Muscle-to-Bone and Soft Tissue-to-Bone Ratio in Children and Adolescents with Obesity

Elsevier

Available online 1 March 2023

Journal of Clinical DensitometryAuthor links open overlay panel, , , ABSTRACTObjectives

To explore the total and regional muscle-to-bone ratio in children and adolescents with obesity and compare the muscle-to-bone ratio (MBR) and soft tissue-to-bone ratio (SBR) to their peers with normal weight or overweight.

Study Design

A total of 219 male and female pediatrics (mean age=12.3±2.5 years) participated in this study. Body composition was assessed with a total body dual X-ray absorptiometry. The MBR was calculated by dividing lean mass by bone mineral content. The SBR was determined by dividing the soft tissue mass (i.e., lean mass+fat mass) and by bone mineral content. Differences in total and regional body composition measures between body mass index (BMI) percentile groups was assessed by ANOVA.

Results

The obesity group had significantly higher MBR compared to the normal weight group for total (19.24±1.56 vs. 18.26±1.64), arm (17.11±1.67 vs. 15.88±1.81), and leg (18.41±1.68 vs. 16.62±1.55). Similarly, the obesity group had significantly higher MBR in the leg (18.41±1.68) compared to the overweight group (17.24±1.45). However, the overweight group was not significantly different from the normal weight or the obesity group for total and arm MBR. The total, arm, and leg SBR was significantly different between all BMI groups. Across the entire sample, MBR and SBR were negatively associated with high-density lipoprotein. SBR was positively associated with insulin, HOMA-IR, low-density lipoprotein, very low-density lipoprotein, triglycerides, and systolic blood pressure

Conclusions

Children with obesity had a higher MBR and SBR compared to their normal weight peers. In addition, there were significant associations between SBR, higher levels of insulin, atherogenic lipoproteins, and increased systolic blood pressure. Thus, SBR may be useful as a marker for increased cardiometabolic disease risk, though more research in this area is warranted.

Section snippetsINTRODUCTION

Obesity is characterized by excess fat mass and associated with decreased levels of physical activity1,2. Studies exploring muscular strength in children and adolescents with obesity have reported incongruent findings. Some studies have reported a positive relationship between obesity and grip strength, muscle thickness, muscle cross-sectional area, voluntary contraction, and elbow extensor strength3, 4, 5, 6. However, others studies have reported a negative relationship between obesity and

Subjects

A total of 219 (101 male, 118 female) children and adolescents participated in this study (age: 12.3±2.5 years) between 2011 and 2016. Participants were recruited from various pediatric clinics within the Minneapolis and St. Paul metropolitan area. Exclusion criteria included untreated obstructive sleep apnea, obesity due to a genetic cause determined by physician diagnosis, previous medical history of weight loss surgery, current use of antihypertensive medications, type I and type II diabetes

RESULTS

Descriptive statistics of the study population are presented in Table 1. Body composition variables of fat mass, lean mass, BMC, and BMD between BMI percentile groups for total body, arm, and leg are contained in Table 2. The obesity group had significantly higher MBR compared to the normal weight group for total body (19.24 ± 1.56 vs. 18.26 ± 1.64) and arm (17.11 ± 1.67 vs. 15.88 ± 1.81) (Figure 1). However, the overweight group was not significantly different from the normal weight and

DISCUSSION

The present study explored differences in body composition and body composition ratios between BMI percentile groups in children and adolescents. Notably, the present study observed significantly higher total and regional body composition measures in children with obesity compared to their normal weight peers. In addition, children with obesity had higher MBRs and SBRs compared to their normal weight peers. The present study also observed significant associations between SBR and cardiometabolic

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

ACKNOWLEDGMENTS

Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number (R01HL110957 [to A.S.K.]).

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© 2023 The International Society for Clinical Densitometry. Published by Elsevier Inc.

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