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. 2019 Apr:121:9-15.
doi: 10.1016/j.bone.2018.12.009. Epub 2018 Dec 15.

Body composition and bone mineral density in childhood

Lisa B Rokoff  1 , Sheryl L Rifas-Shiman  2 , Karen M Switkowski  2 , Jessica G Young  2 , Clifford J Rosen  3 , Emily Oken  4 , Abby F Fleisch  5
Affiliations

Body composition and bone mineral density in childhood

Lisa B Rokoff et al. Bone. 2019 Apr.

Abstract

Background: Body mass compartments may have different directions of influence on bone accrual. Studies of children are limited by relatively small sample sizes and typically make strong assumptions of linear regression.

Objective: To evaluate associations of overall body mass, components of overall body mass (fat-free and total fat), and components of total fat mass (truncal and non-truncal fat), measured via dual-energy X-ray absorptiometry (DXA) and anthropometry, with total body less head areal bone mineral density (aBMD) Z-score in mid-childhood.

Methods: We performed a cross-sectional study among 876 Boston-area children who had DXA measures. We evaluated linearity of associations using generalized additive models.

Results: Children were median 7.7 (range 6-10) years of age, and 61% were white. After adjustment for sociodemographics and other compartments of body mass, overall body mass, particularly the fat-free mass component, appeared to have a positive relationship with aBMD Z-score [e.g., 0.25 (95% CI: 0.23, 0.28) per 1-kg fat-free mass]. The relationship between truncal fat and aBMD Z-score appeared non-linear, with a negative association only in children with levels of fat mass in the upper 15th percentile [-0.17 (95% CI: -0.26, -0.07) aBMD Z-score per 1-kg truncal fat mass], while non-truncal fat mass was not associated with aBMD Z-score.

Conclusions: Our analyses suggest that central adiposity is associated with lower aBMD Z-score only in children with the highest levels of abdominal fat. This finding raises the possibility of a threshold above which central adipose tissue becomes more metabolically active and thereby adversely impacts bone.

Keywords: Adiposity; Areal bone mineral density; Body composition; Dual-energy X-ray absorptiometry.

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Conflict of interest statement

Declarations of interest: The authors have nothing to disclose.

Figures

Figure 1.
Figure 1.
Association between overall body mass and with sex-, age-, race-, and height-standardized total body (excluding skull) areal bone mineral density (aBMD) Z-score in mid-childhood. See Supplemental Table 3 for predicted effect estimates (95% confidence intervals).
Figure 2.
Figure 2.
Associations of components of overall body mass, fat-free mass (panel A) and total fat mass (panel B) with sex-, age-, race-, and height-standardized total body (excluding skull) areal bone mineral density (aBMD) Z-score in mid-childhood. See Supplemental Table 3 for predicted effect estimates (95% confidence intervals).
Figure 3.
Figure 3.
Associations of components of total fat mass, truncal (panel A) and non-truncal (panel B) fat mass, with sex-, age-, race-, and height-standardized total body (excluding skull) areal bone mineral density (aBMD) Z-score in mid-childhood. See Supplemental Table 3 for predicted effect estimates (95% confidence intervals).
See this image and copyright information in PMC

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References

    1. Bachrach LK, Acquisition of optimal bone mass in childhood and adolescence, Trends Endocrinol Metab 12(1) (2001) 22–8. - PubMed
    1. Crocker MK, Yanovski JA, Pediatric obesity: etiology and treatment, Pediatr Clin North Am 58(5) (2011) 1217–40, xi. - PMC - PubMed
    1. Sioen I, Lust E, De Henauw S, Moreno LA, Jimenez-Pavon D, Associations Between Body Composition and Bone Health in Children and Adolescents: A Systematic Review, Calcif Tissue Int 99(6) (2016) 557–577. - PubMed
    1. El Hage RP, Courteix D, Benhamou CL, Jacob C, Jaffre C, Relative importance of lean and fat mass on bone mineral density in a group of adolescent girls and boys, Eur J Appl Physiol 105(5) (2009) 759–64. - PubMed
    1. Ka K, Rousseau MC, Lambert M, O'Loughlin J, Henderson M, Tremblay A, Alos N, Nicolau B, Association between lean and fat mass and indicators of bone health in prepubertal caucasian children, Horm Res Paediatr 80(3) (2013) 154–62. - PubMed

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