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Masztalerz-Kozubek D, Zielinska-Pukos MA, Hamulka J. Sex-specific effects of a Mediterranean diet on lower limb bone strength in Polish children. Bone 2024; 189:117252. [PMID: 39241853 DOI: 10.1016/j.bone.2024.117252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/15/2024] [Accepted: 09/03/2024] [Indexed: 09/09/2024]
Abstract
Lifestyle factors have the potential to influence bone health in various ways, whether positively or negatively. As osteoporosis is believed to originate in early years, it is therefore essential to indicate factors that may positively affect bone health during childhood. The aim of our study was to investigate the effects of early and current diet, vitamin D supplementation, and BMI z-score on bone properties in a group of children aged 3-7 years. A cross-sectional sample of 205 preschoolers and their parents participated in the study. Dietary assessment was made using a modified version of the Polish-adapted Mediterranean Diet score (MVP-aMED) on the basis of the data from food frequency questionnaire (FFQ), filled out by the parents. Quantitative ultrasound (QUS) was used in the assessment of bone properties. In the sex-stratified analysis, significant associations were observed between MVP-aMED score (β = 0.193, 95 % CI: 0.005, 0.237; p = 0.04), BMI z-score (β = -0.318, 95 % CI: -1.455, -0.039; p = 0.04) and QUS z-score, exclusively among girls. After adjustment, only the relationship with diet remained significant (β = 0.209, 95 % CI: 0.007, 0.255; p = 0.04), suggesting that a higher adherence to the Mediterranean Diet may be associated with better bone properties in girls aged 3-7 years old. Our results emphasize the importance of fostering healthy dietary habits and maintaining proper weight in children in order to promote optimal bone development.
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Affiliation(s)
- Daria Masztalerz-Kozubek
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Monika A Zielinska-Pukos
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland
| | - Jadwiga Hamulka
- Department of Human Nutrition, Institute of Human Nutrition Sciences, Warsaw University of Life Sciences (SGGW-WULS), Warsaw, Poland.
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Becetti I, Singhal V, Nimmala S, Lee H, Lawson EA, Bredella MA, Misra M. Serum Oxytocin Levels Decrease 12 Months Following Sleeve Gastrectomy and Are Associated with Decreases in Lean Mass. Int J Mol Sci 2023; 24:10144. [PMID: 37373292 DOI: 10.3390/ijms241210144] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/10/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Oxytocin (OXT), an anorexigenic hormone, is also bone anabolic. Further, OXT administration results in increases in lean mass (LM) in adults with sarcopenic obesity. We examine, for the first time, associations of OXT with body composition and bone endpoints in 25 youth 13-25 years old with severe obesity who underwent sleeve gastrectomy (SG) and 27 non-surgical controls (NS). Forty participants were female. Subjects underwent fasting blood tests for serum OXT and DXA for areal bone mineral density (aBMD) and body composition. At baseline, SG vs. NS had higher median body mass index (BMI) but did not differ for age or OXT levels. Over 12 months, SG vs. NS had greater reductions in BMI, LM, and fat mass (FM). OXT decreased in SG vs. NS 12 months post-SG. While baseline OXT predicted a 12-month BMI change in SG, decreases in OXT levels 12 months post-SG were not associated with decreases in weight or BMI. In SG, decreases in OXT were positively associated with decreases in LM but not with decreases in FM or aBMD. Loss of LM, a strong predictor of BMD, after bariatric surgery may reduce functional and muscular capacity. OXT pathways may be targeted to prevent LM loss following SG.
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Affiliation(s)
- Imen Becetti
- Division of Pediatric Endocrinology, Mass General for Children and Harvard Medical School, Boston, MA 02114, USA
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Vibha Singhal
- Division of Pediatric Endocrinology, Mass General for Children and Harvard Medical School, Boston, MA 02114, USA
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Pediatric Program, MGH Weight Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Supritha Nimmala
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Elizabeth A Lawson
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Miriam A Bredella
- Department of Radiology, Musculoskeletal Imaging and Interventions, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Madhusmita Misra
- Division of Pediatric Endocrinology, Mass General for Children and Harvard Medical School, Boston, MA 02114, USA
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
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Yao W, Luo J, Ao L, Cheng H, Lu S, Liu J, Lu K, Mi J, Yang Y, Liu L. Association of total body fat and fat distribution with bone mineral density among children and adolescents aged 6-17 years from Guangzhou, China. Eur J Pediatr 2023; 182:1115-1126. [PMID: 36580174 DOI: 10.1007/s00431-022-04727-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 12/30/2022]
Abstract
This study aimed to assess the associations of total body fat and fat distribution with bone mineral density (BMD) among children and adolescents in this cross-sectional study. A total of 1032 boys and 897 girls aged 6-17 years were enrolled between May 2019 and June 2019 in Guangzhou, China. BMD, total body fat (fat mass index [FMI] and body fat percentage [BF%]), and fat distribution (trunk-to-limb and android-to-gynoid ratios) were measured by dual-energy X-ray absorptiometry. Inverse probability of treatment weighting regression was used to explore the association between fat and BMD. Traditional regression of covariate adjustment was applied as sensitivity analysis. Regression with inverse probability weighting suggested BF% and android-to-gynoid ratio were negatively associated with BMD in boys (β = - 0.12 and - 0.16, respectively; P < 0.05). Android-to-gynoid ratio was also inversely associated with BMD in girls (β = - 0.08, P < 0.05). When stratified by age, the negative associations were retained in boys aged 12-17 years (β = - 0.23 and - 0.25, respectively; P < 0.001). But for girls, it showed a positive association of FMI with BMD in the 6-9 years group (β = 0.33, P < 0.001) and a negative association between the android-to-gynoid ratio and BMD in the 10-17 years group (β = - 0.10, P < 0.05). Traditional regression supported the robustness of the results. Conclusion: Total body fat is positively associated with BMD in younger girls but inversely associated in older boys. As for abdominal adipose, it is associated with lower BMD in both older boys and girls. What is Known: • The lean mass has been consistently positively associated with bone mineral density (BMD) among children and adolescents. However, the impact of fat mass on BMD remained controversial. • Beyond total body fat, site-specific fat mass, especially abdominal adiposity, might impede bone formation. What is New: • The associations of total body fat and fat distribution with BMD in children and adolescents were gender- and age-specific. • More attention should be paid to the abdominal fat accumulation to promote bone health in older children.
