The relationship between components of the metabolic syndrome and bone health

Abstract

Childhood obesity has become a global epidemic in the past decade. It is now estimated that more than 17% of the US children and adolescents are obese. The effects of childhood obesity on overall health are multiple and involve various organ systems including the musculoskeletal system. Increased fat mass is associated with increased bone mineral density in adults; however, studies regarding obesity's effects on bone mass in children have been conflicting. Some pediatric studies have demonstrated increased bone mass in overweight children compared to healthy weight peers, while others have shown that overweight youth have decreased bone mass relative to bone size and body weight and thus are at increased risk for fracture. Childhood obesity is associated with high fracture rates due to a combination of biologic and biomechanical factors. Childhood obesity has also been linked to multiple orthopedic complications. Reports indicate increased prevalence of musculoskeletal pain, lower extremity malalignment, slipped capital femoral epiphysis, genu valgum, Blount's disease, and foot structure abnormalities in obese children compared to normal-weight counterparts. Increased physical activity is a cornerstone for treatment of childhood obesity; however, obese children often lead a more sedentary lifestyle than normal-weight peers, which in part results from musculoskeletal pain in the back, knees, and feet. In conclusion, while the full impact of obesity on the overall function and development of the growing child has not been studied completely, it is well established that obesity adversely affects the musculoskeletal system. More research is needed to better understand the full impact of obesity on bone accrual, fracture rates, and physical function in children.