Case Control Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Feb 8, 2018; 7(1): 43-48
Published online Feb 8, 2018. doi: 10.5409/wjcp.v7.i1.43
Abdominal obesity adversely affects bone mass in children
Sowmya Krishnan, Michael P Anderson, David A Fields, Madhusmita Misra
Sowmya Krishnan, David A Fields, Department of Pediatrics, University of Oklahoma Health Sciences Center, Harold Hamm Diabetes Center, Oklahoma City, OK 73104, United States
Michael P Anderson, College of Public Health, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, United States
Madhusmita Misra, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA 02114, United States
Author contributions: Krishnan S collected data; Anderson MP helped in statistical analysis; Fields DA and Misra M helped in writing the paper.
Supported by Novo-Nordisk, No. C7042301.
Institutional review board statement: The study has been approved by the University of Oklahoma Health sciences Center Institutional review board research ethics committee and has been performed in accordance with the ethical standards as laid down in the 1964 declaration of Helsinki and its later amendments.
Informed consent statement: All study participants or their legal guardians provided informed consent prior to enrollment in the study.
Conflict-of-interest statement: David A Fields has received grant funding from Nestle and Mead Johnson.
Data sharing statement: Consent was not obtained from participants for sharing data but presented data is anonymized and risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sowmya Krishnan, MD, Associate Professor, Department of Pediatrics, University of Oklahoma Health Sciences Center, Harold Hamm Diabetes Center, 1200, N Children’s Avenue, Suite 4500, Oklahoma City, OK 73104, United States. sowmya-krishnan@ouhsc.edu
Telephone: +1-405-2718000-43091 Fax: +1-405-2713093
Received: August 25, 2017
Peer-review started: September 17, 2017
First decision: October 23, 2017
Revised: November 8, 2017
Accepted: November 27, 2017
Article in press: November 27, 2017
Published online: February 8, 2018
Processing time: 143 Days and 14.1 Hours
Abstract
AIM

To determine the effect of childhood obesity and insulin resistance on bone health.

METHODS

We conducted a cross sectional study in pubertal adolescents and young adults 13-20 years old who were either overweight/obese or normal weight. Participants were Tanner 3 or above for pubertal stage, and had fasting blood work done to measure glucose, insulin, C-reactive protein and lipid levels. Homeostatic model of insulin resistance (HOMA-IR) was calculated using the formula (Fasting Blood Glucose *Insulin/405). Body composition and bone mineral density were measured using dual energy X-ray absorptiometry (DXA; Hologic QDR 4500, Waltham, MA, United Kingdom).

RESULTS

Percent trunk fat was associated inversely with whole body bone mineral content (BMC), whereas HOMA-IR was associated positively with whole body BMC.

CONCLUSION

Our results suggest that abdominal adiposity may have an adverse effect on whole body bone parameters and that this effect is not mediated by insulin resistance.

Keywords: Obesity; Bone mineral density; Insulin resistance

Core tip: Abdominal adiposity has an adverse impact on whole body bone mineral content in adolescents. This effect does not seem to be mediated by the increased insulin resistance associated with increased abdominal adiposity. Attention to body composition rather than just body weight is needed to counsel adolescents regarding optimal bone health.