Adipose Tissue Stimulates Bone Growth in Prepubertal Children

Clark, Emma; Ness, Andy R; Tobias, Jonathan H

doi:10.1210/jc.2006-0332

Cited by 183 publications

(168 citation statements)

References 35 publications

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“…Other studies report a positive association between fat mass and bone growth before puberty [36][37][38]. In girls it seems as puberty attenuate and reverse this effect between fat and bone [36]. This supports our finding; BMI was positively associated with BMD with higher beta values in late sexually matured girls.…”

Section: Discussionsupporting

confidence: 91%

“…Some studies suggest a negative effect of fat mass during childhood and adolescence; obese children are more prone to falls and to fractures due to lower bone mass relative to body size [35]. Other studies report a positive association between fat mass and bone growth before puberty [36][37][38]. In girls it seems as puberty attenuate and reverse this effect between fat and bone [36].…”

Section: Discussionmentioning

confidence: 99%

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The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

et al. 2014

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Summary Bone mass achievement predicts later fracture risk. This population-based study describes bone mineral density levels (BMD) and associated factors in Norwegian adolescents. Compared with international reference ranges, BMD levels appear higher and physical activity levels are positively associated with BMD.Purpose Norway has one of the highest reported incidences of osteoporotic fractures. Maximization of peak bone mass may prevent later fractures. This population-based study compared BMD levels of Norwegian adolescents with international reference ranges and explored associated factors.Methods All first year upper secondary school students, aged 15-19 years in the Tromsø region were invited to the Fit Futures study in 2010-2011. Over 90% of the invited participants attended, 508 girls and 530 boys. BMD was measured at total hip, femoral neck and total body by dual x-ray absorptiometry.Lifestyle variables were collected by self-administered questionnaires and interviews. All analyses were performed sex stratified, using linear regression models.Results In girls mean BMD (SD) was 1.060 (0.124), 1.066 (0.123) and 1.142 (0.077) g/cm² at the total hip, femoral neck and total body respectively. In boys corresponding values were 1.116 (0.147), 1.103 (0.150) and 1.182 (0.097), with significant higher values than the Lunar pediatric reference at 16 years of age In girls, height and self-reported intensive physical activity of more than four hours a week and early sexual maturation were positively associated with BMD at both femoral sites (p<0.047). Among boys age, height, body mass index, physical activity and alcohol intake were positively (p<0.038), whereas early stages of sexual maturation and smoking was negatively (p<0.047) related to BMD.Conclusions Despite the heavy fracture burden, Norwegian adolescents´ BMD levels are higher than agematched Caucasians. Physical activity is associated with 1 SD increased BMD levels in those involved in competition or hard training.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

et al. 2014

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“…(11)(12)(13) However, after adjusting for tibial length and lean mass, positive correlations were found only in girls, not adults. In growing children and adolescents, it is difficult to interpret the relationship between fat and bone because both grow during normal development.…”

Section: Discussionmentioning

confidence: 92%

Fat mass accumulation compromises bone adaptation to load in finnish women: A cross-sectional study spanning three generations

Xu¹,

Nicholson²,

Wang³

et al. 2010

Journal of Bone and Mineral Research

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Body weight and lean mass correlate with bone mass, but the relationship between fat mass and bone remains elusive. The study population consisted of 396 girls and 138 premenopausal mothers and 114 postmenopausal grandmothers of these girls. Body composition and tibial length were assessed using dual-energy X-ray absorptiometry (DXA), and bone traits were determined at the tibia using peripheral quantitative computed tomography (pQCT) in the girls at the ages of 11.2 AE 0.8, 13.2 AE 0.9, and 18.3 AE 1.0 years and in the mothers (44.7 AE 4.1 years) and grandmothers (70.7 AE 6.3 years). The values of relative bone strength index (RBSI), an index reflecting the ratio of bone strength to the load applied on the tibia, were correlated among family members (all p < .05). The mean values of RBSI were similar among 11-and 18-year-old girls and premenopausal women but significantly lower in 13-year-old girls and postmenopausal women. However, in each age group, subjects in the highest BMI tertiles had the lowest RBSI values (all p < .01). RBSI was inversely associated with body weight (all p < .01), indicating a deficit in bone strength relative to the applied load from greater body weight. RBSI was inversely associated with fat mass (all p < .001) across age groups and generations but remained relatively constant with increasing lean mass in girls and premenopausal women (all p > .05), indicating that the bone-strength deficit was attributable to increased fat mass, not lean mass. Moreover, the adverse effect of fat mass was age-dependent, with every unit increase in fat mass associated with a greater decrease in RBSI in pre-and postmenopausal women than in girls (all p < .001). This is largely due to the different capacity of young and adult bones to increase diaphyseal width by periosteal apposition in response to increased load. In summary, increasing body weight with fat accumulation is accompanied by an age-dependent relative bone-strength deficit in women because the beneficial effects of increased fat mass on bone, if any, do not compensate for the mechanical burden that it imposes. ß

