Published online Feb 8, 2018. doi: 10.5409/wjcp.v7.i1.43
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
Adult onset osteoporosis has its antecedent in childhood. With the rise in obesity epidemic, the effect of childhood obesity on bone health needs to be delineated. Historically in adults, higher body mass index (BMI) was believed to be bone protective with increased bone mineral density reported with higher BMI. Further studies have revealed this to be proportional to total lean mass rather than total fat mass. However, the relative distribution of fat in the body may also play a role, and visceral adiposity in particular has been demonstrated to have an adverse impact on bone. Visceral adiposity is directly associated with insulin resistance, and the link between obesity and bone health may be mediated by the underlying insulin resistance. Insulin is a bone anabolic hormone and higher insulin levels may result in increased bone formation. However, a state of insulin resistance may negate the beneficial effects of insulin on bone. This in fact has been suggested in recent studies in adults. However, data in children remain inconclusive.
The main motivation for this research study was to understand the effect of body composition and insulin resistance on bone health in children.
The study showed that percent trunk fat was associated inversely with whole body bone mineral content (BMC), whereas homeostatic model of insulin resistance was associated positively with whole body BMC.
These 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.
Future research should look at other possible connection between adipose tissue and bone health.