Investigation of Metacarpal Bone Morphology in Normal-weight, Overweight and Obese Adolescent Subjects

Objective: The prevalence of childhood and adolescent overweight and obesity is increasing in most developed countries. This study aimed to investigate the metacarpal bone morphology in normal-weight, overweight and obese adolescent subjects at different pubertal stages.Materials and Methods: This radiographic study was performed in 124 subjects at different pubertal stages. The subjects were divided into three groups based on body mass index percentile: normal-weight, overweight and obese. The second and fourth metacarpal bone cortical thickness, width and metacarpal index (MCI) were measured on left hand-wrist radiographs. Results: The values of the second and fourth metacarpal bone cortical thickness and width were significantly different among the groups. The second metacarpal bone MCI was significantly different among the groups. Moreover, the values of the second and fourth metacarpal bone cortical thickness, width and MCI in obese and overweight subjects were greater than those in normal-weight subjects. The values of the second and fourth metacarpal bone cortical thickness and width were significantly different in subjects before and after their pubertal growth peak period. Conclusion: The metacarpal bone parameter in overweight and obese adolescent subjects was significantly greater than that in normal-weight subjects.

Normal Kilolu, Aşırı Kilolu ve Obez Adölesan Bireylerde Metakarpal Kemik Morfolojisinin İncelenmesi

Amaç: Gelişmiş ülkelerde çocuk ve adölesanlarda aşırı kilo ve obezite prevalansı artmaktadır. Bu çalışmanın amacı, farklı pubertal dönemlerde normal kilolu, aşırı kilolu ve obez adölesanlarda metakarpal kemik morfolojisini araştırmaktır. Gereç ve Yöntemler: Bu radyografik çalışmaya, farklı pubertal aşamalarda 124 birey dahil edildi. Olgular vücut kitle indeksi yüzdesine göre normal kilolu, fazla kilolu ve obez bireyler olmak üzere üç gruba ayrıldı. Sol el-bilek radyografilerinde ikinci ve dördüncü metakarpal kemiklerde kortikal kalınlık, genişlik ve metakarpal indeks (MKİ) ölçümleri yapıldı. Bulgular: İkinci ve dördüncü metakarpal kemiklerde kortikal kalınlık ve genişlik gruplar arasında anlamlı olarak farklı bulundu. Gruplar arasında ikinci metakarpal kemik MKİ’de anlamlı bir fark tespit edildi. İkinci ve dördüncü metakarpal kemiğin kortikal kalınlığı, genişliği ve MKİ değerleri obez ve fazla kilolu bireylerde, normal kilolu bireylere göre daha yüksekti. Pubertal büyüme atılımı öncesi ve sonrasında ikinci ve dördüncü metakarpal kemiğin kortikal kalınlık ve genişlik değerlerinde anlamlı farklılıklar bulundu. Sonuç: Aşırı kilolu ve obez adolesan bireylerde, normal kilolu bireylere göre anlamlı derecede daha yüksek metakarpal kemik parametresi bulunmaktadır.

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1. Guo SS, Huang C, Maynard LM, Demerath E, Towne B, Chumlea WC, et al. Body mass index during childhood, adolescence and young adulthood in relation to adult overweight and adiposity: the Fels Longitudinal Study. Int J Obes Relat Metab Disord 2000; 24: 1628.

2. Kopelman PG. Obesity as a medical problem. Nature 2000; 404: 635.

3. Haroun D, Wells JC, Williams JE, Fuller NJ, Fewtrell MS, Lawson MS. Composition of the fat-free mass in obese and nonobese children: matched case-control analyses. Int J Obes 2005; 29: 29-36.

4. Akridge M, Hilgers KK, Silveira AM, Scarfe W, Scheetz JP, Kinane DF. Childhood obesity and skeletal maturation assessed with Fishman’s hand-wrist analysis. Am J Orthod Dentofacial Orthop 2007; 132: 185-90.

5. Maïano C. Prevalence and risk factors of overweight and obesity among children and adolescents with intellectual disabilities. Obes Rev 2011; 12: 189-97.

6. Villareal DT, Apovian CM, Kushner RF, Klein S. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obes Res 2005; 13: 1849-63.

7. De Laet C, Kanis J, Odén A, Johanson H, Johnell O, Delmas P, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 2005; 16: 1330-8.

8. Shapses SA, Sukumar D. Bone metabolism in obesity and weight loss. Annu Rev Nutr 2012; 32: 287-309.

9. Leonard MB, Shults J, Wilson BA, Tershakovec AM, Zemel BS. Obesity during childhood and adolescence augments bone mass and bone dimensions. Am J Clin Nutr 2004; 80: 514-23.

10. Longhi S, Pasquino B, Calcagno A, Bertelli E, Olivieri I, Di Iorgi N et al. Small metacarpal bones of low quality in obese children. Clin Endocrinol 2013; 78: 79-85.

11. Gat-Yablonski G, Yackobovitch-Gavan M, Phillip M. Nutrition and bone growth in pediatrics. Pediatr Clin North Am 2011; 58: 1117- 40.