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“…To date, our knowledge of the fat-bone relationship during growth comes primarily from studies that used dualenergy x-ray absorptiometry (DXA) to assess bone mineral content (BMC) and areal bone mineral density (aBMD) in children and adolescents [1,11,13,15,16,22,26,37,42,48]. Data from the many cross-sectional [1,13,15,16,22,26,37,42,48] and relatively few longitudinal studies [11] are equivocal and conflicting, as many DXA-based studies [13,16,49] failed to account for the influence of muscle force on bone mass.…”

Section: Introductionmentioning

confidence: 99%

“…Data from the many cross-sectional [1,13,15,16,22,26,37,42,48] and relatively few longitudinal studies [11] are equivocal and conflicting, as many DXA-based studies [13,16,49] failed to account for the influence of muscle force on bone mass. The mechanostat theory suggests muscle forces impose the primary load on the skeleton [41].…”

Section: Introductionmentioning

confidence: 99%

How Does Bone Quality Differ Between Healthy-weight and Overweight Adolescents and Young Adults?

Hoy¹,

Macdonald²,

McKay³

2013

Clinical Orthopaedics &Amp; Related Research

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Background Overweight youth have greater bone mass than their healthy-weight peers but sustain more fractures. However, it is unclear whether and how excess body fat influences bone quality in youth. Questions/purposes We determined whether overweight status correlated with three-dimensional aspects of bone quality influencing bone strength in adolescent and young adult females and males. Methods We categorized males (n = 103; mean age, 17 years) and females (n = 85; mean age, 18 years) into healthy-weight and overweight groups. We measured lean mass (LM) and fat mass (FM) with dual-energy x-ray absorptiometry (DXA). We used high-resolution peripheral quantitative CT to assess the distal radius (7% site) and distal tibia (8% site). Bone quality measures included total bone mineral density (Tt.BMD), total area (Tt.Ar), trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), separation (Tb.Sp), and thickness (Tb.Th). We used multiple regression to compare bone quality between healthy-weight and overweight adolescents adjusting for age, ethnicity, limb length, LM, and FM. Results Overweight males had higher (10%-21%) Tt.BMD, BV/TV, and Tb.N and lower Tb.Sp at the tibia and lower Tt.Ar at the radius than healthy-weight males. No differences were observed between overweight and healthy-weight females. LM attenuated the differences in bone quality between groups in males while FM negatively predicted Tt.BMD, BV/TV, Tb.N, and Tb.Th. Conclusions Our data suggest overweight males have enhanced bone quality compared with healthy-weight males; however, when group differences are interpreted in the context of the mechanostat theory, it appears bone quality of overweight adolescents adapts to LM and not to greater FM.

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Adipose Tissue Stimulates Bone Growth in Prepubertal Children

Abstract: In prepubertal children, fat mass is a positive independent determinant of bone mass and size and of increases in these parameters over the following 2 yr, suggesting that adipose tissue acts to stimulate bone growth. However, this relationship is attenuated by puberty.

Cited by 183 publications

References 35 publications

The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

Fat mass accumulation compromises bone adaptation to load in finnish women: A cross-sectional study spanning three generations

How Does Bone Quality Differ Between Healthy-weight and Overweight Adolescents and Young Adults?

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