Body fat mass, lean body mass and associated biomarkers as determinants of bone mineral density in children 6-8years of age - The Physical Activity and Nutrition in Children (PANIC) study

Sonja Soininen; Virpi Sidoroff; Virpi Lindi; Anitta Mahonen; Liisa Kröger; Heikki Kröger; Jarmo Jääskeläinen; Mustafa Atalay; David E Laaksonen; Tomi Laitinen; Timo A Lakka

doi:10.1016/j.bone.2018.01.003

Body fat mass, lean body mass and associated biomarkers as determinants of bone mineral density in children 6-8years of age - The Physical Activity and Nutrition in Children (PANIC) study

Bone. 2018 Mar:108:106-114. doi: 10.1016/j.bone.2018.01.003. Epub 2018 Jan 4.

Authors

Affiliations

¹ Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Institute of Dentistry, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Social and Health Center, City of Varkaus, Savontie 55, 78300 Varkaus, Finland. Electronic address: sonja.soininen@uef.fi.
² Department of Pediatrics, North-Karelia Central Hospital, Tikkamäentie 16, 80210 Joensuu, Finland. Electronic address: virpi.sidoroff@siunsote.fi.
³ Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland. Electronic address: virpi.lindi@uef.fi.
⁴ Institute of Biomedicine, Medical Biochemistry, School of Medicine, University of Eastern Finland, PO Box 1627, Kuopio, Finland. Electronic address: anitta.mahonen@uef.fi.
⁵ Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland. Electronic address: liisa.kroger@kuh.fi.
⁶ Department of Orthopedics and Traumatology, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland. Electronic address: heikki.kroger@kuh.fi.
⁷ Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland. Electronic address: jarmo.jaaskelainen@uef.fi.
⁸ Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland. Electronic address: mustafa.atalay@uef.fi.
⁹ Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Internal Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland. Electronic address: david.laaksonen@uef.fi.
¹⁰ Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland. Electronic address: tomi.laitinen@kuh.fi.
¹¹ Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland. Electronic address: timo.lakka@uef.fi.

PMID: 29307776
DOI: 10.1016/j.bone.2018.01.003

Abstract

Lean body mass (LM) has been positively associated with bone mineral density (BMD) in children and adolescents, but the relationship between body fat mass (FM) and BMD remains controversial. Several biomarkers secreted by adipose tissue, skeletal muscle, or bone may affect bone metabolism and BMD. We investigated the associations of LM, FM, and such biomarkers with BMD in children. We studied a population sample of 472 prepubertal Finnish children (227 girls, 245 boys) aged 6-8years. We assessed BMD, LM, and FM using whole-body dual-energy x-ray absorptiometry and analysed several biomarkers from fasting blood samples. We studied the associations of LM, FM, and the biomarkers with BMD of the whole body excluding the head using linear regression analysis. LM (standardized regression coefficient β=0.708, p<0.001), FM (β=0.358, p<0.001), and irisin (β=0.079, p=0.048) were positive correlates for BMD adjusted for age, sex, and height in all children. These associations remained statistically significant after further adjustment for LM or FM. The positive associations of dehydroepiandrosterone sulphate (DHEAS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), leptin, free leptin index, and high-sensitivity C-reactive protein and the negative association of leptin receptor with BMD were explained by FM. The positive associations of DHEAS and HOMA-IR with BMD were also explained by LM. Serum 25-hydroxyvitamin D was a positive correlate for BMD adjusted for age, sex, and height and after further adjustment for FM but not for LM. LM and FM were positive correlates for BMD also in girls and boys separately. In girls, insulin, HOMA-IR, leptin, and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height, and FM, none of the biomarkers was associated with BMD. In boys, leptin and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height and FM, 25(OH)D was positively and IGF-1 and leptin were negatively associated with BMD. FM strongly modified the association between leptin and BMD. LM but also FM were strong, independent positive correlates for BMD in all children, girls, and boys. Irisin was positively and independently associated with BMD in all children. The associations of other biomarkers with BMD were explained by LM or FM.

Keywords: Body fat mass; Bone mineral density; Child; Cytokine; DXA; Lean body mass.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adipose Tissue / physiology*
Biomarkers / metabolism*
Bone Density / physiology*
Child
Child Nutritional Physiological Phenomena*
Exercise / physiology*
Female
Humans
Male

Substances

Biomarkers