PREDICTORS OF BONE MINERAL DENSITY IN ADOLESCENTS WITH EXCESS WEIGHT

Deisi Maria Vargas,Clovis Arlindo De Sousa,Samantha Karoline Kleis,Luciane Coutinho De Azevedo,Nara Rúbia Dos Santos Lehmkuhl

doi:10.1590/1517-869220202606160524

Deisi Maria Vargas, Clovis Arlindo De Sousa + Show 3 more

Open Access

https://doi.org/10.1590/1517-869220202606160524

Copy DOI

Abstract

ABSTRACT Introduction: Adolescence is characterized as a phase of intense development of the skeletal system. Maximizing bone mass acquisition during adolescence may reduce the risk of bone fractures later in life. Objectives: To analyze bone mineral density (BMD) and its relation to nutritional status and serum vitamin D in adolescents with excess weight. Methods: This is a cross-sectional, exploratory study. Data from 102 adolescents with excess weight, of both sexes, were analyzed. The following indices were evaluated: body mass index (BMI), abdominal circumference (AC), intake of micronutrients (vitamin D, calcium, magnesium and phosphorus), serum 25-hydroxycholecalciferol (25(OH)D concentration, BMD of the proximal femur, lumbar spine (L1-L4) and total body, % body fat mass (% BFM), total BFM, total body lean mass (BLM), body fat mass (BFMI) and lean mass (BLMI). Results: The male adolescents (n=53) had higher values for weight, height, AC, BLM and BLMI, while the females (n=49) had higher % BFM. The majority were obese (53.9%) and had a BMD within the normal range for all evaluation sites. Of the 84 adolescents (n=84) with laboratory examination of 25OHD, 33.3% presented values considered insufficient or deficient. Multivariate linear regression analysis showed that the most important independent predictor of BMD for the girls was BLMI, regardless the evaluation site. For boys, in addition to BLMI, BMI-Z of the proximal femur (neck of the femur and total) was also was a determinant variable for BMD. Conclusion: In this sample of adolescents, BLMI was a positive predictor of BMD in both sexes; and BMI-Z was a positive predictor only in proximal femur in the boys. Level of evidence II; Prognostic studies.

Highlights

Adolescence is characterized as a phase of intense development of the skeletal system
In addition to BLMI, body mass index (BMI)-Z of the proximal femur was was a determinant variable for Bone mineral density (BMD). In this sample of adolescents, BLMI was a positive predictor of BMD in both sexes; and BMI-Z was a positive predictor only in proximal femur in the boys
The linear correlation coefficients showed that, for girls, the femoral neck BMD presented a positive correlation with the BMI and fat mass index (FMI) values, and a negative correlation with the serum vitamin D

Summary

Introduction

Adolescence is characterized as a phase of intense development of the skeletal system. Significant changes in the biopsychosocial order make adolescence a period of potentialities, vulnerability and risks.[1] The skeletal system is one of the organic systems with intense development at this stage of the life cycle, period in which the peak bone mass occurs and the magnitude of this process contributes to reduce the risk of fractures in adulthood.[2]. Age and sexual maturation can be considered as the main factors related to bone mass during adolescence.[3] The variation in peak bone mass is explained by numerous factors, such as gender, race, dietary habits and physical activity, hereditary factors, hormonal factors, presence of intercurrent diseases, chronic use of medications and body composition characteristics.[4] Adiposity excess, associated with increased bone size, can have an adverse effect on its quality.[2] Increased body weight interferes with both bone mass acquisition and loss and is directly linked to the risk of being overweight or obese.[4]

Objectives

Methods

Results

Conclusion