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Clinical Endocrinology

Low-grade systemic inflammation and suboptimal bone mineral density throughout adolescence: a prospective study in girls

Authors

  • Raquel Lucas,

    Corresponding author
    1. Institute of Public Health, University of Porto, Porto, Portugal
    2. Cardiovascular R&D Unit, University of Porto Medical School, Porto, Portugal
    • Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal
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  • Elisabete Ramos,

    1. Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal
    2. Institute of Public Health, University of Porto, Porto, Portugal
    3. Cardiovascular R&D Unit, University of Porto Medical School, Porto, Portugal
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  • Andreia Oliveira,

    1. Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal
    2. Institute of Public Health, University of Porto, Porto, Portugal
    3. Cardiovascular R&D Unit, University of Porto Medical School, Porto, Portugal
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  • Teresa Monjardino,

    1. Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal
    2. Institute of Public Health, University of Porto, Porto, Portugal
    3. Cardiovascular R&D Unit, University of Porto Medical School, Porto, Portugal
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  • Henrique Barros

    1. Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal
    2. Institute of Public Health, University of Porto, Porto, Portugal
    3. Cardiovascular R&D Unit, University of Porto Medical School, Porto, Portugal
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Correspondence: Raquel Lucas, Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Alameda Prof. Hernâni Monteiro, 4200 319 Porto, Portugal, Tel.: +351 22 551 36 52; Fax: +351 22 551 36 53;

E-mail: rlucas@med.up.pt

Summary

Objective

We aimed at quantifying the associations between high-sensitivity C-reactive protein (hs-CRP) and forearm bone mineral density (BMD) throughout adolescence in overweight and normal-weight girls.

Design

Prospective cohort study.

Patients

346 girls born in 1990 and attending schools in Porto, Portugal.

Measurements

Adolescents were evaluated at 13 and 17 years of age using a standard protocol. Forearm BMD was measured by dual-energy X-ray absorptiometry. Anthropometric assessment included weight, height, body fat percentage and waist circumference. Girls were categorized according to age- and sex-specific body mass index (BMI) percentiles as normal weight in both evaluations or overweight in at least one assessment. Pubertal development was estimated using menarche age. Serum hs-CRP was determined using particle-enhanced immunonephelometry. Hs-CRP was log-transformed, and associations were quantified using linear regression coefficients and 95% confidence intervals (95%CI).

Results

An inverse association between hs-CRP and BMD was observed from 13 years of age in overweight girls [−11·26 mg/cm2 (−21·99, −0·52)]. Among normal-weight adolescents, 13-year-old hs-CRP was negatively associated with prospective BMD variation between 13 and 17 years of age [−1·90 mg/cm2 year (−3·35, −0·45)]. Overweight girls who maintained higher levels of hs-CRP throughout adolescence had lower 17-year-old BMD (adjusted mean 0·441 vs 0·483 g/cm2 in those who remained with lower levels of hs-CRP). At 17 years of age, significant inverse associations were found between hs-CRP and BMD among normal-weight and overweight girls.

Conclusions

Obesity-related early systemic inflammation might be involved in suboptimal bone accrual, particularly in overweight girls.

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