Subcutaneous adipose tissue is a positive predictor for bone mineral density in prepubertal children with Prader–Willi syndrome independent of lean mass

<jats:title>Abstract</jats:title> <jats:sec id="j_jpem-2021-0749_abs_001"> <jats:title>Objectives</jats:title> <jats:p>Emerging evidence suggests a fat depot-specific relationship with bone mineral density (BMD) in children, particularly in those who are overweight/obese. However, this has not yet been investigated in detail in children with Prader–Willi syndrome (PWS), a genetic syndrome characterized by a decreased lean mass (LM) and increased fat mass (FM). The objective of this study is to investigate the relationships of LM and FM, particularly fat distribution, with bone mineral parameters.</jats:p> </jats:sec> <jats:sec id="j_jpem-2021-0749_abs_002"> <jats:title>Methods</jats:title> <jats:p>This is a retrospective and cross-sectional study. Forty-seven prepubertal Japanese children with PWS (22 males, mean age: 6.86 years) were included. No subjects had type 2 diabetes mellitus or osteoporotic medications. LM, FM, and BMD and bone mineral content in the total body less head and the lumbar spine were measured using dual-energy x-ray absorptiometry, in addition to subcutaneous/visceral adipose tissue (SAT/VAT), and the ratio of VAT to SAT (V/S) by computed tomography at the umbilical level. Bone mineral apparent density was calculated to correct for bone size.</jats:p> </jats:sec> <jats:sec id="j_jpem-2021-0749_abs_003"> <jats:title>Results</jats:title> <jats:p>LM positively correlated with bone mineral parameters after controlling for age, sex, growth hormone (GH) treatment, and FM. Although FM did not correlate with bone mineral parameters, compartment-specific analysis revealed that SAT positively and V/S negatively correlated with bone mineral parameters after controlling for age, sex, GH treatment and LM.</jats:p> </jats:sec> <jats:sec id="j_jpem-2021-0749_abs_004"> <jats:title>Conclusions</jats:title> <jats:p>A compartment-specific effect of FM on bone mineral parameters was noted such that SAT was a positive predictor for BMD independent of LM in prepubertal children with PWS.</jats:p> </jats:sec>