The relationship between metabolic syndrome and bone mineral density in adolescents: analysis of the National Health and Nutrition Examination Survey

Abstract

Abstract Objectives The purpose of this study was to observe the relationship between metabolic syndrome (MetS) and height (Ht) adjusted Z-scores for areal bone mineral density (aBMD) in adolescents. Methods A retrospective study was conducted on the United States adolescents aged 12–17 years. Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2011–2012, 2013–2014 and 2015–2016 cycles. Ht adjusted Z-scores for aBMD were calculated. Results A total of 969 adolescents (493 boys and 476 girls), aged 14.5 ± 1.7 years were enrolled in this study. After control for age, gender, race, 25-hydroxyvitamin D [25(OH)D], and lean body mass index (LBMI) Z-score, adolescents with MetS had significantly lower levels of total body (less head) aBMD Ht-Z-adjusted Z-score than adolescents with one, two components of MetS and without component of MetS (p<0.05) and significantly lower levels of lumbar spine aBMD Ht-Z-adjusted Z-score than adolescents with one component of MetS and without component of MetS (p<0.05). There were significantly negative associations between total body (less head) aBMD Ht-Z-adjusted Z-score and waist circumference (WC) (β=−0.027, p<0.001, R2=0.057) and homeostasis model assessment insulin resistance (HOMA-IR) (β=−0.225, p<0.001, R2=0.016). There were significantly negative associations between lumbar spine aBMD Ht-Z-adjusted Z-score and WC (β=−0.039, p<0.001, R2=0.058) and HOMA-IR (β=−0.251, p<0.001, R2=0.008). Conclusions The present study demonstrates that MetS may have a negative effect on bone mineral density in adolescents. Abdominal obesity and insulin resistance play a major role on the decline of aBMD in adolescents.