BACKGROUND: Research has shown that lean body mass (LBM) is directly associated with bone mineral density (BMD) and bone mineral content (BMC) in adolescents. In addition, insulin hormone acts as an anabolic agent in bone formation. A mediating effect of greater LBM on lower insulin levels and increased bone health has been previously observed in similar populations. Therefore, the purpose of this study is to examine LBM as a mediator of insulin and bone health variables in high school seniors. METHODS: 84 participants (69% female, 18±1 years of age, Body Mass Index 24±5 kg/m^2) completed this cross-sectional study. Participants were recruited in their senior year of high school and completed one laboratory visit. Participants’ body composition and bone mineral density was measured via dual-energy X-ray absorptiometry (DXA) imaging including total lean body mass (TLBM), bone mineral density (BMD), bone mineral concentration (BMC), and Trabecular Bone Score (TBS) was analyzed using iNsightTM software. Participants' venous blood was drawn to assess fasted insulin levels. Serum insulin levels were analyzed via enzyme-linked immunoassay (ELISA). Multiple linear regression analysis was used to evaluate the relationship among the variables with significance set at p<0.05. RESULTS: TLBM, BMD, BMC and TBS were significantly correlated with one another (p<0.02). In particular, TLBM was positively correlated with BMC (r=0.78), BMD (r=0.65), and TBS (r=0.27), BMC was positively correlated with BMD (r=0.84) and TBS (r=0.34), and BMD and TBS were positively correlated (r=0.45). However, no significant correlations were observed for insulin and TLBM (r= -0.05, p=0.75), insulin and BMC (r= -0.03, p=0.84), insulin and BMD (r= -0.17, p=0.23), insulin and TBS (r= -0.13, p=0.38). DISCUSSION: Adolescents with higher TLBM have higher BMD, BMC and TBS. However, higher TLBM was not related to insulin levels suggesting there may not be a mediator relationship between insulin and bone health parameters in high school seniors. FUNDING: Funding for this project was provided by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R15HL159650 and Elon University Summer Undergraduate Research Experience.

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