title: Adipose tissue stimulates bone growth in prepubertal children.
abstract: BACKGROUND
  Fat mass represents a positive influence on bone mass in adults, independently of other factors such as lean mass, but whether a similar action occurs in children is unclear.
  
  
  OBJECTIVE
  Our objective was to examine the relationship between fat mass and bone mass in children.
  
  
  METHODS
  We conducted combined cross-sectional and prospective analyses at university research clinics.
  
  
  METHODS
  Participants included children aged 9.9 yr from a large population-based birth cohort in southwest England.
  
  
  RESULTS
  Relationships between total body fat mass were measured by dual-energy x-ray absorptiometry at age 9.9 yr, and 1) total-body-less-head bone mass and area at age 9.9 and 2) increase in bone mass and area over the following 2 yr.
  
  
  RESULTS
  There was a strong positive relationship between total body fat mass and total-body-less-head bone mass and area, even after adjustment for height and/or lean mass (P < 0.001). There was a similar positive association between total body fat mass and increase in bone mass and area over the following 2 yr in boys and Tanner stage 1 girls. In contrast, no association was present between fat mass and gain in bone mass and size in Tanner stage 2 girls, whereas a negative association was seen in Tanner stage 3 girls (puberty-fat mass interaction, P < 0.001).
  
  
  CONCLUSIONS
  In prepubertal children, fat mass is a positive independent determinant of bone mass and size and of increases in these parameters over the following 2 yr, suggesting that adipose tissue acts to stimulate bone growth. However, this relationship is attenuated by puberty.
authors.affiliation: Rheumatology Unit, Bristol Royal Infirmary, Bristol BS2 8HW, United Kingdom.
authors.forename: E M
authors.initials: EM
authors.lastname: Clark
authors.forename: A R
authors.initials: AR
authors.lastname: Ness
authors.forename: J H
authors.initials: JH
authors.lastname: Tobias
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000502:physiology*; D001823:Body Composition; D001827:Body Height; D001835:Body Weight; D015519:Bone Density; D001846:Bone Development / Q000502:physiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011627:Puberty / Q000502:physiology*; D012044:Regression Analysis; D012727:Sex Characteristics