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Moon RJ, D’Angelo S, Holroyd CR, Crozier SR, Godfrey KM, Davies JH, Cooper C, Harvey NC. Parent-Offspring Associations in Body Composition: Findings From the Southampton Women's Survey Prospective Cohort Study. J Clin Endocrinol Metab 2023; 108:e726-e733. [PMID: 36943299 PMCID: PMC10438875 DOI: 10.1210/clinem/dgad128] [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: 11/07/2022] [Indexed: 03/23/2023]
Abstract
CONTEXT Children born to parents who are overweight or obese have a high risk of adult obesity, but it is unclear if transgenerational associations relating to unfavorable body composition differ by parent. OBJECTIVE To examine differential mother-offspring and father-offspring associations in body composition in early childhood. METHODS A total of 240 mother-father-offspring trios from a prospective UK population-based pre-birth cohort (Southampton Women's Survey) were included for anthropometry and dual-energy x-ray absorptiometry assessment of whole-body-less-head body composition in the offspring at 3 different ages (4, 6-7, and 8-9 years) and in the mother and father at the 8- to 9-year offspring visit. Associations were assessed using linear regression adjusting for the other parent. RESULTS Positive associations between mother-daughter body mass index (BMI) and fat mass were observed at ages 6 to 7 (BMI: β = .29 SD/SD, 95% CI = .10, .48; fat mass β = .27 SD/SD, 95% CI = .05, .48) and 8 to 9 years (BMI: β = .33 SD/SD, 95% CI = .13, .54; fat mass β = .31 SD/SD, 95% CI = .12, .49), with similar associations at age 4 years but bounding the 95% CI. The mother-son, father-son, and father-daughter associations for BMI and fat mass were weaker at each of the ages studied. CONCLUSION A strong association between the fat mass of mothers and their daughters but not their sons was observed. In contrast, father-offspring body composition associations were not evident. The dimorphic parent-offspring effects suggest particular attention should be given to early prevention of unfavorable body composition in girls born to mothers with excess adiposity.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Stefania D’Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
| | - Christopher R Holroyd
- Department of Rheumatology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton, SO16 7NP, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Justin H Davies
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
- NIHR Biomedical Research Centre, University of Oxford, Oxford OX4 2PG, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
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Trakulpark C, Manpayak T, Weerakulwattana P, Pooliam J, Nakavachara P. Reference values of bone mineral density of proximal femur for Southeast Asian children and adolescents. Arch Osteoporos 2022; 17:145. [PMID: 36400873 DOI: 10.1007/s11657-022-01184-9] [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: 09/01/2022] [Accepted: 11/06/2022] [Indexed: 11/21/2022]
Abstract
UNLABELLED Bone mineral density (BMD) of the proximal femur helps evaluate bone density in children with reduced mechanical loading of the lower extremities. This study provides the first reference values of bone mineral density of proximal femur according to age and sex for Southeast Asian children and adolescents. OBJECTIVES: The study aimed to (1) establish normative data of BMD of the proximal femur (femoral neck and total hip), measured by dual-energy X-ray absorptiometry (DXA), for healthy Thai children aged 5 to 18 years and (2) ascertain the relationships between BMD, growth, and puberty. METHODS Proximal femur scans of 170 boys and 191 girls obtained from DXA (Lunar Prodigy Pro, GE, and software enCORE version 7.53) were un-analyzed and then re-analyzed with the upgraded software enCORE version 17 SP2 for BMD assessment. The bone mineral apparent density of the femoral neck (FNBMAD) was calculated. RESULTS Sex and Tanner stage-specific BMD normative data were generated. BMD values of the femoral neck and total hip increased with age and pubertal progression. FNBMAD values were not markedly influenced by age and puberty. Using multiple linear regression analysis, age and weight affected FNBMD and total hip BMD in boys and girls, but height and Tanner stage only influenced girls. Age did not significantly influence FNBMAD in either sex. Tanner stage weakly influenced FNBMAD only in boys. CONCLUSIONS We established normative reference data for BMD of the proximal femur measured by DXA in Thai children aged 5 to 18 years. Our reference data will help clinicians and researchers assess and interpret the BMD of the proximal femur for Southeast Asian children.
