Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2014) 36 P16 | DOI: 10.1530/endoabs.36.P16

BSPED2014 Poster Presentations (1) (88 abstracts)

Leptin is associated with bone microstructural changes in obese children

Paul Dimitri 1 , Margaret Paggiosi 3 , David King 1 , Nick Bishop 2 & Richard Eastell 2

1Sheffield Children’s NHS Foundation Trust, Sheffield, South Yorkshire, UK; 2The University of Sheffield, Sheffield, South Yorkshire, UK; 3Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK.

Background: Bone mass is low and fracture risk is higher in obese children. We wished to ascertain the relationships of obesity-related changes in hormones with skeletal microstructure.

Method: Children aged 8–15 years matched by gender and pubertal stage were recruited into lean and obese groups (18 pairs). We used high resolution peripheral quantitative computed tomography (HRpQCT – resolution-82 μm) to assess three-dimensional cortical and trabecular microstructure at load-bearing and non-load bearing sites. Lean and fat mass percentage (%) were measured by DXA. Leptin, adiponectin, testosterone and oestrogen were measured by immunoassay.

Results: Lean and obese children were 12.9±2.0 years and 12.6±1.9 years (P=0.23) respectively. There was no difference in height SDS between groups. Radial cortical porosity (mean difference −0.01 (95% CI: −0.02, −0.004), P=0.004) and cortical pore diameter (mean difference −0.005 mm (95% CI: −0.009, −0.001), P=0.009) were lower in obese children. Tibial trabecular thickness was lower (mean difference −0.009 mm (95% CI: −0.015, −0.004), P=0.002) and trabecular number was higher (mean difference 0.23/mm (95% CI: 0.08, 0.38), P=0.006) in obese children. At the radius, fat mass % negatively correlated cortical porosity (r=0.57, P<0.001) and cortical pore diameter (r=0.38, P=0.02) and negatively correlated with tibial trabecular thickness (r=−0.62, P<0.001).

Leptin was higher in obese children (805.3±440.6 vs 98.1±75.4, P<0.001) and was inversely related to radial cortical porosity (r=0.60, 95% CI: (−0.80, −0.30), P<0.001), mean radial cortical pore diameter (r=0.51, 95% CI (−0.75, −0.16), P=0.002), and tibial trabecular thickness (r=0.55, 95%CI: (−0.78, −0.21), P=0.001). In multivariate analyses that included all measured hormones, leptin remained inversely correlated to radial cortical porosity (r2=0.48, P=0.002), mean radial cortical pore diameter (r2=0.26, P=0.01) and tibial trabecular thickness (r2=0.22, P=0.02).

Conclusion: Childhood obesity improves radial cortical porosity but negatively impacts on tibial trabecular microstructure. Leptin appears to be a key hormone mediating these changes. Maladaption of tibial trabecular microstructure may result in an increased risk of tibial fracture in obese children.

Volume 36

42nd Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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