Despite the epidemic of adolescent obesity, the effect of obesity and hormones on bone mineral accrual during growth is poorly
understood. Studies using dual-energy X-ray to examine the effect of obesity on bone mass in children and adolescents have
yielded conflicting results. The aim of this study was to explore the combined and independent contributions of body mass
index, body composition, leptin, insulin, glucose levels and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) to
bone mineral density (BMD) and bone mineral content in a group of Brazilian obese adolescents. This study included 109 post-pubescent
obese adolescents. A whole-body dual-energy X-ray absorptiometry scan was performed,using a HOLOGIC QDR4200, to determine
whole-body BMD and body composition. Blood samples were collected in the outpatient clinic after an overnight fast, and evaluated
for fasting blood glucose and immunoreactive insulin. Leptin levels were assessed with a radioimmunoassay kit. Insulin resistance
was assessed by HOMA-IR and the quantitative insulin sensitivity check index. Our results showed that insulin levels and HOMA-IR
correlated negatively with BMD and a linear regression analysis showed that serum leptin is inversely associated to BMD adjusted
for body mass. In conclusion, our data support the hypothesis that leptin, insulin and HOMA-IR are inversely associated with
BMD and play a significant direct role in bone metabolism.
Keywords Obesity - Bone mass - Hormones - DEXA - Body composition