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Affiliation(s)
- Wanwen Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Jiepeng Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Liping Ao
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Hong Cheng
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Shuang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Junting Liu
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Keyuan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China
| | - Jie Mi
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
- Department of Non-communicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
| | - Yi Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China.
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510310, China.
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Baxter-Jones ADG, Jackowski SA. Sex differences in bone mineral content and bone geometry accrual: a review of the Paediatric Bone Mineral Accural Study (1991-2017). Ann Hum Biol 2022; 48:503-516. [PMID: 35105203 DOI: 10.1080/03014460.2021.2014568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
CONTEXT Girls' and boys' growth patterns differ in timing and tempo, and they have different lifestyles with regards to diet and physical activity. These factors have all been linked with bone mineral accrual. OBJECTIVE To identify the associations of boys' and girls' growth, maturation, and lifestyle choices relating to parameters of bone geometry and mineral accrual. METHODS Between 1991 and 1993, 251 children aged 8-15 years were recruited into a mixed-longitudinal cohort study (The Paediatric Bone Mineral Accrual Study (PBMAS)) and followed repeatedly over 26 years. RESULTS It was found that girls matured approximately two years earlier than boys (11.8 vs. 13.4 years) but on average were shorter, had less lean mass and had greater fat mass (p < 0.05). There was a dissociation between the growth of bone and its mineralisation in both sexes. Boys had greater bone mass and bone geometry (p < 0.05). Both a healthy childhood diet and high levels of physical activity were associated with improved bone parameters. CONCLUSIONS Most, but not all, of the sex differences observed, were explained by height and lean mass differences. The importance of diet and physical activity on obtaining optimal bone mass during adolescence in both sexes was also paramount.
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Affiliation(s)
| | - Stefan A Jackowski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada.,Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Canada
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Association of Body Compositions and Bone Mineral Density in Chinese Children and Adolescents: Compositional Data Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:1904343. [PMID: 34761003 PMCID: PMC8575617 DOI: 10.1155/2021/1904343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/22/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the relationship between body compositions and bone mineral density (BMD) and the effect of composition substitution among Chinese children and adolescents without the influence of multicollinearity. A dual-energy X-ray absorptiometry scan was used to determine the amount of truncal fat (TF), nontruncal fat (NTF), fat-free mass (FFM), and BMD. The compositional data analysis and the compositional proportional substitution analysis were conducted to determine the effect of each part of body compositions on BMD and its substitution effects. Four hundred sixty-six (466) (boys: 51.9%) participants completed this cross-sectional study. For girls, in the overweight group, the relationship between TF and the BMD was positive (β = 2.943e - 01, p = 0.006) while the NTF showed the opposite trend (β = -2.358e - 01, p = 0.009). When 4% NTF or FFM was substituted by TF, the BMD increased by about 0.1 and 0.05 units (p < 0.05), respectively. For boys, the association between FFM and BMD was statistically positive (β = 4.091e - 02, p = 0.0001). There was a positive correlation between TF and BMD (β = 7.963e - 02, p = 0.036). But with the increase of BMI, this correlation shifted in the opposite direction. In conclusion, compared to TF and NTF, FFM had a better protective effect on BMD, especially for boys. The risk of NTF accumulation on BMD was greater than that of TF accumulation. Compared with girls, boys were more sensitive to the amount of TF.
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Relationship between the changes over time of bone mass and muscle health in children and adults: a systematic review and meta-analysis. BMC Musculoskelet Disord 2019; 20:429. [PMID: 31521141 PMCID: PMC6745072 DOI: 10.1186/s12891-019-2752-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background Various cross-sectional studies provide an abundance of evidence that shows a relationship between bone quantity and muscle health. However, one question remains, less-often studied: is their development - or decline – associated? The aim of the research was to conduct a systematic review and meta-analysis to summarize the studies exploring the association between changes in bone mineral density (BMD) and changes in muscle parameters (registration CRD42018093813). Methods We searched for prospective studies, both in children and adults, by consulting electronic databases (Ovid-MEDLINE, Ovid-AMED, Scopus). Each review steps were performed by two independent reviewers. For outcomes reported by less of 3 studies, we synthetized the results narratively. In other cases, a meta-analysis was performed, giving an overall r coefficient and its 95% confidence interval (CI). Results Fifteen papers were included. In connection with the change of BMD, 10 studies concerned the parallel change of lean mass, 4 were about grip strength, and 1 was about physical performance. Children were the population of interest for 5 studies, while the aging population was the focus of the other studies. The correlation between hip BMD and lean mass was significant, with an overall coefficient r = 0.37 (95% CI 0.23–0.49). High heterogeneity was observed between studies but the length of follow-up, sex and study quality did not seem to significantly influence results. The systematic review allowed some other highlights: a significant link between changes in BMD and changes in muscle strength was observed (p-value < 0.05 in the 4 studies), in addition to changes in performance (1 study, r = 0.21, p-value = 0.004). Conclusion Despite the heterogeneity between studies, we highlighted a significant association between the change of BMD and the change of various muscle parameters. Future studies should investigate preventive and therapeutic strategies that are based on a single entity: the ‘muscle-bone unit’.
