resistance; BMC; Areal bone mineral density; Fat-free soft tissue; SAAT; CMR; Dual-energy X-ray absorptiometry; Visceral adipose tissue; DXA; Metabolic equivalent; Bone mineral content; Low-density lipoprotein; HOMA-IR; PA; High-density lipoprotein; Magnetic resonance imaging; aBMD; MET
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2010.11.052

Objective To compare bone mass between overweight adolescents with and without cardiometabolic risk factors (CMR). Associations of bone mass with CMR and adiposity were also determined. Study design Adolescents (aged 14 to 18 years) who were overweight were classified as healthy (n = 55), having one CMR (1CMR; n = 46), or having two or more CMR (≥2CMR; n = 42). CMRs were measured with standard methods and defined according to pediatric definitions of metabolic syndrome. Total body bone mass, fat mass, and fat-free soft tissue mass were measured with dual-energy X-ray absorptiometry. Visceral adipose tissue and subcutaneous abdominal adipose tissue were assessed with magnetic resonance imaging. Results After controlling for age, sex, race, height, and fat-free soft tissue mass, the healthy group had 5.4% and 6.3% greater bone mass than the 1CMR and ≥2CMR groups, respectively (both P values <.04). With multiple linear regression, adjusting for the same co-variates, visceral adipose tissue (β = –0.22), waist circumference (β = –0.23), homeostasis model assessment of insulin resistance (β = –0.23), and high-density lipoprotein cholesterol level (β = 0.22) were revealed to be associated with bone mass (all P values <.04). There was a trend toward a significant inverse association between bone mass and fasting glucose level ( P = .056). No relations were found between bone mass and fat mass, subcutaneous abdominal adipose tissue, blood pressure, or triglyceride level. Conclusion Being overweight with metabolic abnormalities, particularly insulin resistance, low high-density lipoprotein cholesterol level, and visceral adiposity, may adversely influence adolescent bone mass.