Jornal de Pediatria (Aug 2005)
Densidade mineral óssea de adolescentes com sobrepeso e obesidade Bone mineral density in overweight and obese adolescents
Abstract
OBJETIVO: Estudar a densidade óssea como fator concomitante da obesidade em adolescentes pós-púberes, controlando outras variáveis que possam interferir nessa relação. MÉTODOS: Estudo com 83 sobrepesos e obesos (IMC > P85) e 89 não obesos (P5 OBJECTIVE: to study bone density as a concomitant factor for obesity in post-pubertal adolescents, controlling for other variables that may interfere in such a relation. METHODS: Study comprising 83 overweight and obese adolescents (BMI > P85) and 89 non obese ones (P5 < BMI < P85). Cases and controls were selected out of 1,420 students (aged 14-19) from a public school in the city of São Paulo. The bone mineral density of the lumbar spine (L2-L4 in g/cm²) was assessed by dual-energy x-ray absorptiometry (LUNAR™ DPX-L). The variable bone density was dichotomized using 1.194 g/cm² as cutoff point. Bivariate analyses were conducted considering the prevalence of overweight and obesity followed by multivariate analysis (logistic regression) according to a hierarchical conceptual model. RESULTS: The prevalence of bone density above the median was twice more frequent among cases (69.3%) than among controls (32.1%). In the bivariate analysis such prevalence resulted in an odds ratio (OR) of 4.78. The logistic regression model showed that the association between obesity and mineral density is yet more intense with an OR of 6.65 after the control of variables related to sedentary lifestyle and intake of milk and dairy products. CONCLUSION: Obese and overweight adolescents in the final stages of sexual maturity presented higher bone mineral density in relation to their normal-weight counterparts; however, cohort studies will be necessary to evaluate the influence of such characteristic on bone resistance in adulthood and, consequently, on the incidence of osteopenia and osteoporosis at older ages.
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