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Cetin N, Gencler A, Sivrikoz IA. Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2019; 30:853-862. [PMID: 31464242 DOI: 10.4103/1319-2442.265461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Children with idiopathic nephrotic syndrome are primarily treated with glucocorticoids (GCs), but long-term GC use can lead to undesired side effects. We investigated the bone mineral density (BMD) and 25-hydroxyvitamin D (25-OH D) levels in children with the remission phase of steroid-sensitive nephrotic syndrome (SSNS). This study included 32 patients with SSNS who had not received GC treatment in the last 6 months and a control group of 20 healthy children. Serum levels of calcium, phosphate, alkaline phosphatase, 25-(OH)D, and parathyroid hormone (PTH) were measured. BMD was determined in the lumbar spinal region using dual-energy X-ray absorptiometry (DEXA). Serum 25-(OH)D levels were lower in the SSNS patients than in the healthy children (P <0.05), with 22 patients (68.8%) having Z-scores <-1. The Z-scores were positively correlated with 25-(OH)D levels (r = 0.424, P <0.05). PTH levels were higher in patients with osteoporosis than in patients with Z-scores ≥-1 (P <0.05). Bone mineral content and BMD were positively correlated with the age of diagnosis (P <0.01). Receiver-operating characteristic curve analysis showed that the cutoff value of 25-(OH)D levels for predicting low BMD was 14.67 ng/mL with a sensitivity of 90% and a specificity of 64%. The area under the curve (AUC ± standard error) was 0.868 ± 0.064 (95% confidence interval: 0.742-0.994, P = 0.001). Decreased 25-(OH)D levels and the negative effects of long-term GC treatment on BMD persist in SSNS remission phase. Levels of 25-(OH)D <14.67 ng/mL could predict abnormal DEXA scans in children with SSNS remission phase.
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Affiliation(s)
- Nuran Cetin
- Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Aylin Gencler
- Department of Pediatric Nephrology, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Ilknur Ak Sivrikoz
- Department of Nuclear Medicine, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey
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Rønne MS, Heidemann M, Lylloff L, Schou AJ, Tarp J, Bugge A, Laursen JO, Jørgensen NR, Husby S, Wedderkopp N, Mølgaard C. Bone mass development is sensitive to insulin resistance in adolescent boys. Bone 2019; 122:1-7. [PMID: 30738213 DOI: 10.1016/j.bone.2019.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE Insulin resistance may exert a negative influence on bone mass in childhood and adolescence. The objective was to assess the association between insulin resistance and total body less head (TBLH) bone mineral content (BMC) and to investigate whether body composition, physical activity or osteocalcin levels may influence this association. METHODS A longitudinal study with follow-up over more than 6 years was performed and included 562 apparently healthy participants with a mean age of 9.6 years at baseline. Participants underwent DXA scanning at baseline. At the two follow-ups, participants had performed another DXA scanning, had blood samples taken for fasting insulin, glucose and osteocalcin and had physical activity measured with an accelerometer. HOMA-IR was calculated as an index of insulin resistance. RESULTS HOMA-IR was negatively associated with TBLH BMC in boys at follow-ups (β = -31.4, p < 0.001) after adjustment for maturity, height, bone area, and baseline level of TBLH BMC. The negative association remained almost unchanged after further adjustments for body composition and physical activity. No association between HOMA-IR and TBLH BMC was found in girls. CONCLUSION Insulin resistance may be detrimental for bone development through puberty in boys independent of body composition and the level of physical activity.
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Affiliation(s)
- Maria Sode Rønne
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark.
| | - Malene Heidemann
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark
| | - Louise Lylloff
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; Department of Clinical Biochemistry, Hospital Unit West, Gl. Landevej 61, 7400 Herning, Denmark
| | - Anders J Schou
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark
| | - Jakob Tarp
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Anna Bugge
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Physiotherapy and Occupational Therapy, University College Copenhagen, Sigurdsgade 26, 2200 København N, Denmark
| | - Jens Ole Laursen
- Emergency Department, Hospital of South Jutland, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; OPEN, Odense Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, J.B.Winsløws Vej 9 A, 3, 5000 Odense C, Denmark
| | - Steffen Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Orthopaedics, Hospital of Southwestern Denmark, Finsensgade 34, 6700 Esbjerg, Denmark
| | - Christian Mølgaard
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 København N, Denmark
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Individualized evaluation of lumbar bone mineral density in children with cerebral palsy. Arch Osteoporos 2018; 13:120. [PMID: 30397843 DOI: 10.1007/s11657-018-0531-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 09/04/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED Lumbar spine bone mineral density (LS-BMD) assessed by dual-energy X-ray absorptiometry (DXA) is used in children with cerebral palsy (CP) to evaluate bone health. LS-BMD results in children with CP are influenced significantly by their height, BMI, and mobility level. An adjustment for these parameters might improve the clinical significance of the method. PURPOSE/INTRODUCTION DXA evaluation is considered useful in children with CP to assess bone health. For this purpose, LS-BMD is often used. The aim of the study was to estimate the effect of height, BMI, and reduced mobility level of children with CP on LS-BMD and to develop a method to adjust individual results of LS-BMD for these factors. METHODS We conducted a monocentric retrospective analysis of data collected in children and adolescents with CP, who participated in a rehabilitation program and had no history of recurrent fractures. The DXA scan was part of the routine examination for participants older than 4 years of age. The relationship between height and BMI for age Z-scores and age-adjusted LS-BMD Z-scores was analyzed. RESULTS LS-DXA scans of 500 children and adolescents with CP (Gross Motor Function Classification System levels I-V) were included in the statistical analysis (217 female). The mean age was 9.4 years (± 3.7 years). Children with moderate to severe CP had significantly (p < 0.001) lower LS-BMD Z-scores than children with mild CP. We provided nomograms to adjust individual LS-BMD results to their height, BMI, and mobility level. CONCLUSIONS LS-BMD results in children with CP were influenced significantly by their height, BMI, and mobility level. An adjustment of the LS-BMD results to height, BMI, and mobility level might improve the clinical significance of an individual result.