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Affiliation(s)
- Chonlada Trakulpark
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Teerarat Manpayak
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Praewvarin Weerakulwattana
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Julaporn Pooliam
- Research Group and Research Network Division, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pairunyar Nakavachara
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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Shultz SJ, Cruz MR, Casey E, Dompier TP, Ford KR, Pietrosimone B, Schmitz RJ, Taylor JB. Sex-Specific Changes in Physical Risk Factors for Anterior Cruciate Ligament Injury by Chronological Age and Stages of Growth and Maturation From 8 to 18 Years of Age. J Athl Train 2022; 57:830-876. [PMID: 36638346 PMCID: PMC9842121 DOI: 10.4085/1062-6050-0038.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To critically assess the literature focused on sex-specific trajectories in physical characteristics associated with anterior cruciate ligament (ACL) injury risk by age and maturational stage. DATA SOURCES PubMed, CINAHL, Scopus, and SPORTDiscus databases were searched through December 2021. STUDY SELECTION Longitudinal and cross-sectional studies of healthy 8- to 18-year-olds, stratified by sex and age or maturation on ≥1 measure of body composition, lower extremity strength, ACL size, joint laxity, knee-joint geometry, lower extremity alignment, balance, or lower extremity biomechanics were included. DATA EXTRACTION Extracted data included study design, participant characteristics, maturational metrics, and outcome measures. We used random-effects meta-analyses to examine sex differences in trajectory over time. For each variable, standardized differences in means between sexes were calculated. DATA SYNTHESIS The search yielded 216 primary and 22 secondary articles. Less fat-free mass, leg strength, and power and greater general joint laxity were evident in girls by 8 to 10 years of age and Tanner stage I. Sex differences in body composition, strength, power, general joint laxity, and balance were more evident by 11 to 13 years of age and when transitioning from the prepubertal to pubertal stages. Sex differences in ACL size (smaller in girls), anterior knee laxity and tibiofemoral angle (greater in girls), and higher-risk biomechanics (in girls) were observed at later ages and when transitioning from the pubertal to postpubertal stages. Inconsistent study designs and data reporting limited the number of included studies. CONCLUSIONS Critical gaps remain in our knowledge and highlight the need to improve our understanding of the relative timing and tempo of ACL risk factor development.
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Affiliation(s)
- Sandra J. Shultz
- Department of Kinesiology, University of North Carolina, Greensboro
| | | | | | | | | | - Brian Pietrosimone
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Randy J. Schmitz
- Department of Kinesiology, University of North Carolina, Greensboro
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Body composition and bone mineral density by Dual Energy X-ray Absorptiometry: Reference values for young children. Clin Nutr 2021; 41:71-79. [PMID: 34864456 DOI: 10.1016/j.clnu.2021.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/08/2021] [Accepted: 11/09/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND & AIMS Childhood obesity is a global public health threat, with an alarming rise in incidence. Obesity at young age has short-term and long-term morbidity. It is, therefore, important to accurately assess body composition throughout infancy and childhood to identify excess adiposity. However, reference values for age 2-5 years, needed to interpret measurements and identify young children at risk, are lacking. Our primary objective was to fill the current gap in reference values by constructing sex-specific body composition reference values and charts for fat mass (FM), fat mass percentage (FM%), fat mass index (FMI), lean body mass (LBM), lean body mass index (LBMI) and total body less head bone mineral density (BMDTBLH) for children aged 2-5 years using Dual-Energy X-ray Absorptiometry (DXA). METHODS We performed 599 accurate DXA-measurements in 340 term-born children aged 2-5 years, using Lunar Prodigy with Encore software (V14.1). Using GAMLSS, sex-specific reference values and charts were created for FM, FM%, FMI, LBM, LBMI and BMDTBLH. RESULTS Sex-specific body composition reference values and charts for age 2-5 years were constructed. In boys and girls, FM and LBM increased from age 2-5 years (all p ≤ 0.001), but body size-corrected FM% and FMI decreased (all p ≤ 0.023). LBMI remained similar between 2 and 5 years of age. Girls had higher FM, FM% and FMI and lower LBM and LBMI compared to boys. BMC and BMDTBLH increased with age between 2 and 5 years of age (all p < 0.001) and were similar for boys and girls. CONCLUSIONS We present sex-specific reference values and charts for body composition and total body bone mineral density measured by DXA, based on a large cohort of healthy children aged 2-5 years. These longitudinal references can be used for clinical practice and research purposes to monitor body composition and bone mineral density development and identify children at risk for excess adiposity.