12. Solorzano CMB, McCartney CR. Obesity and the pubertal transition in girls and boys. Reproduction 2010; 140: 399-410.

13. Kaplowitz PB. Link between body fat and the timing of puberty. Pediatrics 2008; 121: 208-17.

14. Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995; 107: 58-66.

15. Moore RN, Moyer BA, DuBois LM. Skeletal maturation and craniofacial growth. Am J Orthod Dentofacial Orthop 1990; 98: 33-40.

16. Zerin JM, Hernandez RJ. Approach to skeletal maturation. Hand Clin 1991; 7: 53-62.

17. Barnett E, Nordin BE. The radiological diagnosis of osteoporosis: a new approach. Clin Radiol 1960; 11: 166-74.

18. Hyldstrup L, Nielsen SP. Metacarpal index by digital X-ray radiogrammetry: normative reference values and comparison with dual X-ray absorptiometry. J Clin Densitom 2001; 4: 299- 306.

19. Nielsen SP. The metacarpal index revisited: a brief overview. J Clin Densitom 2001; 4: 199-207.

20. Adami S, Zamberlan N, Gatti D, Zanfisi C, Braga V, Broggini M, et al. Computed radiographic absorptiometry and morphometry in the assessment of postmenopausal bone loss. Osteoporos Int 1996; 6: 8-13.

21. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, et al. CDC growth charts; United States. Adv Data 2000; 314: 1-27.

22. Fishman LS. Radiographic evaluation of skeletal maturation: a clinically oriented method based on hand-wrist films. Angle Orthod 1982; 52: 88-112.

23. Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet 2010; 375: 1737-48.

24. Slyper AH. Childhood obesity, adipose tissue distribution, and the pediatric practitioner. Pediatrics 1998; 102: e4.

25. Strauss RS. Childhood obesity and self-esteem. Pediatrics 2000; 105: e15.

26. Paulis W, Silva S, Koes B, Middelkoop M. Overweight and obesity are associated with musculoskeletal complaints as early as childhood: a systematic review. Obes Rev 2014; 15: 52-67.

27. Adams AL, Kessler JI, Deramerian K, Smith N, Black MH, Porter AH, et al. Associations between childhood obesity and upper and lower extremity injuries. Inj Prev 2013; 19: 191-7.

28. Doyle F, Brown J, Lachance C. Relation between bone mass and muscle weight. Lancet 1970; 1: 391-3.

29. Nava-González EJ, Cerda-Flores RM, García-Hernández PA, Jassode la Peña GA, Bastarrachea RA, Gallegos-Cabriales EC. Densidad mineral ósea y su asociación con la composición corporal y biomarcadores metabólicos del eje insulino-glucosa, hueso y tejido adiposo en mujeres. Gac Med Mex 2015; 151: 731-40.

30. Kemp JP, Sayers A, Smith GD, Tobias JH, Evans DM. Using Mendelian randomization to investigate a possible causal relationship between adiposity and increased bone mineral density at different skeletal sites in children. Int J Epidemiol 2016; 45: 1560-72.

31. van Leeuwen J, Koes BW, Paulis WD, van Middelkoop M. Differences in bone mineral density between normal‐weight children and children with overweight and obesity: a systematic review and meta‐analysis. Obes Rev 2017; 18: 526-46.

32. Goulding A, Taylor RW, Jones IE, McAuley KA, Manning PJ, Williams SM. Overweight and obese children have low bone mass and area for their weight. Int J Obes Relat Metab Disord 2000; 24: 627.

33. Johnson R, Gilbert J, Cooper R, Parsell D, Stewart B, Dai X, et al. Effect of estrogen deficiency on skeletal and alveolar bone density in sheep. J Periodontol 2002; 73: 383-91.

34. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004; 89: 2548-56. 35. Takeda S, Karsenty G. Central control of bone formation. J Bone Miner Metab 2001; 19: 195-8.

36. Kelley JC, Crabtree N, Zemel BS. Bone Density in the Obese Child: Clinical Considerations and Diagnostic Challenges. Calcif Tissue Int 2017; 100: 514-27.

37. Maor G, Rochwerger M, Segev Y, Phillip M. Leptin acts as a growth factor on the chondrocytes of skeletal growth centers. J Bone Miner Res 2002; 17: 1034-43.

38. Dimitri P, Jacques RM, Paggiosi M, King D, Walsh J, Taylor ZA, et al. Leptin may play a role in bone microstructural alterations in obese children. J Clin Endocrinol Metab 2015; 100: 594-602.

39. Kim CH. Measurements of adiposity and body composition. Korean J Obes 2016; 25: 115-20.

40. Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, et al. Pediatric obesity—assessment, treatment, and prevention: an Endocrine Society Clinical Practice guideline. J Clin Endocrinol Metab 2017; 102: 709-57.

41. Dimitri P, Wales JK, Bishop N. Fat and bone in children: differential effects of obesity on bone size and mass according to fracture history. J Bone Miner Res 2010; 25: 527-36.
Meandros Medical And Dental Journal-Cover
  • ISSN: 2149-9063
  • Başlangıç: 2000
  • Yayıncı: Erkan Mor
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