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Liang X, Wu C, Zhao H, Liu L, Du Y, Li P, Wen Y, Zhao Y, Ding M, Cheng B, Cheng S, Ma M, Zhang L, Guo X, Shen H, Tian Q, Zhang F, Deng HW. Assessing the genetic correlations between early growth parameters and bone mineral density: A polygenic risk score analysis. Bone 2018; 116:301-306. [PMID: 30172743 PMCID: PMC6298225 DOI: 10.1016/j.bone.2018.08.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The relationships between early growth parameters and bone mineral density (BMD) remain elusive now. In this study, we performed a large scale polygenic risk score (PRS) analysis to evaluate the potential impact of early growth parameters on the variations of BMD. METHODS We used 2286 Caucasian subjects as cohort 1 and 3404 Framingham Heart Study (FHS) subjects as cohort 2 in this study. BMD at ulna & radius, hip and spine were measured using dual energy X-ray absorptiometry. BMD values were adjusted for age, sex, height and weight as covariates. Genome-wide single-nucleotide polymorphism (SNP) genotyping of the 2286 Caucasian subjects was performed using Affymetrix Human SNP Array 6.0. The GWAS datasets of early growth parameters were driven from the Early Growth Genetics Consortium, including birth weight (BW), birth head circumference (BHC), childhood body mass index (CBMI), pubertal height growth related indexes and tanner stage. Polygenic Risk Score (PRSice) and linkage disequilibrium (LD) score regression analysis were conducted to assess the genetic correlation between early growth parameters and BMD. RESULTS We detected significant genetic correlations in cohort 1, such as total spine BMD vs. CBMI (p value = 1.51 × 10-4, rg = 0.4525), right ulna and radius BMD vs. CBMI (p value = 1.51 × 10-4, rg = 0.4399) and total body BMD vs. tanner stage (p value = 7.00 × 10-4, rg = -0.0721). For cohort 2, significant correlations were observed for total spine BMD vs. height change standard deviation score (SDS) between 8 years and adult (denoted as PGF + PGM) (p value = 3.97 × 10-4, rg = -0.1425), femoral neck BMD vs. the timing of peak height velocity by looking at the height change SDS between age 14 years and adult (denoted as PTF + PTM) (p value = 7.04 × 10-4, rg = -0.2185), and total spine BMD vs. PTF + PTM (p value = 6.86 × 10-4, rg = -0.2180). CONCLUSION Our study results suggest that some early growth parameters could affect the variations of BMD.
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Affiliation(s)
- Xiao Liang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - CuiYan Wu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Hongmou Zhao
- Department of Orthopedics Surgery, Red Cross Hospital, Xi'an 710054, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yanan Du
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Ping Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Zhao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Miao Ding
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Mei Ma
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Lu Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Xiong Guo
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Hui Shen
- Center for Bioinformatics and Genomics, Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, USA
| | - Qing Tian
- Center for Bioinformatics and Genomics, Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, USA
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
| | - Hong-Wen Deng
- Center for Bioinformatics and Genomics, Department of Global Biostatistics and Data Science, School of Public Health and Tropical Medicine, Tulane University, USA.
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11
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Duran I, Martakis K, Rehberg M, Semler O, Schoenau E. Individualized evaluation of lumbar bone mineral density and bone mineral apparent density in children and adolescents. Arch Osteoporos 2018; 13:117. [PMID: 30374788 DOI: 10.1007/s11657-018-0532-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 10/18/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED Lumbar spine bone mineral density (LS-BMD) assessed by dual-energy X-ray absorptiometry (DXA) is used in children to evaluate bone health. LS-BMD results in children are influenced significantly by height and BMI. An adjustment for these parameters may improve the clinical use of the method. PURPOSE/INTRODUCTION DXA evaluation is considered useful in children to assess bone health. For this purpose, lumbar spine bone mineral density (LS-BMD) and bone mineral apparent density (LS-BMAD) are often used. The aim of the study was to estimate the effect of height and BMI on LS-BMD and LS-BMAD in children and adolescents and to develop a method to adjust individual results for these factors. METHODS As part of the National Health and Nutrition Examination Survey (NHANES) study, between the years 2005 and 2010 lumbar DXA scans on randomly selected Americans from 8 to 20 years of age were carried out. From all eligible DXA scans, three major US ethnic groups were evaluated (Non-Hispanic Whites, Non-Hispanic Blacks, and Mexican Americans) for further statistical analysis. The relationship between height as well as BMI for age Z-scores and age-adjusted LS-BMD and LS-BMAD Z-scores was analyzed. RESULTS For the statistical analysis, the DXA scans of 1799 non-Hispanic White children (823 females), of 1696 non-Hispanic Black children (817 females), and of 1839 Mexican American children (884 females) were eligible. The statistical analysis showed that taller and heavier children had significantly (p < 0.001) higher age-adjusted LS-BMD Z-scores than shorter and lighter children. But on LS-BMAD, only BMI and not height had a significant influence. CONCLUSIONS LS-BMD results in children were influenced significantly by their height and BMI, the LS-BMAD results were only influenced by their BMI. For the first time, the proposed method adjusts LS-BMD and LS-BMAD to BMI. An adjustment of the LS-BMD and LS-BMAD results to these factors might improve the clinical significance of an individual result.
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Affiliation(s)
- Ibrahim Duran
- Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.
