Fat–Bone Interactions in Adults With Spina Bifida

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Context
Spina bifida (SB) can lead to changes in body composition and bone mineral density (BMD) through diminished ambulation, renal impairment, and anticonvulsant medication. With increased life expectancy, diseases such as obesity and osteoporosis are emerging comorbidities in SB, with limited data to guide management.
Objective
To examine the relationship between cardiometabolic factors, body composition, BMD, and minimal trauma fractures (MTFs) in adults with SB.
Design
Retrospective cross-sectional study.
Setting and Participants
Forty-nine adults with SB (median age, 32.7 years; interquartile range, 22.6 to 39.0) who had undergone dual-energy x-ray absorptiometry imaging at a single tertiary hospital from 2004 to 2015.
Results
The mean body mass index was 31.7 ± 7.5 kg/m2; 26 (53.1%) were obese. Using age- and sex-matched fat percentiles from the National Health and Nutrition Examination Survey III, 62.5% had a total body percentage fat greater than the 95th percentile. Low bone mass (defined as a Z-score of ≤−2.0) was present in 21.9% at the L1 vertebra and in 35.1% at the femoral neck. Ten (20.4%) had a history of MTFs. A BMD or Z-score at L1, femoral neck, or total body site did not correlate with the occurrence of MTF. Fat mass was significantly and positively associated with BMD after adjustment for age, sex, and height and accounted for 18.6% of the variance in BMD (P = 0.005). The prevalence of metabolic comorbidities, such as hypertension (20.4%) and obstructive sleep apnea (16.3%), was high.
Conclusions
Obesity and low BMD are common in young adults with SB. An increased fat mass correlated significantly with BMD. The prevalence of metabolic complications in patients with SB is increased and deserves further study.
Original languageEnglish
Pages (from-to)1301-1311
Number of pages11
JournalJournal of the Endocrine Society
Volume1
Issue number10
DOIs
Publication statusPublished - 1 Oct 2017

Cite this

@article{18736bc381ea4f5587dfe2e2d356be81,
title = "Fat–Bone Interactions in Adults With Spina Bifida",
abstract = "ContextSpina bifida (SB) can lead to changes in body composition and bone mineral density (BMD) through diminished ambulation, renal impairment, and anticonvulsant medication. With increased life expectancy, diseases such as obesity and osteoporosis are emerging comorbidities in SB, with limited data to guide management.ObjectiveTo examine the relationship between cardiometabolic factors, body composition, BMD, and minimal trauma fractures (MTFs) in adults with SB.DesignRetrospective cross-sectional study.Setting and ParticipantsForty-nine adults with SB (median age, 32.7 years; interquartile range, 22.6 to 39.0) who had undergone dual-energy x-ray absorptiometry imaging at a single tertiary hospital from 2004 to 2015.ResultsThe mean body mass index was 31.7 ± 7.5 kg/m2; 26 (53.1{\%}) were obese. Using age- and sex-matched fat percentiles from the National Health and Nutrition Examination Survey III, 62.5{\%} had a total body percentage fat greater than the 95th percentile. Low bone mass (defined as a Z-score of ≤−2.0) was present in 21.9{\%} at the L1 vertebra and in 35.1{\%} at the femoral neck. Ten (20.4{\%}) had a history of MTFs. A BMD or Z-score at L1, femoral neck, or total body site did not correlate with the occurrence of MTF. Fat mass was significantly and positively associated with BMD after adjustment for age, sex, and height and accounted for 18.6{\%} of the variance in BMD (P = 0.005). The prevalence of metabolic comorbidities, such as hypertension (20.4{\%}) and obstructive sleep apnea (16.3{\%}), was high.ConclusionsObesity and low BMD are common in young adults with SB. An increased fat mass correlated significantly with BMD. The prevalence of metabolic complications in patients with SB is increased and deserves further study.",
author = "Anne Trinh and Phillip Wong and Anuradha Sakthivel and Fahey, {Michael C} and Sabine Hennel and Justin Brown and Strauss, {Boyd J} and Ebeling, {Peter R} and Fuller, {Peter J} and Frances Milat",
year = "2017",
month = "10",
day = "1",
doi = "10.1210/js.2017-00258",
language = "English",
volume = "1",
pages = "1301--1311",
journal = "Journal of the Endocrine Society",
issn = "2472-1972",
publisher = "Oxford University Press",
number = "10",

}

Fat–Bone Interactions in Adults With Spina Bifida. / Trinh, Anne; Wong, Phillip; Sakthivel, Anuradha; Fahey, Michael C; Hennel, Sabine; Brown, Justin; Strauss, Boyd J; Ebeling, Peter R; Fuller, Peter J; Milat, Frances.

