Bone Mineral Density, Hip Bone Geometry, and Calcaneus Trabecular Bone Texture in Obese and Normal-Weight Children

Our study aimed at comparing bone mineral density (BMD), geometric indices of hip bone strength, and indices of trabecular bone texture at the calcaneus in obese and normal-weight children. Fifty-three obese children (10.3 ± 1.4 yr) and 24 normal-weight children (10.4 ± 1.5 yr) participated in this study. Body composition, bone mineral content, and BMD at whole body (WB), lumbar spine (L2-L4), total forearm, and proximal femur (total hip [TH] and femoral neck [FN]) were measured by dual-energy X-ray absorptiometry (DXA). Bone geometry of the hip was evaluated by the hip structure analysis (HSA) program. DXA scans were analyzed at the FN at its narrowest region and the femoral shaft (FS) by the HSA program. Cross-sectional area (CSA) and section modulus (Z) were measured from hip BMD profiles. Texture analysis was performed on digitized radiographs of the calcaneus to assess trabecular bone microarchitecture, and the result was expressed as Hmean. WB BMD, L2-L4 BMD, TH BMD, and FN BMD were significantly higher in obese children compared with normal-weight peers (p < 0.05). FN Z and FS Z were not significantly different between the 2 groups, whereas Hmean parameter was significantly lower in obese children compared with normal-weight peers (p < 0.001). After adjustment for body weight, obese children displayed lower WB BMD, FN CSA, FN Z, FS CSA, and FS Z compared with normal-weight children. This study suggests that BMD of WB and geometric indices of hip bone strength are not adapted to the increased body weight in obese children.