Suboptimal bone microarchitecure in adolescent girls with obesity compared to normal-weight controls and girls with anorexia nervosa

Abstract

Background: Despite their higher areal bone mineral density (aBMD), adolescents with obesity (OB) have an increase in fracture risk, particularly of the extremities, compared with normalweight controls. Whereas bone parameters that increase fracture risk are well characterized in anorexia nervosa (AN), the other end of nutritional spectrum, these data are lacking in adolescents with obesity. Objective: Our objective was to compare bone parameters in adolescent girls across the nutritional spectrum, to determine whether suboptimal bone adaptation to increased body weight may explain the increased fracture risk in OB. Methods: We assessed bone endpoints in 153 adolescent girls 14-21 years old: 50 OB, 48 controls and 55 AN. We used (i) DXA to assess aBMD at the lumbar spine, proximal femur and whole body, and body composition, (ii) high resolution peripheral quantitative CT (HRpQCT) to assess bone geometry, microarchitecture and volumetric BMD (vBMD), and (iii) finite element

In patients with anorexia nervosa, myokine levels are altered but are not associated with bone mineral density loss and bone turnover alteration

“…This cross-sectional study confirmed that patients with AN present lower aBMD values and an alteration in bone remodelling characterized by an increase in bone resorption and a decrease in bone formation compared with young normal-weight women ( 1 , 2 , 3 , 4 , 5 , 6 ). The study was designed to gain a deeper understanding of the biological modifications that act on aBMD in this population of patients, and it especially sought to determine the effects of undernutrition on myokine levels and to examine the potential link between myokines and bone parameters.…”

“…It has been well documented that patients with anorexia nervosa (AN) present lower areal bone mineral density (aBMD) and altered bone remodelling compared with normal-weight women ( 1 , 2 , 3 , 4 , 5 , 6 ). The alteration in these bone characteristics may explain the increased fracture risk observed in this population ( 7 ).…”

The clinical application of high-resolution peripheral computed tomography (HR-pQCT) in adults: state of the art and future directions

“…However, higher absolute values of bone densities, cortical and trabecular architecture, and strength indices were not in proportion to the excess of BMI and particularly of fat mass in obese postmenopausal women [27]. This absence of bone adaptation to higher body weight has also been observed in obese adolescent girls [28]. In addition, long-term and recent weight loss have been associated with lower cortical density and thickness, higher cortical porosity, and lower trabecular density and number [29].…”

Assessment of aerobic exercise capacity in obesity, which expression of oxygen uptake is the best?

“…Maximal aerobic capacity O 2max is a major predictor of bone mass in women. 125 We have noticed that obese populations have higher BMC then NW populations, even in age-matched children and adolescents, 126 which is likely adaptive to the greater mechanical loading that results from their higher BW. 127 There was also a positive correlation between BMI and BMC.…”