| | - K Martakis
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany.,Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - M Rehberg
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
| | - O Semler
- Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany.,Center for Rare Skeletal Diseases in Childhood, University of Cologne, Cologne, Germany
| | - E Schoenau
- Center of Prevention and Rehabilitation, UniReha, University of Cologne, Lindenburger Allee 44, 50931, Cologne, Germany.,Children's and Adolescents' Hospital, University of Cologne, Cologne, Germany
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12
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Hyde AM, Chavoya FA, Silveira FV, Beam WC, Rubin DA. Metabolic responses to walking in children with Prader‐Willi syndrome on growth hormone replacement therapy. Am J Med Genet A 2018; 176:2513-2516. [DOI: 10.1002/ajmg.a.40509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/17/2018] [Accepted: 07/19/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Adam M. Hyde
- Department of Kinesiology California State University Fullerton California
| | - Frank A. Chavoya
- Department of Kinesiology California State University Fullerton California
| | | | - William C. Beam
- Department of Kinesiology California State University Fullerton California
| | - Daniela A. Rubin
- Department of Kinesiology California State University Fullerton California
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13
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Rønne MS, Heidemann M, Schou A, Laursen JO, Bojesen AB, Lylloff L, Husby S, Wedderkopp N, Mølgaard C. Tracking of bone mass from childhood to puberty: a 7-year follow-up. The CHAMPS study DK. Osteoporos Int 2018; 29:1843-1852. [PMID: 29947870 DOI: 10.1007/s00198-018-4556-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 04/27/2018] [Indexed: 02/07/2023]
Abstract
UNLABELLED Bone mass in childhood is highly influenced by puberty. At the same age, bone mass was higher for pubertal than pre-pubertal children. A high level of tracking during 7 years from childhood through puberty was shown, indicating that early levels of bone mass may be important for later bone health. INTRODUCTION Bone mass development in childhood varies by sex and age, but also by pubertal stage. The objectives of this study were to (1) describe bone mass development in childhood as it relates to pubertal onset and to (2) determine the degree of tracking from childhood to adolescence. METHODS A longitudinal study with 7 years of follow-up was initiated in 2008 to include 831 children (407 boys) aged 8 to 17 years. Participants underwent whole body dual-energy X-ray absorptiometry (DXA) scanning, blood collection to quantify luteinizing hormone levels, and Tanner stage self-assessment three times during the 7-year follow-up. Total body less head bone mineral content, areal bone mineral density, and bone area were used to describe development in bone accrual and to examine tracking over 7 years. RESULTS Bone mass in pubertal children is higher than that of pre-pubertal children at the same age. Analysing tracking with quintiles of bone mass Z-scores in 2008 and 2015 showed that more than 80% of participants remained in the same or neighbouring quintile over the study period. Tracking was confirmed by correlation coefficients between Z-scores at baseline and 7-year follow-up (range, 0.80-0.84). CONCLUSIONS Bone mass is highly influenced by pubertal onset, and pubertal stage should be considered when examining children's bone health. Because bone mass indices track from childhood into puberty, children with low bone mass may be at risk of developing osteoporosis later in life.
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Affiliation(s)
- M S Rønne
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark.
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000, Odense C, Denmark.
| | - M Heidemann
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark
| | - A Schou
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark
| | - J O Laursen
- Emergency Department, Hospital of South Jutland, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark
| | - A B Bojesen
- Hospital of South Jutland, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark
| | - L Lylloff
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Valdemar Hansens Vej 1-23, 2600, Glostrup, Denmark
- Department of Clinical Biochemistry, Hospital Unit West, Gl. Landevej 61, 7400, Herning, Denmark
| | - S Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark
- Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000, Odense C, Denmark
| | - N Wedderkopp
- Research in Childhood Health, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - C Mølgaard
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000, Odense C, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark
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14
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Birth size, body composition, and adrenal androgens as determinants of bone mineral density in mid-childhood. Pediatr Res 2018; 83:993-998. [PMID: 29360806 DOI: 10.1038/pr.2018.12] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/18/2017] [Indexed: 01/24/2023]
Abstract
BackgroundBirth weight has an impact on adult bone mass. Higher birth weight is associated with greater bone mineral content (BMC) and children born small for gestational age (SGA) are at an increased risk for impaired accrual of bone mass. Our aim was to study whether the impact of birth size or early childhood growth on bone mass is visible already in mid-childhood.MethodsWe studied 49 children born large for gestational age (LGA), 56 children born appropriate for gestational age (AGA), and 23 children born SGA at 5.0-8.7 years of age. Body composition was assessed by whole-body dual-energy X-ray absorptiometry. Fasting blood samples and anthropometric data were collected.ResultsThe children born SGA had lower bone mineral density (BMD) Z-score (P<0.001) and age- and sex-adjusted BMD (P<0.005) than the LGA and AGA children. Adjusted BMC, muscle mass, and body fat percentage (%BF) did not differ between the study groups. Muscle mass, BMI SD score (SDS), %BF, and serum dehydroepiandrosterone sulfate (DHEAS) concentration were the strongest predictors of high BMD in mid-childhood.ConclusionSGA-born children had lower BMD in mid-childhood compared with AGA- and LGA-born ones. Muscle mass or BMI SDS, %BF, and DHEAS were significant predictors of childhood BMD.
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15
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Soininen S, Sidoroff V, Lindi V, Mahonen A, Kröger L, Kröger H, Jääskeläinen J, Atalay M, Laaksonen DE, Laitinen T, Lakka TA. Body fat mass, lean body mass and associated biomarkers as determinants of bone mineral density in children 6-8years of age - The Physical Activity and Nutrition in Children (PANIC) study. Bone 2018; 108:106-114. [PMID: 29307776 DOI: 10.1016/j.bone.2018.01.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 11/24/2017] [Accepted: 01/03/2018] [Indexed: 11/23/2022]
Abstract
Lean body mass (LM) has been positively associated with bone mineral density (BMD) in children and adolescents, but the relationship between body fat mass (FM) and BMD remains controversial. Several biomarkers secreted by adipose tissue, skeletal muscle, or bone may affect bone metabolism and BMD. We investigated the associations of LM, FM, and such biomarkers with BMD in children. We studied a population sample of 472 prepubertal Finnish children (227 girls, 245 boys) aged 6-8years. We assessed BMD, LM, and FM using whole-body dual-energy x-ray absorptiometry and analysed several biomarkers from fasting blood samples. We studied the associations of LM, FM, and the biomarkers with BMD of the whole body excluding the head using linear regression analysis. LM (standardized regression coefficient β=0.708, p<0.001), FM (β=0.358, p<0.001), and irisin (β=0.079, p=0.048) were positive correlates for BMD adjusted for age, sex, and height in all children. These associations remained statistically significant after further adjustment for LM or FM. The positive associations of dehydroepiandrosterone sulphate (DHEAS), insulin, homeostatic model assessment for insulin resistance (HOMA-IR), leptin, free leptin index, and high-sensitivity C-reactive protein and the negative association of leptin receptor with BMD were explained by FM. The positive associations of DHEAS and HOMA-IR with BMD were also explained by LM. Serum 25-hydroxyvitamin D was a positive correlate for BMD adjusted for age, sex, and height and after further adjustment for FM but not for LM. LM and FM were positive correlates for BMD also in girls and boys separately. In girls, insulin, HOMA-IR, leptin, and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height, and FM, none of the biomarkers was associated with BMD. In boys, leptin and free leptin index were positively and leptin receptor was negatively associated with BMD adjusted for age, height, and LM. After adjustment for age, height and FM, 25(OH)D was positively and IGF-1 and leptin were negatively associated with BMD. FM strongly modified the association between leptin and BMD. LM but also FM were strong, independent positive correlates for BMD in all children, girls, and boys. Irisin was positively and independently associated with BMD in all children. The associations of other biomarkers with BMD were explained by LM or FM.
