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Bone structure and volumetric BMD in overweight children: a longitudinal study

Rachel J Wetzsteon1, Moira A Petit, Heather M Macdonald

  • 1Department of Pediatrics, Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|August 8, 2008
PubMed

Insights

Overweight children have greater bone strength, but it doesn't adapt to excess body fat. Bone strength in overweight children is linked to larger muscle area, not fat mass.

Area of Science:

  • Pediatric Endocrinology
  • Bone Biology
  • Body Composition

Background:

  • The impact of excess body fat on bone strength development in children is not fully understood.
  • Bone accrual is critical during childhood for lifelong skeletal health.

Purpose of the Study:

  • To compare bone measures and strength indices in healthy weight (HW) versus overweight (OW) children.
  • To investigate how bone strength adapts to excess body fat and muscle mass in children over time.

Main Methods:

  • Assessed bone mineral density (BMD), bone area, bone strength indices (BSI, SSIp), and muscle cross-sectional area (CSA) in 9-11 year old children using peripheral quantitative computed tomography (pQCT).
  • Compared outcomes at baseline and over 16 months between HW (n=302) and OW (n=143) groups.
  • Utilized analysis of covariance to adjust for confounding factors.

Main Results:

  • Overweight children exhibited significantly greater absolute bone measures and bone area at baseline compared to healthy weight children.
  • Bone strength indices (SSIp) in OW children were lower when adjusted for body fat, but similar when adjusted for muscle CSA.
  • Increases in bone strength over 16 months were associated with lean mass changes, not fat mass, and were driven by greater bone area expansion in OW children.

Conclusions:

  • While overweight children possess greater absolute bone strength, their bone strength does not adapt proportionally to their excess body fat.
  • Bone strength accrual in overweight children appears to be primarily driven by increased muscle mass and bone area, rather than fat mass.
  • These findings suggest that interventions focusing on muscle development may be more beneficial for optimizing bone strength in overweight children.

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