Metabolic Syndrome and Bone Density in Obese Adolescents
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Issue
Vol. 14 No. 1 (2019)
Accepted
19 March 2019
Published
19 March 2019
Keywords:
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adolescent, bone density, metabolic syndrome, obesity
Abstract
The purpose of this study was to analyse the correlations of metabolic syndrome components (central obesity, triglyceride levels, and hypertension) and related factors including nutrient intake and bone physical activity with bone density in obese adolescents. A cross-sectional study was conducted involving 47 obese adolescents (15-18 years) from three high schools in Semarang city, Central Java, selected by consecutive sampling. Bone density was measured by the Quantitative Ultrasound method. Metabolic syndrome and osteopenia were detected in 28% and 11% subjects, respectively. Positive correlations were found between triglyceride levels, calcium intake, vitamin D intake, current bone-physical activity (cBPA) and bone density (p<0.05). Conversely, central obesity, blood pressure, protein intake, animal protein, plant protein, phosphorus, potassium, sodium, past bone-physical activity (pBPA), and total bone-physical activity (tBPA) were not correlated with bone density. It was found that calcium intake, cBPA, and triglyceride levels were the two strongest factors related to bone density (adjusted R2=52.5%). This study showed that obese adolescents are at risk of having metabolic syndrome and higher triglyceride levels imply lower bone density.
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Muhammad D, Dieny FF. 2016. Hubungan asupan Vitamin A, C, dan E dengan Kejadian Sindrom Metabolik pada Remaja Obesitas. Journal of Nutrition College 5(4):289-297.
Pludowski P, Litwin M, Sladowska J, Antoniewicz J, Niemirska A, Wierzbicka A, Lorenc RS. 2007. Bone mass and body composition in children and adolescent with primary hypertension. AHA Journal 2007(51):77-83.
Pollock NK, Bernard P, Gutin B, Davis C, ZhuH, Dong Y. 2011. Adolescent obesity, bone mass, and cardiometabolic risk factors. J Pediatr 158(5):727-734.
Promislow JH, Gruen DG, Slymen DJ, Connor EB. 2002. Protein consumption and bone mineral density in the elderly. Am J Epidemiol 155(7):636-644.
Pulungan AB, Marzuki AN, Julia M, Rosaliana I, Damayanti W, Yanuarso P, et al. 2014. Diagnosis dan Tata Laksana Sindrom Metabolik pada Anak dan Remaja. Konsensus Ikatan Dokter Anak Indonesia. Jakarta: IDAI
Reid I. 2002. Relationship among body mass, Its components, and bone. Bone 31(5):547-555.
Russel M, Mendes N, Miller K, Rossen CJ, Lee H Klibanski A, et al. 2010. Viseral fat is negative predictore of bone density measures in obese adolescent girls. J Clin Endrocinol Metab 95(3):1247-1255.
Sellemeyer DE, Stone KL, Sebastian A, Cumming S. 2001. A High Ratio of Dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in post menopousal woman. Am J Clin Nutr 73(1):118-122.
Sok KW, Kok YC, Suhaimi H F, Ahmad F, Soelaiman. 2016. The relationship between metabolic syndrome and osteoporosis: A review. Nutrients 8(347):1-18.
Thorpe M, Mojtahedi MC, Novakofski KC, McAuley E, Evan EM. 2008. A positive association of lumbar spine bone mineral density with dietary protein is suppressed by a negative association with protein sulfur. J Nutr 138(1):80-85.
Weeks BK, Beck BR. 2008. The BPAQ: A bone specific physical activity assessment instrument. International Osteoporosis Foundation 19(11):1567-1577.
Whitney E, Rolfes SR. 2011. Understanding Nutrition. 12th ed. USA: Wadsworth Cengange Learning.
Widajanti L. 2009. Survei Konsumsi Gizi. Semarang: Badan Penerbit Universitas Diponegoro.
Yazici S, Yazici M, Korkmaz U, Erkan ME, Baki AE, Erden I, et all. 2011. Relationship between blood pressure levels and bone mineral density in postmenopousal Turkish women. Arch Med Sci 7(2):264-270.
Yu A, Cheng M, Coalson R. 2010. Calcium inhibits paracellular sodium conductance through claudin-2 by competitive binding. J Biol Chem 285(47):37060-37069.
Bantas K. 2012. Perbedaan gender pada kejadian sindrom metabolik pada penduduk perkotaan di Indonesia. Jurnal Kesehatan Masyarakat Nasional 7(5):219-226.