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Sigurdsson GV, Schmidt S, Mellström D, Ohlsson C, Karlsson M, Lorentzon M, Saalman R. Physical exercise is associated with beneficial bone mineral density and body composition in young adults with childhood-onset inflammatory bowel disease. Scand J Gastroenterol 2021; 56:699-707. [PMID: 33945377 DOI: 10.1080/00365521.2021.1913759] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) have an increased risk of compromised bone mineral density (BMD) and body composition. There are limited data on the physical exercise (PE) habits of patients with childhood-onset IBD and on the associations between PE and BMD and body composition. PATIENTS AND METHODS In total, 72 young adults with childhood-onset IBD and 1341 normative young adult controls answered questionnaires regarding PE [hours/week (h/w)] in the last 12 months. BMD and body composition were measured with dual x-ray absorptiometry (DXA) and presented as age- and gender-adjusted Z-scores for BMD, skeletal muscle index (SMI, the weight of lean mass in arms and legs/m2), and percentage body fat (Fat %). RESULTS A total of 41 (57%) patients with IBD engaged in PE during the previous 12 months, as compared to 913 (68%) of the controls (p = .053). Sedentary patients had significantly lower median BMD, SMI, and Fat % Z-scores than the controls with corresponding PE habits (all p < .05). In contrast, highly active (>4 h/week) patients had total body BMD, SMI, and Fat % in the same range as the controls with corresponding PE levels (p = .151, p = .992, and p = .189, respectively), albeit with lower BMDs in the spine (p = .007) and femoral neck (p = .015). Using multiple regression analyses, a diagnosis of childhood-onset IBD was independently associated with inferior BMD and body composition, regardless of the amount of PE. CONCLUSION Physical exercise is associated with beneficial bone mineral density and body composition in patients with IBD despite the negative effects of the disease.
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Affiliation(s)
- Gudmundur Vignir Sigurdsson
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia's Children's Hospital, Gothenburg, Sweden
| | | | - Dan Mellström
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Drug Treatment, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Magnus Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University and Skåne University Hospital, Malmo, Sweden
| | - Mattias Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.,Mary MacKillop Institute for Health Research, Melbourne, Australia
| | - Robert Saalman
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia's Children's Hospital, Gothenburg, Sweden
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Dong H, Yan Y, Liu J, Cheng H, Zhao X, Shan X, Huang G, Mi J, Mi J, Liu J, Cheng H, Zhao X, Shan X, Huang G, Hou D, Wang W, Meng L, Liu Q, Yi Y, Liu L, Ao L, Lu S, Sun J, Wang X, Li Y, Ding W, Zhang L, Jia L, Liu G, Enqing L, Lei P, Yan W, Liu F, Zhang Y, Cheng Y, Chen S, Zhao Q, Cao F, Mu K, Niu D, Xi B, Zhao M, Xiong F, Zhu G. Reference centiles for evaluating total body fat development and fat distribution by dual-energy x-ray absorptiometry among children and adolescents aged 3–18 years. Clin Nutr 2021; 40:1289-1295. [DOI: 10.1016/j.clnu.2020.08.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/24/2020] [Accepted: 08/14/2020] [Indexed: 11/27/2022]
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van Santen SS, Olsson DS, Hammarstrand C, Wijnen M, Fiocco M, van den Heuvel-Eibrink MM, Johannsson G, Janssen JAMJL, van der Lely AJ, Neggers SJCMM. Body Composition and Bone Mineral Density in Craniopharyngioma Patients: A Longitudinal Study Over 10 Years. J Clin Endocrinol Metab 2020; 105:5900043. [PMID: 32869850 DOI: 10.1210/clinem/dgaa607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/27/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Patients with craniopharyngioma suffer from obesity and impaired bone health. Little is known about longitudinal changes in body composition and bone mineral density (BMD). OBJECTIVE To describe body composition and BMD (change). DESIGN Retrospective longitudinal study. SETTING Two Dutch/Swedish referral centers. PATIENTS Patients with craniopharyngioma (n = 112) with a dual X-ray absorptiometry (DXA) scan available (2 DXA scans, n = 86; median Δtime 10.0 years; range 0.4-23.3) at age ≥ 18 years (58 [52%] male, 50 [45%] childhood onset). MAIN OUTCOME MEASURES Longitudinal changes of body composition and BMD, and associated factors of ΔZ-score (sex and age standardized). RESULTS BMI (from 28.8 ± 4.9 to 31.2 ± 5.1 kg/m2, P < .001), fat mass index (FMI) (from 10.5 ± 3.6 to 11.9 ± 3.8 kg/m2, P = .001), and fat free mass index (FFMI) (from 18.3 ± 3.2 to 19.1 ± 3.2 kg/m2, P < .001) were high at baseline and increased. Fat percentage and Z-scores of body composition did not increase, except for FFMI Z-scores (from 0.26 ± 1.62 to 1.06 ± 2.22, P < .001). Z-scores of total body, L2-L4, femur neck increased (mean difference 0.61 ± 1.12, P < .001; 0.74 ± 1.73, P < .001; 0.51 ± 1.85, P = .02). Linear regression models for ΔZ-score were positively associated with growth hormone replacement therapy (GHRT) (femur neck: beta 1.45 [95% CI 0.51-2.39]); and negatively with radiotherapy (femur neck: beta -0.79 [-1.49 to -0.09]), glucocorticoid dose (total body: beta -0.06 [-0.09 to -0.02]), and medication to improve BMD (L2-L4: beta -1.06 [-1.84 to -0.28]). CONCLUSIONS Z-scores of BMI, fat percentage, and FMI remained stable in patients with craniopharyngioma over time, while Z-scores of FFMI and BMD increased. Higher glucocorticoid dose and radiotherapy were associated with BMD loss and GHRT with increase.
