title: Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity.
abstract: Childhood obesity is associated with compromised bone health. We studied bone characteristics and their determinants in obese young adults. The study included 68 subjects with early-onset severe obesity and 73 normal-weight controls. Data on physical activity (PA), diet and smoking were collected. Bone characteristics were measured using peripheral QCT. The obese and control subjects were similar in age (mean 19.6 ± 2.6 years) and height but BMIs differed (39.7 and 22.6 kg/m(2)). A clustering of unhealthy lifestyles was marked: Obese subjects reported less supervised PA in childhood, adolescence and currently (p < 0.03) and were more likely to smoke (p = 0.005), and had a lower healthy eating index (HEI) (p = 0.007) but similar alcohol consumption compared with controls. In obese women, all crude bone characteristics were higher than in controls; in men, the differences were smaller. Associations of lifestyle factors with bone characteristics were tested using partial correlations. Independently of BMI, supervised PA in adolescence and alcohol consumption were related positively to bone characteristics in both groups. HEI associated positively with bone characteristics only in controls, while smoking was a positive determinant of bone characteristics only in obese subjects. The multivariate model showed that the contribution of lifestyle factors to bone characteristics was minimal compared with BMI. Early-onset obesity is accompanied by poor dietary quality, sedentary lifestyle, and more frequent smoking, but the overall contribution of these lifestyle factors to bone strength is limited. Bone strength is more likely to be compromised in men and in unloaded bone sites in subjects with early-onset severe obesity. The impact of obesity-related endocrine changes on bone characteristics need to be evaluated in future studies.
authors.affiliation: Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland. heli.viljakainen@helsinki.fi.
authors.forename: H T
authors.initials: HT
authors.lastname: Viljakainen
authors.affiliation: Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Valta
authors.affiliation: Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Lipsanen-Nyman
authors.affiliation: Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.|Novo Nordisk Pharma Oy, Espoo, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Saukkonen
authors.affiliation: Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.|Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.|Department of Obstetrics and Gynecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Kajantie
authors.affiliation: Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Andersson
authors.affiliation: Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.|Folkhälsan Research Center, Helsinki, Finland.|Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.|Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Mäkitie
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001696:Biomechanical Phenomena; D015992:Body Mass Index; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000150:complications*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Bone; Early-onset severe obesity; Lifestyle factors; pQCT