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Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity

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Abstract

Childhood obesity is associated with compromised bone health. We studied bone characteristics and their determinants in obese young adults. The study included 68 subjects with early-onset severe obesity and 73 normal-weight controls. Data on physical activity (PA), diet and smoking were collected. Bone characteristics were measured using peripheral QCT. The obese and control subjects were similar in age (mean 19.6 ± 2.6 years) and height but BMIs differed (39.7 and 22.6 kg/m2). A clustering of unhealthy lifestyles was marked: Obese subjects reported less supervised PA in childhood, adolescence and currently (p < 0.03) and were more likely to smoke (p = 0.005), and had a lower healthy eating index (HEI) (p = 0.007) but similar alcohol consumption compared with controls. In obese women, all crude bone characteristics were higher than in controls; in men, the differences were smaller. Associations of lifestyle factors with bone characteristics were tested using partial correlations. Independently of BMI, supervised PA in adolescence and alcohol consumption were related positively to bone characteristics in both groups. HEI associated positively with bone characteristics only in controls, while smoking was a positive determinant of bone characteristics only in obese subjects. The multivariate model showed that the contribution of lifestyle factors to bone characteristics was minimal compared with BMI. Early-onset obesity is accompanied by poor dietary quality, sedentary lifestyle, and more frequent smoking, but the overall contribution of these lifestyle factors to bone strength is limited. Bone strength is more likely to be compromised in men and in unloaded bone sites in subjects with early-onset severe obesity. The impact of obesity-related endocrine changes on bone characteristics need to be evaluated in future studies.

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Acknowledgments

H. T. Viljakainen, H. Valta, M. Lipsanen-Nyman, and O. Mäkitie were involved in the recruitment and data collection. H. T. Viljakainen, E. Kajantie , and O. Mäkitie analyzed and interpreted the data. H. T. Viljakainen, H. Valta, and O. Mäkitie were responsible for the writing of the manuscript and the others critically revised the manuscript. All the authors have contributed to the study design and approved the final version of the submitted manuscript. The authors have no disclosures. Research nurses Nea Boman and Sirpa Nolvi are acknowledged for their valuable work in patient assessments. The study was supported by grants from the Academy of Finland, the Folkhälsan Research Foundation, the Finnish Pediatric Research Foundation, the Sigrid Juselius Foundation, and the Helsinki University Hospital Research Funds.

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Authors and Affiliations

  1. Children’s Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland

    H. T. Viljakainen, H. Valta, M. Lipsanen-Nyman, T. Saukkonen, E. Kajantie, S. Andersson & O. Mäkitie

  2. Novo Nordisk Pharma Oy, Espoo, Finland

    T. Saukkonen

  3. Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland

    E. Kajantie

  4. Department of Obstetrics and Gynecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland

    E. Kajantie

  5. Folkhälsan Research Center, Helsinki, Finland

    O. Mäkitie

  6. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

    O. Mäkitie

  7. Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden

    O. Mäkitie

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  1. H. T. Viljakainen
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Correspondence to H. T. Viljakainen.

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The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

The study was approved by the Research Ethics Committee of the Hospital District of Helsinki and Uusimaa which includes the observance of human and animal rights. Informed consent was obtained from all individual participants included in the study.

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223_2015_31_MOESM1_ESM.pptx

Supplemental material. Between group differences (= control – obese) in the characteristics of A) radius, B) tibia in men and the characteristics of C) radius and D) tibia in women. Differences were tested with multivariate analysis with models including age, supervised PAss, alcohol consumption, smoking and waist circumference. On x-axis numbering for bone characteristics: 1; Distal Tot CSA [mm2], 2; Tot Den [mg/cm3], 3; Trab Den [mg/cm3], 4; Proximal/Diaphyseal Tot CSA [mm2], 5; Cort Den [mg/cm3] and 6; polar SSI [mm3]. Bars represent mean with 95 % CI (PPTX 138 kb)

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Viljakainen, H.T., Valta, H., Lipsanen-Nyman, M. et al. Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity. Calcif Tissue Int 97, 364–375 (2015). https://doi.org/10.1007/s00223-015-0031-4

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