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Affiliation(s)
- Selveta S van Santen
- Department of Medicine, Endocrinology; Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
- Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
| | - Daniel S Olsson
- Department of Medicine, Endocrinology; Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Casper Hammarstrand
- Department of Medicine, Endocrinology; Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mark Wijnen
- Department of Medicine, Endocrinology; Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marta Fiocco
- Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
- Mathematical Institute, Leiden University, Leiden, The Netherlands
- Department of Biomedical Data Sciences, Medical Statistics Section, Leiden University Medical Center, Leiden, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
- Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
| | - Gudmundur Johannsson
- Department of Medicine, Endocrinology; Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Joseph A M J L Janssen
- Department of Medicine, Endocrinology; Erasmus Medical Center, Rotterdam, The Netherlands
| | - Aart J van der Lely
- Department of Medicine, Endocrinology; Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sebastian J C M M Neggers
- Department of Medicine, Endocrinology; Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Paediatric Oncology/Haematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
- Princess Máxima Center for Paediatric Oncology, Utrecht, The Netherlands
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Shypailo RJ, Wong WW. Fat and fat-free mass index references in children and young adults: assessments along racial and ethnic lines. Am J Clin Nutr 2020; 112:566-575. [PMID: 32469402 DOI: 10.1093/ajcn/nqaa128] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/07/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Fat-free mass index (FFMI) and fat mass index (FMI) are superior to BMI and fat percentage in evaluating nutritional status. However, existing references fail to account for racial/ethnic differences in body composition among children. OBJECTIVES Our goal was to produce age-based normative references for FFMI and FMI in children for specific racial/ethnic groups. METHODS Body composition, weight, and height were measured in 1122 normal healthy children aged 2-21 y. Bone mineral content measured by DXA, total body water by deuterium dilution, and total body potassium by whole-body γ counting were combined to calculate fat-free mass (FFM) and fat mass (FM) using equations based on the Reference Child and Adolescent models. FFMI and FMI were calculated by dividing FFM and FM by height squared, respectively. After outlier removal, the LMS (Lambda-Mu-Sigma) function within R's GAMLSS package was used to produce age-based FFMI and FMI growth curves for black (B), white (W), and Hispanic (H) children for each sex. Combined models were produced in cases where outcomes did not differ by race/ethnicity. Resulting models were compared with previously published FFMI and FMI models. RESULTS FFMI and FMI models based on 1079 children, aged 2-21 y, were created for both sexes. FFMI models for B children showed higher values throughout. W and H children were combined to produce FFMI models for each sex. H boys were modeled individually for FMI, whereas W and B boys were combined. FMI models for girls were created for each race/ethnicity. Models agreed well with those based on children from the United Kingdom of comparable race/ethnicity. CONCLUSIONS Race/ethnicity-specific references for FFMI and FMI will increase the accuracy of health and nutrition status assessment in children over race/ethnicity-generic references. The models allow the calculation of SD scores to assess health and nutrition status in children.
