Role of Cardiometabolic Risk Factors in Childhood Bone Development

November 18, 2019 updated by: Norman Pollock, Augusta University

Role of Cardiometabolic Risk Factors in Childhood Bone Development (Healthy Heart 'N' Bones Study)

The proposed research brings together complementary expertise to systematically elucidate the longitudinal effects of (1) total and regional body fat and (2) the metabolic impairment that accompanies obesity on bone development during growth. The contribution of this research will be significant because it will provide a solid foundation for understanding the influence of fat (total and regional distribution) on overall bone strength, and whether insulin resistance, beta-cell dysfunction, abnormal lipids, and inflammation could be underpinning factors in the fat-bone strength relationship via effects on bone modeling activity. This knowledge will provide critical information needed to maximize potential therapeutic interventions to counter the linked risks of obesity and osteoporosis, both major public health concerns.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

The overall goal of this study is to clarify the relationship of adiposity with bone development during adolescence, and to explicate the mechanisms that regulate the effect of excess adiposity on bone. In this effort, we will conduct a 2-year longitudinal study in 400 children and adolescents aged 9-15 years. Using the peak adolescent growth period as a model for probing determinants of bone health may allow for a clearer picture of the processes that regulate bone development, as these processes are highly active at this growth stage. Unlike other studies with surrogates for adiposity, we plan to measure total and central adiposity directly, using dual energy X-ray absorptiometry (DXA) and magnetic resonance imaging. Both bone quantity and bone quality, the two principal determinants of bone strength, will be assessed by peripheral quantitative computed tomography (pQCT) at weight-bearing (tibia) and non-weight-bearing (radius) skeletal sites. Peripheral QCT provides 3-dimensional bone measurements that are not confounded by changes in bone size, a significant confounder of most past studies, which have relied on 2-dimensional bone imaging techniques. To identify mechanistic factors, which may explain the effect of adiposity on bone development, we will measure arterial stiffness, endothelial function, and fasting levels of glucose, insulin, lipids, and C-reactive protein (CRP) to assess how vascular dysfunction, insulin resistance, abnormal lipids, and inflammation are related to bone modeling activity, as measured by serum markers of bone formation and resorption. All measurements will be assessed at baseline and after 1 and 2 years of follow-up.

Study Type

Observational

Enrollment (Anticipated)

400

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Georgia
      • Augusta, Georgia, United States, 30912
        • Recruiting
        • Medical College of Georgia; Augusta University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

9 years to 15 years (Child)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Probability Sample

Study Population

400 children and adolescents aged 9 to 15 years

Description

Inclusion Criteria:

  1. Otherwise healthy children and adolescents between 9 and 15 years old
  2. Subject and parent/guardian understands the study protocol and agrees to comply with it
  3. Informed Consent Form signed by the parent/guardian and assent signed by the subject

Exclusion Criteria:

  1. Subjects with (a history of) metabolic or gastrointestinal diseases including hepatic disorders
  2. Subjects presenting chronic degenerative and/or inflammatory diseases
  3. Subjects receiving systemic treatment or topical treatment likely to interfere with evaluation of the study parameters (salicylates, antibiotics)
  4. Subjects receiving corticosteroid treatment
  5. Subjects using oral anticoagulants
  6. Subjects who have participated in a clinical study more recently than one month before the current study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Prospective Cohort
400 otherwise healthy children and adolescents aged 9-15 years will be recruited to participate in a 2-year longitudinal study.
Other: Observational Study

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Bone mineral mass
Time Frame: Change from baseline bone mineral mass at 2 years
Measurement of bone quantity assessed by peripheral quantitative computed tomography
Change from baseline bone mineral mass at 2 years
Bone strength-strain index
Time Frame: Change from baseline bone strength-strain index at 2 years
Measurement of bone quality assessed by peripheral quantitative computed tomography
Change from baseline bone strength-strain index at 2 years

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Serum N-terminal propeptide of type 1 procollagen (P1NP)
Time Frame: Change from baseline P1NP at 2 years
Marker of bone formation as measured in serum
Change from baseline P1NP at 2 years
Serum C-terminal telopeptide of type 1 collagen (CTX)
Time Frame: Change from baseline CTX at 2 years
Marker of bone resorption as measured in serum
Change from baseline CTX at 2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Augusta University

Investigators

  • Principal Investigator: Norman K Pollock, Ph.D., Department of Medicine, Medical College of Georgia, Augusta University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

December 1, 2014

Primary Completion (Anticipated)

December 1, 2021

Study Completion (Anticipated)

December 30, 2021

Study Registration Dates

First Submitted

January 22, 2015

First Submitted That Met QC Criteria

January 30, 2015

First Posted (Estimate)

February 4, 2015

Study Record Updates

Last Update Posted (Actual)

November 20, 2019

Last Update Submitted That Met QC Criteria

November 18, 2019

Last Verified

November 1, 2019

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 616274

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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