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Small metacarpal bones of low quality in obese children
Author(s) -
Longhi Silvia,
Pasquino Bruno,
Calcagno Annalisa,
Bertelli Enrica,
Olivieri Irene,
Di Iorgi Natascia,
Radetti Giorgio
Publication year - 2013
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2012.04476.x
Subject(s) - medicine , medullary cavity , metacarpal bones , overweight , endocrinology , body mass index , orthodontics
Summary Objective It is still not known whether fat mass excess could exert a positive effect on bone. The aim of our study was to evaluate bone strength and quality in a group of overweight and obese children and adolescents by assessing bone geometry at metacarpal bones and ultrasound at phalangeal level. Design and patients This is a cross sectional observational study performed in 123 subjects, aged 11·2 ± 2·9 years. Measurements Digitalized X‐rays were evaluated at the level of the 2nd metacarpal bone for the determination of the outer ( D ) and inner ( d ) diameter, cortical area ( CA ), medullary endocortical area ( EA ), metacarpal index ( MI ) and bone strength (Bending Breaking Resistance Index; BBRI ). A total of 98 subjects underwent amplitude dependent speed of sound (Ad‐ SOS ) and bone transmission time ( BTT ) assessment by phalangeal ultrasonography. Results SD s for each measured parameter were as follows: Males: D = −0·71 ± 0·95, d = −0·29 ± 0·86, CA = −0·69 ± 0·69, EA = −0·32 ± 0·79, Ad‐ SOS = −1·14 ± 0·91, BTT = −1·17 ± 1·11 and BBRI (417 ± 151 vs 495 ± 174 mm 3 ) were all significantly lower than in controls ( P < 0·05). Females: D = −1·03 ± 1·06, d = −0·38 ± 0·92, CA = −0·91 ± 0·72, EA = −0·46 ± 0·79, Ad‐ SOS = −1·08 ± 1·11, BTT = −0·97 ± 1·07 and BBRI (342 ± 117 vs 649 ± 318 mm 3 ) were all significantly lower than in controls ( P < 0·05). Conclusions Obese children show an unfavourable bone geometry and a bone of low quality and reduced strength compared to controls at a nonweight bearing skeletal site. This finding seems to support a detrimental effect of fat mass on bone and explain the frequent occurrence of wrist fractures in this group of children.