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Affiliation(s)
- Roman J Shypailo
- USDA/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - William W Wong
- USDA/Agricultural Research Service Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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Sigurdsson GV, Schmidt S, Mellström D, Ohlsson C, Karlsson M, Lorentzon M, Saalman R. Altered body composition profiles in young adults with childhood-onset inflammatory bowel disease. Scand J Gastroenterol 2020; 55:169-177. [PMID: 32008409 DOI: 10.1080/00365521.2020.1716061] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background: Patients with inflammatory bowel disease (IBD) often develop alterations in body composition in terms of their proportions of lean mass and fat mass, as well as reduced bone mineral density (BMD). However, there are limited data on the skeletal muscle index (SMI) and percentage fat (fat %) for young adults with childhood-onset IBD. Our aim was to investigate the body compositions of these patients, with the focus on SMI and fat %.Methods: Body composition was estimated by dual x-ray absorptiometry for 94 young adults with childhood-onset IBD aged 18-27 years, 65 of whom had ulcerative colitis. The Z-scores for SMI, fat %, and BMD were calculated using the normative data from 1,289 individuals with corresponding age. Based on the SMI and fat % Z-scores, each patient was classified as having a body composition profile that was: (i) normal; (ii) obese (fat % Z-score >1); (iii) myopenic (SMI Z-score < -1); or (iv) myopenic-obese.Results: A higher proportion of young adults with childhood-onset IBD had a body composition profile classified as myopenic (24%) or myopenic-obese (9%), as compared to the controls (myopenic [16%, p = .016]; myopenic-obese [2%, p = .002]). Patients with the myopenic or myopenic-obese profile had significantly lower total body BMD Z-scores (-1.3 ± 0.7 and -1.4 ± 0.9, respectively) than patients with the normal profile (-0.2 ± 1.1; p < .001 and p = .004, respectively). Diagnosis of IBD in childhood represented an additional risk for low BMD, regardless of SMI Z-score.Conclusion: Young adults with childhood-onset IBD have a high risk for having altered body composition traits.SummaryYoung adults with childhood-onset IBD carry a high risk for altered body composition traits. The myopenic and myopenic-obese body composition profiles were more frequently observed in patients with IBD than controls, and these profiles were strongly associated with low BMD.
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Affiliation(s)
- Gudmundur Vignir Sigurdsson
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silviás Children Hospital, Gothenburg, Sweden
| | | | - Dan Mellström
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Magnus Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Mattias Lorentzon
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg and Region Västra Götaland, Geriatric Medicine Clinic, Sahlgrenska University Hospital Mölndal, Sweden
| | - Robert Saalman
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and The Queen Silvia Children's Hospital, Gothenburg, Sweden
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Evensen E, Emaus N, Furberg AS, Kokkvoll A, Wells J, Wilsgaard T, Winther A, Skeie G. Adolescent body composition and associations with body size and growth from birth to late adolescence. The Tromsø study: Fit Futures-A Norwegian longitudinal cohort study. Pediatr Obes 2019; 14:e12492. [PMID: 30590874 DOI: 10.1111/ijpo.12492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/11/2018] [Accepted: 09/30/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND Fat and fat-free masses and fat distribution are related to cardiometabolic risk. OBJECTIVES to explore how birth weight, childhood body mass index (BMI) and BMI gain were related to adolescent body composition and central obesity. METHODS In a population-based longitudinal study, body composition was measured by dual-energy X-ray absorptiometry in 907 Norwegian adolescents (48% girls). Associations between birth weight, BMI categories, and BMI gain were evaluated by fitting linear mixed models and conditional growth models with fat mass index (FMI, kg/m2 ), fat-free mass index (FFMI, kg/m2 ) standard deviation scores (SDS), and central obesity at 15 to 20 years, as well as change in FMI SDS and FFMI SDS between ages 15 to 17 and 18 to 20 as outcomes. RESULTS Birth weight was associated with FFMI in adolescence. Greater BMI gain in childhood, conditioned on prior body size, was associated with higher FMI, FFMI, and central overweight/obesity with the strongest associations seen at age 6 to 16.5 years: FMI SDS: β = 0.67, 95% CI (0.63-0.71), FFMI SDS: 0.46 (0.39, 0.52), in girls, FMI SDS: 0.80 (0.75, 0.86), FFMI SDS: 0.49 (0.43, 0.55), in boys. CONCLUSIONS Compared with birth and early childhood, high BMI and greater BMI gain at later ages are strong predictors of higher fat mass and central overweight/obesity at 15 to 20 years of age.
