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The Positive Relationship between Moderate-to-Vigorous Physical Activity and Bone Mineral Content Is Not Mediated by Free Leptin Index in Prepubertal Children: The PANIC Study.

  • Constable, Annie M1, 2
  • Porter, Josie E1
  • Benger, Danielle1
  • Vlachopoulos, Dimitris1
  • Barker, Alan R1
  • Moore, Sarah A3
  • Soininen, Sonja2, 4
  • Haapala, Eero A2, 5
  • Westgate, Kate6
  • Brage, Soren6
  • Agostinete, Ricardo R7
  • Fernandes, Romulo A7
  • Lakka, Timo A2, 8, 9
  • 1 Children's Health and Exercise Research Centre, Sport and Health Sciences, University of Exeter, Exeter EX1 1TX, UK.
  • 2 Institute of Biomedicine, Kuopio Campus, University of Eastern Finland, FI-70211 Kuopio, Finland. , (Finland)
  • 3 School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada. , (Canada)
  • 4 Social and Health Center, 78300 City of Varkaus, Finland. , (Finland)
  • 5 Faculty of Sport and Health Sciences, University of Jyväskylä, 40014 Jyväskylä, Finland. , (Finland)
  • 6 MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge CB2 0SL, UK.
  • 7 Laboratory of InVestigation in Exercise (LIVE), Department of Physical Education, Sao Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil. , (Brazil)
  • 8 Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Eastern Finland, 70210 Kuopio, Finland. , (Finland)
  • 9 Foundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, 70100 Kuopio, Finland. , (Finland)
Published Article
International Journal of Environmental Research and Public Health
Publication Date
May 18, 2021
DOI: 10.3390/ijerph18105365
PMID: 34069919


Moderate-to-vigorous physical activity (MVPA) positively influences bone mineral content (BMC) in prepubertal children, but it is unknown whether this relationship is partially mediated by free leptin index. The aim of this study was to examine whether the relationship between MVPA and total body less head (TBLH) BMC is mediated or moderated by free leptin index in prepubertal children. We performed a cross-sectional analysis on 401 children (194 girls) from baseline examinations of the Physical Activity and Nutrition in Childhood Study. We applied the four-way decomposition mediation analysis method to assess whether free leptin index, measured from fasted blood samples, mediated the relationship between accelerometer-measured MVPA and TBLH BMC measured by dual-energy X-ray absorptiometry. MVPA had a positive controlled direct effect on TBLH BMC in girls and boys (β = 0.010 to 0.011, p < 0.05). There was no mediation or interaction between MVPA, free leptin index and TBLH BMC in girls or boys (β = -0.000 to 0.001, p > 0.05). Our study indicates that MVPA positively influences TBLH BMC through pathways not related to free leptin index in predominantly normal-weight prepubertal children, likely primarily through mechanical loading. The relationships between MVPA, free leptin index and TBLH BMC may be influenced by other factors such as pubertal status and adiposity, so it is unknown whether these observations extend to overweight and obese children at different stages of puberty.

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