Racial Differences in the Association of Subcutaneous and Visceral Fat on Bone Mineral Content in Prepubertal Children

Total fat mass plays a significant role in determining bone mass, but the specific role of central adiposity independent of total fat mass has not been widely studied. Prepubertal (Tanner 1) children (n = 181; 65 boys, 116 girls, 7.8 ± 1.5 years), including 99 Caucasians and 82 African Americans from Birmingham, Alabama, participated in this study. Body composition, including total body and trunk fat mass, and bone mineral content (BMC) were measured using dual-energy X-ray absorptiometry. Subcutaneous abdominal adipose tissue (SAAT) and intra-abdominal adipose tissue (IAAT) were determined by single-slice computed tomography (CT). After adjusting for gender, age, height, total fat, and lean mass, trunk weight was inversely correlated with BMC in Caucasians (r = −0.56, P < 0.0001) and in African Americans (r = −0.37, P < 0.05). In Caucasians, independent of gender, age, height, total fat, and lean mass, there was an inverse correlation between SAAT and BMC (r = −0.58, P < 0.0001) but no significant correlation between IAAT and BMC; in addition, SAAT explained 6% of the variance in BMC. In contrast, in African Americans, SAAT and BMC were not significantly correlated. However, while adjusting for gender, age, height, SAAT, total fat, and lean mass, an inverse association between IAAT and BMC was observed in African Americans (r = −0.50, P < 0.01); IAAT also explained 3% of the variance in BMC. These findings suggest that, in general, total abdominal weight is negatively associated with bone mass, but there appear to be racial differences with regard to the contributions of subcutaneous and visceral fat to BMC in prepubertal children.