In: Journal of the Endocrine Society, Vol. 1, No. 10, 01.10.2017, p. 1301-1311.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Fat–Bone Interactions in Adults With Spina Bifida

AU - Trinh, Anne

AU - Wong, Phillip

AU - Sakthivel, Anuradha

AU - Fahey, Michael C

AU - Hennel, Sabine

AU - Brown, Justin

AU - Strauss, Boyd J

AU - Ebeling, Peter R

AU - Fuller, Peter J

AU - Milat, Frances

PY - 2017/10/1

Y1 - 2017/10/1

N2 - ContextSpina bifida (SB) can lead to changes in body composition and bone mineral density (BMD) through diminished ambulation, renal impairment, and anticonvulsant medication. With increased life expectancy, diseases such as obesity and osteoporosis are emerging comorbidities in SB, with limited data to guide management.ObjectiveTo examine the relationship between cardiometabolic factors, body composition, BMD, and minimal trauma fractures (MTFs) in adults with SB.DesignRetrospective cross-sectional study.Setting and ParticipantsForty-nine adults with SB (median age, 32.7 years; interquartile range, 22.6 to 39.0) who had undergone dual-energy x-ray absorptiometry imaging at a single tertiary hospital from 2004 to 2015.ResultsThe mean body mass index was 31.7 ± 7.5 kg/m2; 26 (53.1%) were obese. Using age- and sex-matched fat percentiles from the National Health and Nutrition Examination Survey III, 62.5% had a total body percentage fat greater than the 95th percentile. Low bone mass (defined as a Z-score of ≤−2.0) was present in 21.9% at the L1 vertebra and in 35.1% at the femoral neck. Ten (20.4%) had a history of MTFs. A BMD or Z-score at L1, femoral neck, or total body site did not correlate with the occurrence of MTF. Fat mass was significantly and positively associated with BMD after adjustment for age, sex, and height and accounted for 18.6% of the variance in BMD (P = 0.005). The prevalence of metabolic comorbidities, such as hypertension (20.4%) and obstructive sleep apnea (16.3%), was high.ConclusionsObesity and low BMD are common in young adults with SB. An increased fat mass correlated significantly with BMD. The prevalence of metabolic complications in patients with SB is increased and deserves further study.

AB - ContextSpina bifida (SB) can lead to changes in body composition and bone mineral density (BMD) through diminished ambulation, renal impairment, and anticonvulsant medication. With increased life expectancy, diseases such as obesity and osteoporosis are emerging comorbidities in SB, with limited data to guide management.ObjectiveTo examine the relationship between cardiometabolic factors, body composition, BMD, and minimal trauma fractures (MTFs) in adults with SB.DesignRetrospective cross-sectional study.Setting and ParticipantsForty-nine adults with SB (median age, 32.7 years; interquartile range, 22.6 to 39.0) who had undergone dual-energy x-ray absorptiometry imaging at a single tertiary hospital from 2004 to 2015.ResultsThe mean body mass index was 31.7 ± 7.5 kg/m2; 26 (53.1%) were obese. Using age- and sex-matched fat percentiles from the National Health and Nutrition Examination Survey III, 62.5% had a total body percentage fat greater than the 95th percentile. Low bone mass (defined as a Z-score of ≤−2.0) was present in 21.9% at the L1 vertebra and in 35.1% at the femoral neck. Ten (20.4%) had a history of MTFs. A BMD or Z-score at L1, femoral neck, or total body site did not correlate with the occurrence of MTF. Fat mass was significantly and positively associated with BMD after adjustment for age, sex, and height and accounted for 18.6% of the variance in BMD (P = 0.005). The prevalence of metabolic comorbidities, such as hypertension (20.4%) and obstructive sleep apnea (16.3%), was high.ConclusionsObesity and low BMD are common in young adults with SB. An increased fat mass correlated significantly with BMD. The prevalence of metabolic complications in patients with SB is increased and deserves further study.

U2 - 10.1210/js.2017-00258

DO - 10.1210/js.2017-00258

M3 - Article

VL - 1

SP - 1301

EP - 1311

JO - Journal of the Endocrine Society

JF - Journal of the Endocrine Society

SN - 2472-1972

IS - 10

ER -