Cargando…

The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children

Obesity appears to have a negative impact on pediatric bone health, and insulin resistance may mediate this relationship. It is unclear if cardiorespiratory fitness (CRF) has a protective effect on bone in obese children. We tested the hypothesis that CRF attenuates the negative effect of obesity an...

Descripción completa

Detalles Bibliográficos
Autores principales: Shawar, Reem S, Puyau, Maurice, Shypailo, Roman, Musaad, Salma, Bacha, Fida F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265985/
http://dx.doi.org/10.1210/jendso/bvab048.1352
_version_ 1783719846741016576
author Shawar, Reem S
Puyau, Maurice
Shypailo, Roman
Musaad, Salma
Bacha, Fida F
author_facet Shawar, Reem S
Puyau, Maurice
Shypailo, Roman
Musaad, Salma
Bacha, Fida F
author_sort Shawar, Reem S
collection PubMed
description Obesity appears to have a negative impact on pediatric bone health, and insulin resistance may mediate this relationship. It is unclear if cardiorespiratory fitness (CRF) has a protective effect on bone in obese children. We tested the hypothesis that CRF attenuates the negative effect of obesity and insulin resistance on skeletal health in a large cohort of Hispanic youth. We studied 413 (193 males and 220 females) children and adolescents from the Viva la Familia Study. They were all pubertal; mean age (SD) 13.4 ± 2.3 years; 27% were normal weight (NW), 19% overweight (OW) and 54% obese (OB). They underwent measurement of body composition, total body bone mineral content (BMC) and density (BMD) by DXA scan; VO2peak using the ramp protocol on a treadmill for CRF; fasting glucose and insulin. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. BMC increased from NW to OW to OB (mean 1.35 ± 0.4, 1.41 ± 0.4, and 1.49 ± 0.4 kg, respectively, p=.005). Peak VO2 decreased from NW to OW to OB (41.3 ± 9.7, 35.5 ± 7.7, 28.9. ± 5.5 mL/kg per min, respectively, p <.001). After adjusting for sex, age and lean body mass, BMC was inversely related to fat mass (r = -0.34, p <.001) and HOMA-IR (r = -0.29, p <.001). Similar relationships were found for BMD. In a regression model with BMC as the dependent variable, lean body mass (standardized coefficient (β)=0.95, p <.001) was positively and fat mass (β=-0.18, p <0.001) negatively associated with BMC (model R(2)=0.88, p<.001). HOMA-IR (β=-0.07, p =0.001) and VO2peak (β=0.09, p =0.003) had significant and opposite associations with BMC (model p<.001) but fat mass was no longer a significant contributor. With BMD as the dependent variable, lean body mass (β=0.82, p <.001), HOMA-IR (β=-0.06, p =0.04) and peak VO2 (β=0.17, p <.001), but not fat mass, contributed to the variance in BMD (R(2)=0.79, p<.001). In conclusion, lean body mass is the major determinant of BMC and BMD in Hispanic youth. Adiposity associated insulin resistance has a negative effect on BMC and BMD. CRF contributes positively to the variance in BMC and BMD. This suggests that CRF and higher lean mass attenuate the adverse effects of insulin resistance on bone health in children.
format Online
Article
Text
id pubmed-8265985
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-82659852021-07-09 The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children Shawar, Reem S Puyau, Maurice Shypailo, Roman Musaad, Salma Bacha, Fida F J Endocr Soc Pediatric Endocrinology Obesity appears to have a negative impact on pediatric bone health, and insulin resistance may mediate this relationship. It is unclear if cardiorespiratory fitness (CRF) has a protective effect on bone in obese children. We tested the hypothesis that CRF attenuates the negative effect of obesity and insulin resistance on skeletal health in a large cohort of Hispanic youth. We studied 413 (193 males and 220 females) children and adolescents from the Viva la Familia Study. They were all pubertal; mean age (SD) 13.4 ± 2.3 years; 27% were normal weight (NW), 19% overweight (OW) and 54% obese (OB). They underwent measurement of body composition, total body bone mineral content (BMC) and density (BMD) by DXA scan; VO2peak using the ramp protocol on a treadmill for CRF; fasting glucose and insulin. The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. BMC increased from NW to OW to OB (mean 1.35 ± 0.4, 1.41 ± 0.4, and 1.49 ± 0.4 kg, respectively, p=.005). Peak VO2 decreased from NW to OW to OB (41.3 ± 9.7, 35.5 ± 7.7, 28.9. ± 5.5 mL/kg per min, respectively, p <.001). After adjusting for sex, age and lean body mass, BMC was inversely related to fat mass (r = -0.34, p <.001) and HOMA-IR (r = -0.29, p <.001). Similar relationships were found for BMD. In a regression model with BMC as the dependent variable, lean body mass (standardized coefficient (β)=0.95, p <.001) was positively and fat mass (β=-0.18, p <0.001) negatively associated with BMC (model R(2)=0.88, p<.001). HOMA-IR (β=-0.07, p =0.001) and VO2peak (β=0.09, p =0.003) had significant and opposite associations with BMC (model p<.001) but fat mass was no longer a significant contributor. With BMD as the dependent variable, lean body mass (β=0.82, p <.001), HOMA-IR (β=-0.06, p =0.04) and peak VO2 (β=0.17, p <.001), but not fat mass, contributed to the variance in BMD (R(2)=0.79, p<.001). In conclusion, lean body mass is the major determinant of BMC and BMD in Hispanic youth. Adiposity associated insulin resistance has a negative effect on BMC and BMD. CRF contributes positively to the variance in BMC and BMD. This suggests that CRF and higher lean mass attenuate the adverse effects of insulin resistance on bone health in children. Oxford University Press 2021-05-03 /pmc/articles/PMC8265985/ http://dx.doi.org/10.1210/jendso/bvab048.1352 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) ), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Pediatric Endocrinology
Shawar, Reem S
Puyau, Maurice
Shypailo, Roman
Musaad, Salma
Bacha, Fida F
The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children
title The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children
title_full The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children
title_fullStr The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children
title_full_unstemmed The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children
title_short The Effect of Cardiorespiratory Fitness and Insulin Resistance on Bone Health in Hispanic Children
title_sort effect of cardiorespiratory fitness and insulin resistance on bone health in hispanic children
topic Pediatric Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8265985/
http://dx.doi.org/10.1210/jendso/bvab048.1352
work_keys_str_mv AT shawarreems theeffectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT puyaumaurice theeffectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT shypailoroman theeffectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT musaadsalma theeffectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT bachafidaf theeffectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT shawarreems effectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT puyaumaurice effectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT shypailoroman effectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT musaadsalma effectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren
AT bachafidaf effectofcardiorespiratoryfitnessandinsulinresistanceonbonehealthinhispanicchildren