External skeletal robustness and adiposity in adolescents of low socioeconomic status: A cross-sectional analysis of body composition

Objectives: External skeletal robustness has been decreasing in children, potentially due to a lack of physical activity and the increased prevalence of obesity. However, whether socioeconomic status (SES) influences external skeletal robustness in adolescents has not yet been examined. Methods: A cross-sectional study was performed to examine 370 Chilean adolescents (16.15 ± 1.01 years old) recruited from distinct educational establishments. Body fat percentage (BF%) was evaluated using Ellis' equations for Hispanic children. Obesity was defined as ≥25 BF% in males and ≥ 30 BF% in females. External skeletal robustness was obtained by measuring the humerus biepicondylar width and height (Frame-Index). SES was obtained through the ESOMAR survey. Results: Females exhibited significantly greater BF% and lower Frame-Index values than males (P <.001). Obese adolescents (by BF%) had greater Frame-Index values than non-obese adolescents (P <.001). Females of medium-high SES had significantly lower BF% and Frame-Index values than females of medium and medium-low SES. BF% had a positive correlation with Frame-Index values in all SES groups studied, except in males of medium-high SES. As SES decreased, the correlation increased in both sexes, but overall, the correlation was greater in females than males. Conclusions: The results of this investigation suggest that obesity increases external skeletal robustness in adolescents. Additionally, lower SES corresponded to higher BF% and Frame-Index values. Therefore, modern conditions that influence the prevalence of obesity in adolescence could be affecting bone health in adolescents, primarily in females of medium-low SES.