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Affiliation(s)
- Elin Evensen
- Department of Clinical Research, University Hospital of North Norway, Tromsø, Norway.,Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Nina Emaus
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne-Sofie Furberg
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.,Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway
| | - Ane Kokkvoll
- Department of Paediatrics,, Finnmark Hospital Trust, Hammerfest, Norway
| | - Jonathan Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street, Institute of Child Health, London, UK
| | - Tom Wilsgaard
- Department of Clinical Research, University Hospital of North Norway, Tromsø, Norway.,Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Winther
- Division of Neurosciences, Orthopedics and Rehabilitation Services, University Hospital of North Norway, Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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11
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Wells JCK, Davies PSW, Fewtrell MS, Cole TJ. Body composition reference charts for UK infants and children aged 6 weeks to 5 years based on measurement of total body water by isotope dilution. Eur J Clin Nutr 2019; 74:141-148. [PMID: 30809008 PMCID: PMC6949189 DOI: 10.1038/s41430-019-0409-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 11/18/2018] [Accepted: 01/02/2019] [Indexed: 02/03/2023]
Abstract
Background Until recently, pediatric body composition reference data were very limited, hindering interpretation of measurements. In the last decade, such data emerged for several techniques for children ≥ 5 years, but equivalent data for younger age groups remain lacking, due to their poor compliance with most techniques. Objectives To provide reference data for use in clinical practice and research from 6 weeks to 5 years, that are based on measurements of total body water (TBW) by isotope dilution. Design The data on anthropometry and TBW were available from studies of 463 infants and children aged 6 weeks to 7 years, conducted between 1988 and 2010. Both breast-fed and formula-fed infants were included. TBW was measured by 2H- or 18O-labeled water, and converted to fat-free mass (FFM) using published hydration coefficients. Reference charts and SD scores (SDS) were constructed for FFM, fat mass (FM), FFM index and FM index for each sex, using the lambda-mu-sigma method. Results Both sexes were significantly heavier and longer than UK 1990 reference data (p < 0.01), but did not differ in body mass index SDS. Breast-fed infants were longer than formula-fed infants but did not differ in body composition. Conclusions These reference data will enhance the ability of clinicians to assess and monitor body composition and FFM/FM accretion in clinical practice in younger age groups. Total body water can be measured in most patients, though abnormalities of hydration must be addressed. However, the centiles do not overlap exactly with those published for older age groups, limiting comparability between younger and older children.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK. .,Population, Policy, and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
| | - Peter S W Davies
- Child Health Research Center, Centre for Children's Health Research, University of Queensland, Brisbane, QLD, Australia
| | - Mary S Fewtrell
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK.,Population, Policy, and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Tim J Cole
- Population, Policy, and Practice Programme, UCL Great Ormond Street Institute of Child Health, London, UK
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12
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Goldberg MR, Nachshon L, Sinai T, Epstein-Rigbi N, Oren Y, Eisenberg E, Katz Y, Elizur A. Risk factors for reduced bone mineral density measurements in milk-allergic patients. Pediatr Allergy Immunol 2018; 29:850-856. [PMID: 30099766 DOI: 10.1111/pai.12972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/23/2018] [Accepted: 08/02/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Earlier studies noted that young adults with IgE-mediated cow's milk allergy (IgE-CMA) have significantly lower bone mineral density (BMD) than age- and gender-matched controls. We sought to identify additional risk factors contributing to the low BMD in IgE-CMA patients. METHODS Postpubertal (defined by Tanner stage V) IgE-CMA patients (n = 78; 16- to 30-year-old females and 17.5- to 30-year-old males) were evaluated prospectively for BMD using a DXA scan, serum values of bone turnover factor, and dietary and lifestyle questionnaires. Patients receiving > 2 short courses of systemic steroid treatments were excluded. RESULTS Abnormal BMD measurements (T- or Z-scores < -1.0) of the lumbar vertebrae, femoral neck, or hip were noted in 60 patients, while normal BMD values were present in 18 patients, despite similarly decreased calcium intakes between the groups (P = 0.92). Patients with abnormal BMD were more likely to be asthmatic (P = 0.014), have a lower weight z-score (P = 0.007), have a decreased percent caloric intake derived from fat (P = 0.01), and have an increased carbohydrate intake (P = 0.03), in comparison with the normal-BMD group. Serum values of bone turnover were similar between the groups. On multivariate regression analysis, only asthma significantly (P = 0.006) increased the risk for osteopenia and osteoporosis (OR 38.5, 95% CI 2.8-500). Fitting continuous z-scores into a regression model, both asthma and weight z-score were significant (adjusted r2 = 0.272). Asthma was significantly overrepresented in osteopenic and osteoporotic subpopulations while decreased weight only in patients with osteoporosis. CONCLUSIONS In the context of a low calcium intake, asthma and weight are independent risk factors for decreased BMD in IgE-CMA patients.
