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Adiposity and bone health in Spanish adolescents. The HELENA study

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Abstract

Summary

While the association of lean mass (LM) with bone mass is well understood, the association of fat mass (FM) with bone mass is controversial. Our results support that adolescents with higher levels of adiposity have greater bone mass, but this association is fully explained by their higher levels of LM.

Introduction

We aimed (1) to study the independent association of FM and LM with bone mass and (2) to study the differences in bone mass by weight status in adolescents, after controlling for relevant confounders, such as physical activity (PA), calcium intake, and LM.

Methods

Participants were 330 adolescents (167 boys, 12.5–17.5 years) from the HELENA study. The relationships of FM (DXA, n = 330; BodPod, n = 282) and LM (DXA, n = 330) with different bone variables (whole body, total hip, lumbar spine, and femoral neck) were analyzed by linear regression, and differences between weight status were analyzed by ANCOVA.

Results

Fat mass (DXA) was positively associated with bone variables in both sexes, after adjustment for height, calcium intake, and sexual maturation. Additional adjustment by PA slightly increases the associations. However, adjustment for LM inverted these associations. Similar results were obtained using BodPod instead of DXA for assessing FM. Overweight/obese adolescents had higher BMC than their non-overweight peers in most of regions studied. Additional adjustment for PA slightly increased the differences between weight status groups, while adjusting for LM inverted the associations. LM was strong and positively associated with all bone variables in both sexes. Additional adjustment for PA or FM did not change the results.

Conclusions

Adolescents with higher levels of adiposity have greater bone mass, but this association is explained by their higher levels of LM.

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Acknowledgments

The HELENA study takes place with the financial support of the European Community Sixth RTD Framework Programme (Contract FOOD-CT-2005-007034). The writing group takes sole responsibility for the content of this article. This study was also supported by a grant from the Spanish Ministry of Health: Maternal, Child Health and Development Network (number RD08/0072), grants from the Spanish Ministry of Science and Innovation (EX-2008-0641; JCI-2010-07055), and the Swedish Heart-Lung Foundation (20090635). Finally, this study was also supported (LGM, GVR, LAM) by a grant from Mutua de la Agrupación de Propietarios de Fincas Rústicas de España (Fundación MAPFRE), Spain. We gratefully acknowledge all participating adolescents and their parents for their collaboration.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Avd. Domingo Miral s/n, 50009, Zaragoza, Spain

    L. Gracia-Marco, D. Jiménez-Pavón, G. Rodríguez, G. Vicente-Rodríguez & L. A. Moreno

  2. Department of Physiatry and Nursing, School of Health Sciences, University of Zaragoza, Avd. Domingo Miral s/n, 50009, Zaragoza, Spain

    L. Gracia-Marco & L. A. Moreno

  3. Unit for Preventive Nutrition, Department of Bioscience and Nutrition, Karolinska Institute, Huddinge, Sweden

    F. B. Ortega

  4. Department of Physiology, School of Medicine, University of Granada, Granada, Spain

    F. B. Ortega, D. Jiménez-Pavón & M. J. Castillo

  5. Department of Pediatrics, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain

    G. Rodríguez

  6. Instituto Aragonés de Ciencias de la Salud, Aragón, Spain

    G. Rodríguez

  7. Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing, University of Zaragoza, Ronda Misericordia 5, 22001-Huesca, Zaragoza, Spain

    G. Vicente-Rodríguez

Authors
  1. L. Gracia-Marco
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  2. F. B. Ortega
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  3. D. Jiménez-Pavón
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  4. G. Rodríguez
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  5. M. J. Castillo
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  6. G. Vicente-Rodríguez
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  7. L. A. Moreno
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Corresponding author

Correspondence to L. Gracia-Marco.

Appendix

Appendix

http://www.helenastudy.com/research.php

Research groups from Zaragoza and Granada were involved in the preparation of this paper.

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Gracia-Marco, L., Ortega, F.B., Jiménez-Pavón, D. et al. Adiposity and bone health in Spanish adolescents. The HELENA study. Osteoporos Int 23, 937–947 (2012). https://doi.org/10.1007/s00198-011-1649-3

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  • DOI: https://doi.org/10.1007/s00198-011-1649-3

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