Adiposity, Insulin Resistance, and Bone Mass in Children and Adolescents

Joseph M. Kindler, Andrea J. Lobene, Kara A. Vogel, Berdine R. Martin, Linda D. McCabe, Munro Peacock, Stuart J. Warden, George P. McCabe, Connie M. Weaver

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Context: Insulin resistance is an adverse health outcome that accompanies obesity. Fat mass is negatively associated with the bone mass after adjustment for confounders. Insulin resistance might be an intermediary in this relationship. Objective: To determine whether insulin resistance is an intermediary in the relationship between adiposity and bone mass in adolescents. Design: Cross-sectional secondary analysis of baseline data from a previous randomized trial. Setting: University research facility. Participants: A total of 240 adolescents (68% female), aged 7 to 15 years. Main Outcome Measures: Using dual energy x-ray absorptiometry, bone mineral content (BMC), areal bone mineral density, lean mass, and fat mass were measured. Skeletal sites of interest included the total body and lumbar spine (LS). Waist circumference was measured using an anthropometric tape measure. Insulin and glucose were measured in fasting sera, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Path analysis was performed to determine whether the relationship between adiposity and bone was mediated through insulin resistance. Results: Fat mass (r = 0.467; P < 0.001) and waist circumference (r = 0.487; P < 0.001) correlated positively with HOMA-IR. Controlling for race, sex, maturation, lean mass, and height, fat mass, waist circumference, and HOMA-IR were negatively associated with LS BMC and total body areal bone mineral density (P < 0.05 for all). Additionally, path models for fat mass (95% CI, -5.893 to -0.956) and waist circumference (95% CI, -15.473 to -2.124) showed a negative relationship with LS BMC via HOMA-IR. Conclusions: These results support an intermediary role of insulin resistance in the relationship between adiposity and LS bone mass.

Original languageEnglish (US)
Pages (from-to)892-899
Number of pages8
JournalThe Journal of clinical endocrinology and metabolism
Volume104
Issue number3
DOIs
StatePublished - Mar 1 2019

Fingerprint

Adiposity
Insulin Resistance
Bone
Insulin
Bone and Bones
Bone Density
Waist Circumference
Minerals
Fats
Spine
Homeostasis
Sexual Maturation
Fasting
Tapes
Obesity
Cross-Sectional Studies
X-Rays
Outcome Assessment (Health Care)
Health
Glucose

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Kindler, J. M., Lobene, A. J., Vogel, K. A., Martin, B. R., McCabe, L. D., Peacock, M., ... Weaver, C. M. (2019). Adiposity, Insulin Resistance, and Bone Mass in Children and Adolescents. The Journal of clinical endocrinology and metabolism, 104(3), 892-899. https://doi.org/10.1210/jc.2018-00353

Adiposity, Insulin Resistance, and Bone Mass in Children and Adolescents. / Kindler, Joseph M.; Lobene, Andrea J.; Vogel, Kara A.; Martin, Berdine R.; McCabe, Linda D.; Peacock, Munro; Warden, Stuart J.; McCabe, George P.; Weaver, Connie M.

In: The Journal of clinical endocrinology and metabolism, Vol. 104, No. 3, 01.03.2019, p. 892-899.

Research output: Contribution to journalArticle

Kindler, JM, Lobene, AJ, Vogel, KA, Martin, BR, McCabe, LD, Peacock, M, Warden, SJ, McCabe, GP & Weaver, CM 2019, 'Adiposity, Insulin Resistance, and Bone Mass in Children and Adolescents', The Journal of clinical endocrinology and metabolism, vol. 104, no. 3, pp. 892-899. https://doi.org/10.1210/jc.2018-00353
Kindler, Joseph M. ; Lobene, Andrea J. ; Vogel, Kara A. ; Martin, Berdine R. ; McCabe, Linda D. ; Peacock, Munro ; Warden, Stuart J. ; McCabe, George P. ; Weaver, Connie M. / Adiposity, Insulin Resistance, and Bone Mass in Children and Adolescents. In: The Journal of clinical endocrinology and metabolism. 2019 ; Vol. 104, No. 3. pp. 892-899.
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AU - Lobene, Andrea J.

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AU - McCabe, Linda D.

AU - Peacock, Munro

AU - Warden, Stuart J.

AU - McCabe, George P.

AU - Weaver, Connie M.

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N2 - Context: Insulin resistance is an adverse health outcome that accompanies obesity. Fat mass is negatively associated with the bone mass after adjustment for confounders. Insulin resistance might be an intermediary in this relationship. Objective: To determine whether insulin resistance is an intermediary in the relationship between adiposity and bone mass in adolescents. Design: Cross-sectional secondary analysis of baseline data from a previous randomized trial. Setting: University research facility. Participants: A total of 240 adolescents (68% female), aged 7 to 15 years. Main Outcome Measures: Using dual energy x-ray absorptiometry, bone mineral content (BMC), areal bone mineral density, lean mass, and fat mass were measured. Skeletal sites of interest included the total body and lumbar spine (LS). Waist circumference was measured using an anthropometric tape measure. Insulin and glucose were measured in fasting sera, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Path analysis was performed to determine whether the relationship between adiposity and bone was mediated through insulin resistance. Results: Fat mass (r = 0.467; P < 0.001) and waist circumference (r = 0.487; P < 0.001) correlated positively with HOMA-IR. Controlling for race, sex, maturation, lean mass, and height, fat mass, waist circumference, and HOMA-IR were negatively associated with LS BMC and total body areal bone mineral density (P < 0.05 for all). Additionally, path models for fat mass (95% CI, -5.893 to -0.956) and waist circumference (95% CI, -15.473 to -2.124) showed a negative relationship with LS BMC via HOMA-IR. Conclusions: These results support an intermediary role of insulin resistance in the relationship between adiposity and LS bone mass.

AB - Context: Insulin resistance is an adverse health outcome that accompanies obesity. Fat mass is negatively associated with the bone mass after adjustment for confounders. Insulin resistance might be an intermediary in this relationship. Objective: To determine whether insulin resistance is an intermediary in the relationship between adiposity and bone mass in adolescents. Design: Cross-sectional secondary analysis of baseline data from a previous randomized trial. Setting: University research facility. Participants: A total of 240 adolescents (68% female), aged 7 to 15 years. Main Outcome Measures: Using dual energy x-ray absorptiometry, bone mineral content (BMC), areal bone mineral density, lean mass, and fat mass were measured. Skeletal sites of interest included the total body and lumbar spine (LS). Waist circumference was measured using an anthropometric tape measure. Insulin and glucose were measured in fasting sera, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Path analysis was performed to determine whether the relationship between adiposity and bone was mediated through insulin resistance. Results: Fat mass (r = 0.467; P < 0.001) and waist circumference (r = 0.487; P < 0.001) correlated positively with HOMA-IR. Controlling for race, sex, maturation, lean mass, and height, fat mass, waist circumference, and HOMA-IR were negatively associated with LS BMC and total body areal bone mineral density (P < 0.05 for all). Additionally, path models for fat mass (95% CI, -5.893 to -0.956) and waist circumference (95% CI, -15.473 to -2.124) showed a negative relationship with LS BMC via HOMA-IR. Conclusions: These results support an intermediary role of insulin resistance in the relationship between adiposity and LS bone mass.

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