Bone mineral density, hip bone geometry, and calcaneus trabecular bone texture in obese and normal-weight children

Area of Science:

• Pediatric Endocrinology
• Bone Metabolism
• Obesity Research

Background:

• Childhood obesity is a growing concern with potential long-term health implications.
• Bone health in obese children requires further investigation, particularly regarding bone strength adaptation to increased body weight.

Purpose of the Study:

• To compare bone mineral density (BMD), hip bone strength indices, and calcaneal trabecular bone texture between obese and normal-weight children.
• To determine if bone strength indices in obese children are adequately adapted to their increased body weight.

Main Methods:

• Dual-energy X-ray absorptiometry (DXA) was used to measure body composition and BMD at various sites (whole body, lumbar spine, forearm, proximal femur).
• Hip Structure Analysis (HSA) evaluated hip bone geometry (cross-sectional area [CSA], section modulus [Z]).
• Texture analysis of calcaneal radiographs assessed trabecular bone microarchitecture (Hmean).

Main Results:

• Obese children exhibited higher whole body, lumbar spine, total hip, and femoral neck BMD compared to normal-weight peers.
• No significant differences in femoral neck (FN) Z and femoral shaft (FS) Z were found between groups.
• Obese children showed significantly lower calcaneal Hmean (trabecular bone texture) and, after adjusting for body weight, lower WB BMD, FN CSA, FN Z, FS CSA, and FS Z.

Conclusions:

• While obese children have higher overall BMD, their hip bone geometry and strength indices may not be proportionally increased.
• Reduced trabecular bone texture in obese children warrants further investigation.
• Bone strength adaptation to increased body weight in obese children appears insufficient.