Carbone L, Johnson KC, Huang Y, Pettinger M, Thomas F, Cauley J, Crandall C, Tinker L, LeBoff MS, Wactawski-Wende J, et al. 2016. Sodium intake and osteoporosis.Finding from the women’s health initiative. J Clin Endrocinol Metab 101(4):1414-1421.
Czernik B, Moerman E, Grant D, Lehmann J, Manolagas S, Jilka R. 2002. Divergent efect of selective peroxisome proliferator activated receptor-γ2 ligands on adipocyte versus osteoblas differentiation. Endocrinology 143(6):2376-2384.
da Silva VN, Goldberg TBL, Mosca LN, Rizzo ADCB, dos Santos TA, Corrente JE. 2014. Metabolic syndrome reduces bone mineral density in overweight adolescent. Bone 66:1-7.
da Dilva VN, Fiorelli LNM, da Silva CC, Kurokawa CS, Goldberg TMB. 2017. Do metabolic syndrome and its components have an impact on bone mineral density in adolescent? Nutr Metab 14(1):1.
Debbie AL, Sattar N, Jon HT. 2012. The association of fasting lipids with bone mass in adolescent: Findings from a cross-sectional study. J Clin Endocrinol Metab 97(6):2068-2076.
Dieny FF, Widyastuti N, Fitranti DY. 2015. Sindrom metabolik pada remaja obes: prevalensi
dan hubungannya dengan kualitas diet. J Gizi Klinik Indonesia 12(1):1-11.
El-Masry S, Hassan N, El-Banna R, El Hussieny M. 2014. The relation between visceral and subcutaneous fat to bone mass among egyptian children and adolescent. OA Maced J Med Sci 2(4):573-578.
Fitriyanti AR, Sulchan M. 2015. Pengaruh konseling modifikasi gaya hidup terhadap penurunan asupan natrium, tekanan darah, dan kadar creactive protein (CRP) pada remaja obesitas dengan sindrom metabolik. Journal of Nutrition College 4(2):300-307.
Gropper S, Smith J, Groff J. 2009. Macromineral. Adams P, editors. Advanced Nutrition and Human Metabolism. 5th ed. USA: Wadsworth Cengange Learning.
Guadalupe M, Megias S, Viveros M, Bolanos P, Pinero B. 2012. Prevalence of metabolic syndrome in a population of obese children and adolescent. Endocrinol Nutr 59(3):155-159.
Gunn CA, Weber J, McGill A, Kruger MC. 2015. Increased intake of seleced vegetables,herbs, and fruit may reduce bone turnover in post-menopousal women. Nutrients 7(4):2499-2517.
Hardinsyah, Damyanthi E, Zulianti W. 2008. Hubungan konsumsi susu dan kalsium dengan densitas tulang dan tinggi badan remaja. J Gizi Pangan 3(1):43-48.
Heaney R, Layman D. 2008. Amount and type of protein influences bone health. Am J Clin Nutr 87(5):1567-1570.Hwang DK, Choi HJ. 2010. The relationship between lowbone mass and metabolic syndrome in Korean women. Osteoporos Int 21(3):425-431.
Joen YK, Lee, JG, Kim SS, Kim BH, Kim SJ, Kim YK, et all. 2011. Association between bone mineral density and metabolic syndrome in pre- and postmenopausal woman. Endocrine J 58(2):87-93.
Kim J, Jung M, Hong Y, Park J, Choi BS. 2013. Physical activity in adolescence has a protective effect on bone mineral density in young men. J Prev Med Public Health 46(2):89-95.
Kini U, Nandeesh BN. 2012. Physiology of Bone Formation, Remodeling, and Metabolism. In:Fogelman I, Gnanasegaran G, Van der Wall H, editors. Radionuclide and Hybrid Bone Imaging. New York: Springer.
Kusharto CM, Supariasa IDN. 2014. Survey Konsumsi Gizi. Yogyakarta: Graha Ilmu.
Lee AW, Cho SS. 2015. Association between phosporus intake and bone health in the nhanes population. Nutrition Journal 14(28):1-7.
Lee RD. 2007. Diseases of the Muscoloskeletal System. In: Nelms M, Sucher K, Roth SL. Nutrition Therapy and Pathophysiology. 2nd ed. USA: Wadsworth Cengange learning.
