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Published in: Clinical Orthopaedics and Related Research® 4/2013

01-04-2013 | Symposium: Childhood Obesity and Musculoskeletal Problems

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

Authors: Christa L. Hoy, MSc, Heather M. Macdonald, PhD, Heather A. McKay, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 4/2013

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Abstract

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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Metadata
Title
How Does Bone Quality Differ Between Healthy-weight and Overweight Adolescents and Young Adults?
Authors
Christa L. Hoy, MSc
Heather M. Macdonald, PhD
Heather A. McKay, PhD
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 4/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2576-0

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