Bone Health of Obese Adolescents During Weight Loss

肥胖青少年减肥期间的骨骼健康

• 批准号: 8094389
• 负责人: Babette S Zemel
• 金额: $ 48.36万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-07-25 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8094389
• 关键词: Address; Adolescence; Adolescent; Adult; Age; Behavior; Behavior Therapy; Behavioral; Biomechanics; Body Weight decreased; Bone Density; Bone Development; Case-Control Studies; Child; Childhood; Clinical; Conflict (Psychology); Data; Development; Diet; Dimensions; Enrollment; Epidemic; Family; Fatty acid glycerol esters; Fracture; Goals; Growth; Individual; Intervention; Length; Life Style; Measurement; Measures; Mediator of activation protein; Methods; Modeling; Morbidity - disease rate; Non obese; Obesity; Osteoporosis; Peripheral; Physical activity; Puberty; Public Health; Radial; Randomized; Recruitment Activity; Relative (related person); Reporting; Research Personnel; Risk; Site; Staging; Stress; Technology; Testing; Weight maintenance regimen; Weight-Bearing state; X-Ray Computed Tomography; aged; arm; base; bone; bone age; bone health; bone mass; bone strength; case control; critical period; density; design; expectation; group intervention; indexing; innovation; mortality; muscle strength; nutrition; nutrition education; obesity in children; obesity treatment; osteoporosis with pathological fracture; primary outcome; programs; randomized trial; soft tissue; substantia spongiosa; tibia; treatment as usual; treatment trial; two-dimensional

DESCRIPTION (provided by applicant): The childhood obesity epidemic raises important clinical and public health questions about the effects of both obesity and obesity treatment on bone development. Osteoporotic fractures are a major cause of morbidity and mortality in the aged. However, peak bone mass, achieved shortly after puberty, is the key determinant of lifetime osteoporotic fracture risks. The size and direction of effects of obesity and weight loss on bone health in childhood are unclear, partly because of bone ascertainment issues. Obese children and adolescents may have elevated fracture risks, contrary to expectations based on adult data. Primary aims of the proposed study are to: 1) characterize and compare bone health of obese and non-obese adolescents using the most accurate methods available, and 2) investigate the impact of comprehensive behavior weight control program on the bone health of obese adolescents. Aim 1 will use a case-control design to compare bone status measures of 88 obese adolescents (ages 10 to 14 years), to be recruited for a randomized obesity treatment trial, with the same measurements as a group of 51 contemporary non-obese control adolescents. For Aim 2, the 88 obese adolescents will be enrolled in a 12-month randomized trial, with 1:1 assignment, of a comprehensive, group, family-based, behavioral weight control program vs. individualized nutrition education (usual care). For both aims the primary outcome will be bone strength, estimated by stress-strength index, and measured by peripheral quantitative computerized tomography (pQCT) at the tibia, a weight-bearing site. Hypotheses are that bone strength for length will be higher in the obese compared to the non-obese adolescents (Aim 1), but will decrease with weight loss compared to usual care (Aim 2). Secondary aims are to assess the impact of obesity and weight loss on bone strength at the radius, on trabecular bone and potential mediators of the association between obesity and bone health, such as nutrition, physical activity, and muscle strength. Relevance to Public Health: Obesity and osteoporotic fractures are two significant and increasing public health problems. As it is unclear if adolescents who develop or are treated for obesity before they reach maximum bone mass are at increased or decreased risk for osteoporosis, this study will compare bone health of obese and non-obese adolescents and investigate the impact of a weight loss program on bone health.

描述（由申请人提供）：儿童肥胖症的流行引起了关于肥胖症和肥胖症治疗对骨骼发育影响的重要临床和公共卫生问题。骨质疏松性骨折是老年人发病和死亡的主要原因。然而，青春期后不久达到的峰值骨量是终生骨质疏松性骨折风险的关键决定因素。肥胖和减肥对儿童骨骼健康影响的大小和方向尚不清楚，部分原因是骨骼确定问题。肥胖的儿童和青少年可能会增加骨折的风险，这与基于成人数据的预期相反。该研究的主要目的是：1）使用最准确的方法描述和比较肥胖和非肥胖青少年的骨健康，2）调查综合行为体重控制计划对肥胖青少年骨健康的影响。目标1将采用病例对照设计，比较88名肥胖青少年（年龄10至14岁）的骨状态指标，招募随机肥胖治疗试验，与51名当代非肥胖对照青少年相同的测量值。对于目标2，88名肥胖青少年将参加一项为期12个月的随机试验，1：1分配，综合，团体，以家庭为基础的行为体重控制计划与个性化营养教育（常规护理）。对于这两个目标，主要结局将是骨强度，通过应力强度指数估计，并通过胫骨（承重部位）的外周定量计算机断层扫描（pQCT）测量。假设是，与非肥胖青少年相比，肥胖青少年的长度骨强度更高（目标1），但与常规护理相比，体重减轻会降低（目标2）。次要目的是评估肥胖和体重减轻对桡骨骨强度、骨小梁和肥胖与骨健康之间相关性的潜在介质（如营养、体力活动和肌肉力量）的影响。与公共卫生的相关性：肥胖和骨质疏松性骨折是两个重要的和日益严重的公共卫生问题。由于目前尚不清楚在达到最大骨量之前出现肥胖或接受肥胖治疗的青少年患骨质疏松症的风险是否增加或降低，因此本研究将比较肥胖和非肥胖青少年的骨骼健康，并调查减肥计划的影响对骨骼健康的影响。