Cristi-Montero Carlos, Peña-Jorquera Humberto, Landaeta-Díaz Leslie, Mello Julio B, Araya-Quintanilla Felipe, Brand Caroline, Reuter Cézane, Jorquera Carlos, Ferrari Gerson
IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile.
Facultad de Salud y Ciencias Sociales, Universidad de las Américas, Santiago, Chile.
Front Nutr. 2022 Nov 15;9:1040116. doi: 10.3389/fnut.2022.1040116. eCollection 2022.
Excess adipose tissue negatively influences bone health during childhood, affecting future bone fragility diseases such as osteoporosis. However, little is known about how adolescent appendicular skeletal muscle mass index (ASMI) may mediate the relation between fatness and bone mineral content (BMC).
The sample comprised 1,296 adolescents (50% girls) aged 10-14. A principal component analysis was performed to obtain a factor made up of four fatness indicators (a) neck circumference, (b) kilograms of fat, (c) visceral fat area, and (d) waist-to-height ratio. BMC, kilograms of fat, visceral fat area, and appendicular skeletal muscle mass were obtained by a multi-frequency bioelectrical impedance analyzer. ASMI was calculated as the appendicular skeletal muscle mass divided by height squared (kg/m). A mediation analysis was performed adjusting by age, sex, maturation, socioeconomic status, physical activity, and adolescents' body weight. We also explore differences by sex and nutritional status.
The fatness factor explained 71.5% of the proportion variance. Fatness was inversely associated with the ASMI and BMC, while the ASMI was positively related to BMC. Overall, the inverse relationship between fatness and BMC was partially mediated by the adolescents' ASMI (29.7%, indirect effect: B= -0.048, 95%CI -0.077 to -0.022), being higher in girls than in boys (32.9 vs. 29.2%). Besides, the mediation effect was higher in adolescents with normal body weight than with overweight-obese (37.6 vs 23.9%, respectively).
This finding highlighted the relevance of promoting healthy habits to reduce fatness and improve muscle mass in adolescents. Moreover, this highlights the central role of ASMI mediating the inverse association between fatness and BMC in female and male adolescents. Public health strategies should promote bone health in childhood, reducing the incidence of early osteopenia and osteoporosis.
过多的脂肪组织会对儿童时期的骨骼健康产生负面影响，影响未来诸如骨质疏松症等骨骼脆性疾病。然而，关于青少年四肢骨骼肌质量指数（ASMI）如何介导肥胖与骨矿物质含量（BMC）之间的关系，我们知之甚少。
样本包括1296名10 - 14岁的青少年（50%为女孩）。进行主成分分析以获得一个由四个肥胖指标组成的因子：（a）颈围、（b）脂肪千克数、（c）内脏脂肪面积和（d）腰高比。通过多频生物电阻抗分析仪获得BMC、脂肪千克数、内脏脂肪面积和四肢骨骼肌质量。ASMI的计算方法是四肢骨骼肌质量除以身高的平方（kg/m²）。进行中介分析，并根据年龄、性别、成熟度、社会经济地位、身体活动和青少年体重进行调整。我们还按性别和营养状况探讨了差异。
肥胖因子解释了71.5%的比例方差。肥胖与ASMI和BMC呈负相关，而ASMI与BMC呈正相关。总体而言，肥胖与BMC之间的负相关部分由青少年的ASMI介导（29.7%，间接效应：B = -0.048，95% CI -0.077至-0.022），女孩的介导作用高于男孩（分别为32.9%和29.2%）。此外，体重正常的青少年的中介效应高于超重 - 肥胖青少年（分别为37.6%和23.9%）。
这一发现凸显了促进健康习惯以减少青少年肥胖和增加肌肉量的重要性。此外，这突出了ASMI在介导男女青少年肥胖与BMC之间负相关关系中的核心作用。公共卫生策略应促进儿童期的骨骼健康，降低早期骨质减少和骨质疏松症的发病率。