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Affiliation(s)
- Sonja Soininen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Institute of Dentistry, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Social and Health Center, City of Varkaus, Savontie 55, 78300 Varkaus, Finland.
| | - Virpi Sidoroff
- Department of Pediatrics, North-Karelia Central Hospital, Tikkamäentie 16, 80210 Joensuu, Finland.
| | - Virpi Lindi
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Anitta Mahonen
- Institute of Biomedicine, Medical Biochemistry, School of Medicine, University of Eastern Finland, PO Box 1627, Kuopio, Finland.
| | - Liisa Kröger
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Heikki Kröger
- Department of Orthopedics and Traumatology, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Musculoskeletal Research Unit (KMRU), University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital, University of Eastern Finland, PO Box 100, 70029 Kuopio, Finland.
| | - Mustafa Atalay
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland.
| | - David E Laaksonen
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Internal Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland.
| | - Timo A Lakka
- Institute of Biomedicine, Physiology, School of Medicine, University of Eastern Finland, PO Box 1627, 70211 Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, PO Box 100, 70029 Kuopio, Finland; Kuopio Research Institute of Exercise Medicine, Haapaniementie 16, 70100 Kuopio, Finland.
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Kouda K, Ohara K, Nakamura H, Fujita Y, Jaalkhorol M, Iki M. Fat mass is positively associated with bone mass acquisition in children with small or normal lean mass: A three-year follow-up study. Bone 2018; 107:222-227. [PMID: 29313815 DOI: 10.1016/j.bone.2017.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/14/2017] [Accepted: 12/02/2017] [Indexed: 11/27/2022]
Abstract
The independent impact of fat mass (FM) on bone health is difficult to assess, as FM is correlated with lean soft tissue mass (LSTM). In a previous cross-sectional study, FM was suggested to help promote high bone mass acquisition in adolescents with small LSTM. The present prospective cohort study investigated the effects of FM on bone in pubertal children after stratification by height-normalized index of LSTM (LSTMI). The source population was all 5th grade children enrolled in either one of the two public elementary schools in Hamamatsu, Japan. Of these, 545 children who participated in both baseline (at age 11) and follow-up (at age 14) surveys were included in the present analysis. Body composition and whole body areal bone mineral density (aBMD) were measured using dual-energy X-ray absorptiometry. From baseline to follow-up, significant (P<0.05) differences were observed in changes in aBMD among tertiles of change in FM in both sexes after adjusting for confounding factors including LSTMI. After stratification by tertiles of sex-specific LSTMI, adjusted means of changes in aBMD according to tertiles of change in FM within the lowest and second lowest tertiles of LSTMI in both sexes showed a significant increase from the lower tertiles to the highest tertile of change in FM. In the highest tertile of LSTMI, changes in FM showed no significant association with changes in aBMD. These findings suggest that adipose tissue might help promote high bone mass acquisition in pubertal children with small or normal LSTMI.
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Affiliation(s)
- Katsuyasu Kouda
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan.
| | - Kumiko Ohara
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe 657-8501, Japan
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe 657-8501, Japan
| | - Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan
| | - Myadagmaa Jaalkhorol
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama 589-8511, Japan
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17
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Khwanchuea R, Punsawad C. Association between Anthropometric Indices, Body Composition and Bone Parameters in Thai Female Adolescents. Indian J Pediatr 2017; 84:908-914. [PMID: 28799060 DOI: 10.1007/s12098-017-2422-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 07/05/2017] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To investigate correlations between anthropometrics and body composition with bone parameters of the whole-body and lumbar spine in non-obese and obese Thai female adolescents. METHODS This study was performed in 135 female adolescents aged 15 to 18 y enrolled in secondary schools in southern Thailand. Subjects were grouped into non-obesity (underweight and normal-to-overweight) (BMI < 25) and obesity (BMI ≥ 25) groups. Anthropometric indices for obesity [body weight (BW), waist circumference (WC), and body mass index (BMI)] were recorded. Bone parameters (BMC, BMD, and Z-scores) of the whole-body and lumbar spine (L1-L4) and body composition (LBM, BFM, %fat, %lean, and %bone) were assessed by dual-energy X-ray absorptiometry (DXA). Correlations between anthropometrics, body composition, and bone parameters were evaluated and compared between subject groups. RESULTS The obesity group had significantly higher means of whole-body BMD, BMC and Z-score than non-obese group (p < 0.05). BMI and BW were positively associated with BFM and %fat (p < 0.05) for non-obese subjects. Obese subjects had greater lumbar spine BMC compared to non-obese subjects. BFM was correlated with whole-body BMC in obese group. BW was a positive determinant of BMC at both sites in all subject groups, particularly for obese subjects; BW had positive associations with all bone parameters at the lumbar spine. CONCLUSIONS BW can be used as a determinant of all bone parameters at lumbar spine, and BFM had a positive effect on whole-body BMC in Thai obese female adolescent subjects.
