Low HDL cholesterol may lead to disruption of bone (re)modeling in obese early pubertal girls

Anna Newton, Lynae Hanks, Suzanne Judd, Stephenie Wallace, Nefertiti Durant, Krista Casazza


Aim: Cardiovascular risk factors and compromised bone phenotype are apparent in obese children. Identification of cardiovascular-bone linking factors is warranted. The objective is to determine the association between circulating factors of lipid metabolism and bone parameters in obese early-pubertal females.

Materials and Methods: 43 peri-pubertal obese girls aged 7-11 years who underwent dual-energy x-ray absorptiometry (DXA) to measure whole body bone mineral content (BMC) and peripheral quantitative computed tomography (pQCT) to measure bone parameters were included. Lipids (total cholesterol, TC; high-density lipoprotein cholesterol, HDL; low-density lipoprotein cholesterol, LDL; triglyceride, TG), bone turnover markers (carboxy-terminal collagen crosslinks, CTX; type 1 procollagen N-terminal propeptide, P1NP), and inflammatory cytokines (tumor necrosis factor alpha, TNFα; interleukin-6, IL-6) were obtained from venipuncture.

Results: HDL was positively associated with P1NP (p<0.01) and total bone area at 66% radial length, yet negatively associated with total bone density (p<0.05). Stratification by HDL level revealed significant differences in total bone area at 66% radial length between normal- and low-HDL groups. TNFa and IL-6 contributed to the observed differences (p≤0.05).

Conclusion: The findings herein indicate a link between lipid and inflammatory markers and bone parameters in overweight/obese girls, which may partially explain the increased risk of fracture in this population.


Bone (re)modeling; cytokines; HDL cholesterol; obesity; puberty

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