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Submitted on February 13, 2006
Accepted on April 7, 2006
Community Based Medicine, Clinical Sciences at South Bristol, University of Bristol
* To whom correspondence should be addressed. E-mail: Jon.Tobias{at}bristol.ac.uk.
Context: 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: To examine the relationship between fat mass and bone mass in children.
Design: Combined cross sectional and prospective analyses.
Setting: University research clinics
Participants: Age 9.9 children from a large population-based birth cohort in southwest England
Outcomes: Relationships between total body fat mass as measured by DXA at age 9.9, and (1) total body less head (TBLH) bone mass and area at age 9.9, and (2) increase in bone mass and area over the following two years.
Results: There was a strong positive relationship between total body fat mass and TBLH 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 two years 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 two years, suggesting that adipose tissue acts to stimulate bone growth. However, this relationship is attenuated by puberty.
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