Do metabolic syndrome and its components have an impact on bone mineral density in adolescents?
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REVIEW
Open Access
Do metabolic syndrome and its components have an impact on bone mineral density in adolescents? Valéria Nóbrega da Silva1, Luciana Nunes Mosca Fiorelli1, Carla Cristiane da Silva2, Cilmery Suemi Kurokawa3 and Tamara Beres Lederer Goldberg1*
Abstract In recent years, there has been growing concern about the occurrence of metabolic syndrome (MetS) at an early age and its effects on bone mass in adolescents. Adolescence is considered a critical period for bone mass gain. Impaired bone acquisition during this phase can lead to “suboptimal” peak bone mass and increase the risk of osteopenia/osteoporosis and fractures in old age. The objective of this review was to perform a critical analysis of articles that specifically focus on this age group, evaluating the influence of MetS and its components on bone mineral density in adolescents. A possible relationship between this syndrome and bone mass has been demonstrated, but the number of studies addressing this topic in adolescents is small. Despite the scarcity of evidence, the results of those studies show that Metabolic Syndrome is negatively correlated with bone mass and also that some components of MetS are negatively correlated with bone mineral density in adolescents. However, the associations between MetS and bone mass development need to be further explored in the age group corresponding to adolescence. Further good-quality studies are necessary to complement the understanding of this relationship. Keywords: Metabolic syndrome X, Abdominal obesity, Waist circumference, Bone mineral density, Hypertriglyceridemia, Adolescents
Background Metabolic syndrome (MetS) is a clinical condition characterized by a combination of abdominal obesity, altered glucose metabolism, dyslipidemia, and arterial hypertension. This combination of metabolic alterations predisposes affected individuals to the development of cardiovascular diseases and type 2 diabetes mellitus [1, 2]. In addition to the cardiovascular problems extensively documented in the scientific literature, previous studies have shown a possible relationship between MetS and bone mass, however the results are still inconsistent [3–7]. In adults, studies have shown a negative correlation between MetS and bone mineral density (BMD) [3, 6, 8, 9]. These findings have been questioned in a recent systematic * Correspondence: [email protected] 1 Department of Pediatrics, Discipline of Adolescent Medicine, Postgraduate Program in Gynecology, Obstetrics, and Mastology, Botucatu School of Medicine, UNESP, São Paulo State University, Botucatu, São Paulo, Brazil Full list of author information is available at the end of the article
review with meta-analysis, suggesting that BMD at different sites does not differ between adult men and women with and without MetS [10]. However, the authors suggested caution in the interpretation of the results and indicated the need for prospective studies [10]. Among Caucasian Dutch adults, an association with femoral BMD was observed in older women with MetS, even after a
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