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Affiliation(s)
- Michael R Goldberg
- Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Beer Yaakov, Israel
| | - Liat Nachshon
- Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Beer Yaakov, Israel
| | - Tali Sinai
- School of Nutritional Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naama Epstein-Rigbi
- Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Beer Yaakov, Israel
| | - Yael Oren
- Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Beer Yaakov, Israel
| | - Eli Eisenberg
- Raymond and Beverly Sackler School of Physics and Astronomy, Tel Aviv University, Tel Aviv, Israel
| | - Yitzhak Katz
- Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Beer Yaakov, Israel.,Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Elizur
- Institute of Allergy, Immunology and Pediatric Pulmonology, Assaf Harofeh Medical Center, Beer Yaakov, Israel.,Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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13
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Li J, Ding W, Cao J, Sun L, Liu S, Zhang J, Zhao H. Serum 25-hydroxyvitamin D and bone mineral density among children and adolescents in a Northwest Chinese city. Bone 2018; 116:28-34. [PMID: 30006192 DOI: 10.1016/j.bone.2018.07.006] [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: 04/02/2018] [Revised: 07/02/2018] [Accepted: 07/08/2018] [Indexed: 12/24/2022]
Abstract
Although vitamin D is essential for bone health, little is known about prevalence of vitamin D deficiency and low bone mineral density (BMD) among children, especially those in developing countries. It also remains unclear whether serum 25-hydroxyvitamin D [25(OH)D] is associated with BMD among children. We investigated these questions among children and adolescents in Yinchuan (latitude: 38° N), Ningxia, an economically underdeveloped province in Northwest China. A total of 1582 children (756 boys and 826 girls), aged 6-18 years, were recruited from schools using the stratified random sampling method in fall 2015. Serum 25(OH)D concentrations were measured by enzyme-linked immunosorbent assay, and BMD was quantified by dual-energy X-ray absorptiometry. Vitamin D deficiency (defined as serum 25(OH)D ≤ 37.5 nmol/L) was present in 35.5% of study subjects. There were no clear patterns of differences in serum 25(OH)D concentrations across the four age groups compared (6-9 years, 10-13 years, 14-16 years, and 17-18 years). The prevalence of low total body less head (TBLH) BMD (defined as a Z-score of ≤ -2.0 standard deviations away from the mean BMD values of the Chinese pediatric reference population) among children examined was 1.8% and was not significantly different among the four age groups considered. Linear regression analysis revealed that age, weight, and height were significantly and positively associated with TBLH BMD and that the strongest determinant of TBLH BMD was age in boys and weight in girls. There were no significant correlations between serum 25(OH)D concentrations and BMD obtained for total body and at various skeletal sites (r ranged from -0.005 to 0.014) regardless of whether children evaluated were sufficient, insufficient, or deficient in vitamin D. In conclusion, more than one-third of children and adolescents in a Northwest Chinese city were deficient in vitamin D but only <2% of them developed low BMD.
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Affiliation(s)
- Jing Li
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Wenqing Ding
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Juan Cao
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Lijiao Sun
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Shanghong Liu
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China
| | - Jianjun Zhang
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.
| | - Haiping Zhao
- Department of Child and Adolescent Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China.
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14
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Dordevic AL, Bonham M, Ghasem-Zadeh A, Evans A, Barber E, Day K, Kwok A, Truby H. Reliability of Compartmental Body Composition Measures in Weight-Stable Adults Using GE iDXA: Implications for Research and Practice. Nutrients 2018; 10:nu10101484. [PMID: 30321991 PMCID: PMC6213248 DOI: 10.3390/nu10101484] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/05/2018] [Accepted: 10/10/2018] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to explore the reliability and precision of body compartment measures, in particular visceral adipose tissue, in weight stable adults over a range of BMIs using GE-Lunar iDXA. Weight-stable participants aged 18–65 years had a total body composition scan on GE-Lunar iDXA either on three separate occasions over a three month period (n = 51), or on a single occasion for duplicate scans with repositioning (n = 30). The coefficient of variation (CV%) and least significant change (LSC) of body compartments were calculated. The CV was higher for all measures over three months (range 0.8–5.9%) compared with same-day precision-scans (all < 2%). The CV for visceral adipose tissue (VAT) was considerably higher than all other body compartments (42.2% three months, 16.2% same day scanning). To accurately measure VAT mass using the GE iDXA it is recommended that participants have a BMI ≥ 25 kg/m2, or VAT mass > 500 g. Changes observed in VAT mass levels below 500 g should be interpreted with caution due to lack of precision and reliability. All other compartmental measures demonstrated good reliability, with less than 6% variation over three months.
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Affiliation(s)
- Aimee L Dordevic
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Maxine Bonham
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Ali Ghasem-Zadeh
- Department of Endocrinology, Department of Medicine, Austin Health, the University of Melbourne, West Heidelberg 3081, Australia.
| | - Alison Evans
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Elizabeth Barber
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Kaitlin Day
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Alastair Kwok
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
| | - Helen Truby
- Department of Nutrition, Dietetics & Food, Monash University, Notting Hill 3168, Australia.
