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 journalArticlepeer-review

5 Scopus citations


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
JournalJournal of Clinical Endocrinology and Metabolism
Issue number3
StatePublished - Dec 28 2018

ASJC Scopus subject areas

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

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