Abstract
The association between vitamin D [25(OH)D] and bone health has been widely studied in children. Given that 25(OH)D and bone health are associated with muscular fitness, this could be the cornerstone to understand this relationship. Hence, the purpose of this work was to examine if the relation between 25(OH)D and areal bone mineral density (aBMD) was mediated by muscular fitness in children with overweight/obesity. Eighty-one children (8-11 years, 53 boys) with overweight/obesity were included. Body composition was measured with dual energy X-ray Absorptiometry (DXA), 25(OH)D was measured in plasma samples and muscular fitness was assessed by handgrip and standing long jump tests (averaged z-scores were used to represent overall muscular fitness). Simple mediation analyses controlling for sex, years from peak height velocity, lean mass and season were carried out. Our results showed that muscular fitness z-score, handgrip strength and standing long jump acted as mediators in the relationship between 25(OH)D and aBMD outcomes (percentages of mediation ranged from 49.6% to 68.3%). In conclusion, muscular fitness mediates the association of 25(OH)D with aBMD in children with overweight/obesity. Therefore, 25(OH)D benefits to bone health could be dependent on muscular fitness in young ages.
Highlights
The World Health Organization defines osteoporosis as a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue [1]
Vitamin D status is reflected by 25-hydroxyvitamin D (25(OH)D) levels and its concentration in children with obesity is influenced by vitamin D intake, season, ethnicity/race, decreased exposure to sunlight as a consequence of the sedentary lifestyle, or by 25(OH)D sequestration through adipose tissue [5]
To the best of our knowledge, this is the first study in children with overweight/obesity analyzing whether muscular fitness acts as mediator in the association between
Summary
The World Health Organization defines osteoporosis as a systemic skeletal disease characterized by low bone density and microarchitectural deterioration of bone tissue [1]. Vitamin D status is reflected by 25-hydroxyvitamin D (25(OH)D) levels and its concentration in children with obesity is influenced by vitamin D intake, season, ethnicity/race, decreased exposure to sunlight as a consequence of the sedentary lifestyle, or by 25(OH)D sequestration through adipose tissue [5]. This prohormone is essential for bone development and remodeling processes, as well as for normal calcium and phosphorus homeostasis [6]. Some studies evidenced that 25(OH)D-deficient children had lower aBMD Z-score at the lumbar spine (LS) and the total body, probably influenced by the consequent increase in parathormone levels [7,8]
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