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Affiliation(s)
- Rapheeporn Khwanchuea
- School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand.
| | - Chuchard Punsawad
- School of Medicine, Walailak University, 222 Thasala District, Nakhon Si Thammarat, 80161, Thailand
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18
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Farr JN, Dimitri P. The Impact of Fat and Obesity on Bone Microarchitecture and Strength in Children. Calcif Tissue Int 2017; 100:500-513. [PMID: 28013362 PMCID: PMC5395331 DOI: 10.1007/s00223-016-0218-3] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 12/10/2016] [Indexed: 12/15/2022]
Abstract
A complex interplay of genetic, environmental, hormonal, and behavioral factors affect skeletal development, several of which are associated with childhood fractures. Given the rise in obesity worldwide, it is of particular concern that excess fat accumulation during childhood appears to be a risk factor for fractures. Plausible explanations for this higher fracture risk include a greater propensity for falls, greater force generation upon fall impact, unhealthy lifestyle habits, and excessive adipose tissue that may have direct or indirect detrimental effects on skeletal development. To date, there remains little resolution or agreement about the impact of obesity and adiposity on skeletal development as well as the mechanisms underpinning these changes. Limitations of imaging modalities, short duration of follow-up in longitudinal studies, and differences among cohorts examined may all contribute to conflicting results. Nonetheless, a linear relationship between increasing adiposity and skeletal development seems unlikely. Fat mass may confer advantages to the developing cortical and trabecular bone compartments, provided that gains in fat mass are not excessive. However, when fat mass accumulation reaches excessive levels, unfavorable metabolic changes may impede skeletal development. Mechanisms underpinning these changes may relate to changes in the hormonal milieu, with adipokines potentially playing a central role, but again findings have been confounding. Changes in the relationship between fat and bone also appear to be age and sex dependent. Clearly, more work is needed to better understand the controversial impact of fat and obesity on skeletal development and fracture risk during childhood.
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Affiliation(s)
- Joshua N Farr
- Robert and Arlene Kogod Center on Aging and Endocrine Research Unit, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Paul Dimitri
- The Academic Unit of Child Health, Department of Paediatric Endocrinology, Sheffield Children's NHS Foundation Trust, University of Sheffield, Western Bank, Sheffield, S10 2TH, UK.
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Hauksson HH, Hrafnkelsson H, Magnusson KT, Johannsson E, Sigurdsson EL. Vitamin D status of Icelandic children and its influence on bone accrual. J Bone Miner Metab 2016. [PMID: 26220169 DOI: 10.1007/s00774-015-0704-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The importance of vitamin D for children's bone health has been well established, but the effects of less severe deficiency are not fully known. The main objective of this study was to assess the vitamin D status of Icelandic children at the age of 7, and again at 9 years of age, and the association of vitamin D status with bone mineral content and bone accrual over 2 years. We invited 321 children to participate in this study, and 267 (83 %) took part; 211 (79 %) underwent a DXA scan and 164 were again scanned 2 years later; 159 (60 %) vitamin D samples were measured and 119 (75 %) were measured again 2 years later. At age 7, 65 % of the children had vitamin D concentrations <50 nmol/l, and at age 9 this figure was 60 %. At age 7, 43 % of the children had insufficient amounts of vitamin D (37.5-50 nmol/l), and 22 % had a vitamin D deficiency (<37.5 nmol/l). In linear regression analysis, no association was found between vitamin D and bone mineral content. Furthermore, there was no significant difference in bone accrual over 2 years for the children with insufficient or deficient vitamin D at both ages, compared to those having more than 50 nmol/l at both time points. More than 60 % of Icelandic children have inadequate concentrations of vitamin D in serum repeatedly over a 2-year interval. However, vitamin D in the range did not have a significant effect on bone mineral content or accrual at ages 7 and 9.
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Affiliation(s)
| | - Hannes Hrafnkelsson
- Seltjarnarnes Health Care Center, Seltjarnarnes, Iceland
- Center for Research in Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
| | - Kristjan Thor Magnusson
- Center for Research in Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
| | - Erlingur Johannsson
- Center for Research in Sport and Health Sciences, School of Education, University of Iceland, Reykjavik, Iceland
| | - Emil L Sigurdsson
- Solvangur Health Care Center, Hafnarfjordur, Iceland.
- Department of Family Medicine, University of Iceland, Reykjavik, Iceland.
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Schiavone S, Morgese MG, Mhillaj E, Bove M, De Giorgi A, Cantatore FP, Camerino C, Tucci P, Maffulli N, Cuomo V, Trabace L. Chronic Psychosocial Stress Impairs Bone Homeostasis: A Study in the Social Isolation Reared Rat. Front Pharmacol 2016; 7:152. [PMID: 27375486 PMCID: PMC4896906 DOI: 10.3389/fphar.2016.00152] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/26/2016] [Indexed: 12/31/2022] Open
Abstract
Chronic psychosocial stress is a key player in the onset and aggravation of mental diseases, including psychosis. Although a strong association between this psychiatric condition and other medical co-morbidities has been recently demonstrated, few data on the link between psychosis and bone homeostasis are actually available. The aim of this study was to investigate whether chronic psychosocial stress induced by 4 or 7 weeks of social isolation in drug-naïve male Wistar rats could alter bone homeostasis in terms of bone thickness, mineral density and content, as well as markers of bone formation and resorption (sclerostin, cathepsin K, and CTX-I). We found that bone mineral density was increased in rats exposed to 7 weeks of social isolation, while no differences were detected in bone mineral content and area. Moreover, 7 weeks of social isolation lead to increase of femur thickness with respect to controls, suggesting the development of a hyperostosis condition. Isolated rats showed no changes in sclerostin levels, a marker of bone formation, compared to grouped animals. Conversely, bone resorption markers were significantly altered after 7 weeks of social isolation in terms of decrease in cathepsin K and increase of CTX-I. No alterations were found after 4 weeks of isolation rearing. Our observations suggest that chronic psychosocial stress might affect bone homeostasis, more likely independently from drug treatment. Thus, the social isolation model might help to identify possible new therapeutic targets to treat the burden of chronic psychosocial stress and to attempt alternative therapy choices.