Liu W, Lin R, Liu A, Du L,Chen Q. 2010. Prevalence and association between obesity and metabolic syndrome among chinese elementary school children: a school- based survey. BMC Public Health 10(1):1-7.
Lopez FR, Chedraui P, Lopez JL. 2010. Bone mass gain during puberty and adolescence: deconstructing gender characteristic. Current Medical Chemistry 17(5):453-466.
Michaelsson K, Wolk A, Jacobsoon A, Kindmark A, Grundbreg E,Stiger F. 2006. The positive effect of dietary vitamin d intake on bone mineral density in men is modulated by the polyadenosite repeat polymorpism of the vitamin d receptor. Bone 39(6):1343-1351.
[MoH] Ministry of Health. 2014. Pedoman Gizi Seimbang. Jakarta: Ministry of Health Republic of Indonesia.
[MoH] Ministry of Health. 2013. Indonesia Basic Health Research (Riskesdas) 2013. Jakarta; Ministry of Health Republic of Indonesia.
[MoH] Ministry of Health. 2018. Indonesia Basic Health Research (Riskesdas) 2018. Jakarta; Ministry of Health Republic of Indonesia.
Muhammad D, Dieny FF. 2016. Hubungan asupan Vitamin A, C, dan E dengan Kejadian Sindrom Metabolik pada Remaja Obesitas. Journal of Nutrition College 5(4):289-297.
Pludowski P, Litwin M, Sladowska J, Antoniewicz J, Niemirska A, Wierzbicka A, Lorenc RS. 2007. Bone mass and body composition in children and adolescent with primary hypertension. AHA Journal 2007(51):77-83.
Pollock NK, Bernard P, Gutin B, Davis C, ZhuH, Dong Y. 2011. Adolescent obesity, bone mass, and cardiometabolic risk factors. J Pediatr 158(5):727-734.
Promislow JH, Gruen DG, Slymen DJ, Connor EB. 2002. Protein consumption and bone mineral density in the elderly. Am J Epidemiol 155(7):636-644.
Pulungan AB, Marzuki AN, Julia M, Rosaliana I, Damayanti W, Yanuarso P, et al. 2014. Diagnosis dan Tata Laksana Sindrom Metabolik pada Anak dan Remaja. Konsensus Ikatan Dokter Anak Indonesia. Jakarta: IDAI
Reid I. 2002. Relationship among body mass, Its components, and bone. Bone 31(5):547-555.
Russel M, Mendes N, Miller K, Rossen CJ, Lee H Klibanski A, et al. 2010. Viseral fat is negative predictore of bone density measures in obese adolescent girls. J Clin Endrocinol Metab 95(3):1247-1255.
Sellemeyer DE, Stone KL, Sebastian A, Cumming S. 2001. A High Ratio of Dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in post menopousal woman. Am J Clin Nutr 73(1):118-122.
Sok KW, Kok YC, Suhaimi H F, Ahmad F, Soelaiman. 2016. The relationship between metabolic syndrome and osteoporosis: A review. Nutrients 8(347):1-18.
Thorpe M, Mojtahedi MC, Novakofski KC, McAuley E, Evan EM. 2008. A positive association of lumbar spine bone mineral density with dietary protein is suppressed by a negative association with protein sulfur. J Nutr 138(1):80-85.
Weeks BK, Beck BR. 2008. The BPAQ: A bone specific physical activity assessment instrument. International Osteoporosis Foundation 19(11):1567-1577.
Whitney E, Rolfes SR. 2011. Understanding Nutrition. 12th ed. USA: Wadsworth Cengange Learning.
Widajanti L. 2009. Survei Konsumsi Gizi. Semarang: Badan Penerbit Universitas Diponegoro.
Yazici S, Yazici M, Korkmaz U, Erkan ME, Baki AE, Erden I, et all. 2011. Relationship between blood pressure levels and bone mineral density in postmenopousal Turkish women. Arch Med Sci 7(2):264-270.
Yu A, Cheng M, Coalson R. 2010. Calcium inhibits paracellular sodium conductance through claudin-2 by competitive binding. J Biol Chem 285(47):37060-37069.
Authors
SukmasariV., DienyF. F., & PanunggalB. (2019). Metabolic Syndrome and Bone Density in Obese Adolescents. Jurnal Gizi Dan Pangan, 14(1), 9-16. https://doi.org/10.25182/jgp.2019.14.1.9-16
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