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: 7474770
• 负责人: NICOLAS STETTLER-DAVIS
• 金额: $ 59.54万
• 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 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7474770
• 关键词: Address; Adolescence; Adolescent; Adult; Age; Behavior; Behavior Therapy; Behavioral; Biomechanics; Body Weight decreased; Bone Density; Bone Development; Caring; Case-Control Studies; Child; Childhood; Clinical; Conflict (Psychology); Data; Development; Diet; Diet Modification; Dimensions; Enrollment; Epidemic; Family; Fatty acid glycerol esters; Fracture; Goals; Individual; Intervention; Length; Life Style; Measurement; Measures; Mediator of activation protein; Methods; Modeling; Morbidity - disease rate; Non obese; Obesity; Osteoporosis; Outcome; Peripheral; Physical activity; Puberty; Public Health; Randomized; Randomized Controlled Clinical Trials; Recruitment Activity; Relative (related person); Reporting; Research Personnel; Risk; Site; Staging; Stress; Technology; Testing; Upper arm; Weight; Weight maintenance regimen; Weight-Bearing state; X-Ray Computed Tomography; aged; base; bone; bone health; bone strength; case control; critical developmental period; density; design; expectation; indexing; innovation; mortality; muscle strength; nutrition; nutrition education; obesity treatment; osteoporosis with pathological fracture; programs; radius bone structure; size; soft tissue; substantia spongiosa; tibia; 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）：儿童肥胖流行对肥胖和肥胖治疗对骨骼发育的影响提出了重要的临床和公共卫生问题。骨质疏松性骨折是老年发病率和死亡率的主要原因。然而，青春期后不久就达到的峰值骨量是终生骨质疏松骨折风险的关键决定因素。肥胖和体重减轻对儿童骨骼健康的影响的大小和方向尚不清楚，部分原因是骨骼确定性问题。肥胖的儿童和青少年可能患有骨折风险升高，与基于成人数据的期望相反。拟议研究的主要目的是：1）使用最准确的方法来表征和比较肥胖和非肥胖青少年的骨骼健康，以及2）研究综合行为体重控制计划对肥胖青少年骨骼健康的影响。 AIM 1将使用病例对照设计来比较88名肥胖青少年（10至14岁）的骨状态度量，以进行随机肥胖治疗试验，并进行了与一组51个现代非肥胖青少年的测量。对于AIM 2，88名肥胖青少年将参加为期12个月的随机试验，其中1：1分配是全面的，基于家庭的，基于家庭的，行为体重控制计划与个性化营养教育（通常的护理）。对于两种目的，主要结果将是骨强度，由应力强度指数估算，并通过胫骨（一个重量的位点）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，肥胖的骨骼强度将更高（AIM 1），但与通常的护理相比，随着体重减轻的降低（AIM 2）。次要目的是评估肥胖症和体重减轻对肥胖与骨骼健康（例如营养，体育活动和肌肉力量）之间关联的潜在介体对骨骼强度的影响。与公共卫生的相关性：肥胖和骨质疏松性骨折是两个重大且增加的公共卫生问题。由于尚不清楚在达到肥胖症之前开发或接受治疗的青少年是否达到骨质骨骼的骨质质量增加或降低骨质疏松症的风险，因此这项研究将比较肥胖和非肥胖青少年的骨骼健康，并研究体重减轻计划对骨骼健康的影响。