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Affiliation(s)
- Stefania Schiavone
- Department of Experimental and Clinical Medicine, University of Foggia Foggia, Italy
| | - Maria G Morgese
- Department of Experimental and Clinical Medicine, University of Foggia Foggia, Italy
| | - Emanuela Mhillaj
- Department of Physiology and Pharmacology, "Sapienza" University of Rome Rome, Italy
| | - Maria Bove
- Department of Physiology and Pharmacology, "Sapienza" University of Rome Rome, Italy
| | - Angelo De Giorgi
- Dual Diagnosis Unit, Azienda Sanitaria Locale della Provincia di Foggia Foggia, Italy
| | | | - Claudia Camerino
- Department of Physiology and Pharmacology, "Sapienza" University of RomeRome, Italy; Department of Basic Medical Science, Neuroscience and Sense Organs, University of BariBari, Italy
| | - Paolo Tucci
- Department of Experimental and Clinical Medicine, University of Foggia Foggia, Italy
| | - Nicola Maffulli
- Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of SalernoSalerno, Italy; Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and DentistryLondon, UK
| | - Vincenzo Cuomo
- Department of Physiology and Pharmacology, "Sapienza" University of Rome Rome, Italy
| | - Luigia Trabace
- Department of Experimental and Clinical Medicine, University of Foggia Foggia, Italy
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Videhult FK, Öhlund I, Hernell O, West CE. Body mass but not vitamin D status is associated with bone mineral content and density in young school children in northern Sweden. Food Nutr Res 2016; 60:30045. [PMID: 26945233 PMCID: PMC4779328 DOI: 10.3402/fnr.v60.30045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/29/2016] [Accepted: 01/29/2016] [Indexed: 12/13/2022] Open
Abstract
Background High latitude of residence where sun exposure is limited affects vitamin D status. Although vitamin D levels have been associated with poor bone health, cut-off values for optimising bone health are yet to be decided. Objective To assess vitamin D intake and status among young school children living at latitude 63–64 °N, in northern Sweden and to examine the association between vitamin D status and bone mineral content (BMC) and bone mineral density (BMD). Design In a cross-sectional study, diet was assessed by a 4-day food diary and a food frequency questionnaire in 8- to 9-year-old children (n=120). Energy, vitamin D, and calcium intakes were calculated. Physical activity was assessed using a pedometer for 7 days. Serum 25-hydroxyvitamin D (S-25[OH]D) levels were analysed by high-pressure liquid chromatography-atmospheric pressure chemical ionisation-mass spectrometry (n=113). BMC and BMD were assessed by dual energy X-ray absorptiometry scan. Height and weight were measured by standard procedures and BMI z-score was calculated using WHO AnthroPlus programme. Results The majority of children, 91%, did not reach the recommended vitamin D intake of 7.5 µg/day and 50% had insufficient S-25[OH]D levels defined as <50 nmol/l. The highest concentrations of S-25[OH]D were observed during the summer months (p=0.01). Body mass (p<0.01) but not S-25[OH]D was associated with measures of BMC and BMD. Furthermore, boys had higher total BMC (p=0.01), total body less head BMC (p=0.02), fat free mass (p<0.01), and a higher degree of physical activity (p=0.01) compared to girls. Conclusions Body mass was related to BMC and BMD measures in a population of prepubertal school children living at high latitudes in Sweden. Despite insufficient S-25[OH]D levels and low vitamin D intake, this did not appear to affect bone parameters. Prospective studies with repeated assessment of vitamin D status are needed to examine cut-off values for optimising bone health.
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Affiliation(s)
- Frida K Videhult
- Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden;
| | - Inger Öhlund
- Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Olle Hernell
- Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Christina E West
- Pediatrics, Department of Clinical Sciences, Faculty of Medicine, Umeå University, Umeå, Sweden
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Winther A, Ahmed LA, Furberg AS, Grimnes G, Jorde R, Nilsen OA, Dennison E, Emaus N. Leisure time computer use and adolescent bone health--findings from the Tromsø Study, Fit Futures: a cross-sectional study. BMJ Open 2015; 5:e006665. [PMID: 26063563 PMCID: PMC4486947 DOI: 10.1136/bmjopen-2014-006665] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Low levels of physical activity may have considerable negative effects on bone health in adolescence, and increasing screen time in place of sporting activity during growth is worrying. This study explored the associations between self-reported screen time at weekends and bone mineral density (BMD). DESIGN In 2010/2011, 1038 (93%) of the region's first-year upper-secondary school students (15-18 years) attended the Tromsø Study, Fit Futures 1 (FF1). A follow-up survey (FF2) took place in 2012/2013. BMD at total hip, femoral neck and total body was measured as g/cm(²) by dual X-ray absorptiometry (GE Lunar prodigy). Lifestyle variables were self-reported, including questions on hours per day spent in front of television/computer during weekends and hours spent on leisure time physical activities. Complete data sets for 388/312 girls and 359/231 boys at FF1/FF2, respectively, were used in analyses. Sex stratified multiple regression analyses were performed. RESULTS Many adolescents balanced 2-4 h screen time with moderate or high physical activity levels. Screen time was positively related to body mass index (BMI) in boys (p=0.002), who spent more time in front of the computer than girls did (p<0.001). In boys, screen time was adversely associated with BMDFF1 at all sites, and these associations remained robust to adjustments for age, puberty, height, BMI, physical activity, vitamin D levels, smoking, alcohol, calcium and carbonated drink consumption (p<0.05). Screen time was also negatively associated with total hip BMD(FF2) (p=0.031). In contrast, girls who spent 4-6 h in front of the computer had higher BMD than the reference (<2 h). CONCLUSIONS In Norwegian boys, time spent on screen-based sedentary activity was negatively associated with BMD levels; this relationship persisted 2 years later. Such negative associations were not present among girls. Whether this surprising result is explained by biological differences remains unclear.
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Affiliation(s)
- Anne Winther
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway
| | - Luai Awad Ahmed
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Anne-Sofie Furberg
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Guri Grimnes
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Rolf Jorde
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ole Andreas Nilsen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, Southampton, UK
- Victoria University, Wellington, New Zealand
| | - Nina Emaus
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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