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15
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Gómez-Campos R, Andruske CL, Arruda MD, Urra Albornoz C, Cossio-Bolaños M. Proposed equations and reference values for calculating bone health in children and adolescent based on age and sex. PLoS One 2017; 12:e0181918. [PMID: 28759569 PMCID: PMC5536292 DOI: 10.1371/journal.pone.0181918] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 07/10/2017] [Indexed: 12/02/2022] Open
Abstract
Background The Dual Energy X-Ray Absorptiometry (DXA) is the gold standard for measuring BMD and bone mineral content (BMC). In general, DXA is ideal for pediatric use. However, the development of specific standards for particular geographic regions limits its use and application for certain socio-cultural contexts. Additionally, the anthropometry may be a low cost and easy to use alternative method in epidemiological contexts. The goal of our study was to develop regression equations for predicting bone health of children and adolescents based on anthropometric indicators to propose reference values based on age and sex. Methods 3020 students (1567 males and 1453 females) ranging in ages 4.0 to 18.9 were studied from the Maule Region (Chile). Anthropometric variables evaluated included: weight, standing height, sitting height, forearm length, and femur diameter. A total body scan (without the head) was conducted by means of the Dual Energy X-Ray Absorptiometry. Bone mineral density (BMD) and the bone mineral content (BMC) were also determined. Calcium consumption was controlled for by recording the intake of the three last days prior to the evaluation. Body Mass Index (BMI) was calculated, and somatic maturation was determined by using the years of peak growth rate (APHV). Results Four regression models were generated to calculate bone health: for males BMD = (R2 = 0.79) and BMC = (R2 = 0.84) and for the females BMD = (R2 = 0.76) and BMC = (R2 = 0.83). Percentiles were developed by using the LMS method (p3, p5, p15, p25, p50, p75, p85, p95 and p97). Conclusions Regression equations and reference curves were developed to assess the bone health of Chilean children and adolescents. These instruments help identify children with potential underlying problems in bone mineralization during the growth stage and biological maturation.
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Affiliation(s)
- Rossana Gómez-Campos
- Faculty of Physical Education, State University of Campinas, Campinas, Brazil
- Universidad Autonoma de Chile, Talca, Chile
| | - Cynthia Lee Andruske
- Escuela de Pedagogías en Inglés, Facultad de Ciencias de la Educación, Universidad de Talca (Campus Linares), Talca, Chile
- Research Network on Human Biological Development, Arequipa, Peru
| | - Miguel de Arruda
- Faculty of Physical Education, State University of Campinas, Campinas, Brazil
| | - Camilo Urra Albornoz
- Escuela de Kinesiología, Facultad de Salud, Universidad Santo Tomás, Talca, Chile
| | - Marco Cossio-Bolaños
- Faculty of Physical Education, State University of Campinas, Campinas, Brazil
- Department of Physical Activity Sciences, Catholic University of Maule, Talca, Chile
- Universidad Nacional de San Agustín, Arequipa, Perú
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16
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Baptista F, Rebocho LM, Cardadeiro G, Zymbal V, Rosati N. Sex- and Maturity-Related Differences in Cortical Bone at the Distal Radius and Midshaft Tibia Evaluated by Quantitative Ultrasonography. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:2043-2049. [PMID: 27181690 DOI: 10.1016/j.ultrasmedbio.2016.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 03/16/2016] [Accepted: 04/01/2016] [Indexed: 06/05/2023]
Abstract
Boys usually have higher values of bone mineral density measured by dual-energy X-ray absorptiometry than girls, but contradictorily also have a greater incidence of fractures during growth. The purpose of this study was to investigate sex- and maturity-related differences in bone speed of sound (SoS) at the radius and tibia in a sample of 625 healthy children aged 10-14 y and to analyze the contributions of physical activity (PA) to possible dissimilarities. Radial and tibial SoS was evaluated by quantitative ultrasound, maturity was estimated as the years of distance from the peak height velocity age, and PA was assessed by accelerometry. Comparisons between sexes and maturity groups (low: below average [<-2.5 y], high: average or above [≥-2.5 y]) were made by two-sample t-tests with unequal variances. Girls in the high-maturity group had higher SoS at the radius and tibia compared with girls in the low-maturity group (p < 0.001). There were no SoS differences at the radius or tibia between the high- and low-maturity groups in boys. Within high-maturity children, girls had higher SoS than boys at the radius and tibia (p < 0.001). There were no differences at the radius and tibia between girls and boys with low maturity. The results were not modified after controlling for PA. Regardless of PA, the results provide insight into sex- and maturity-related differences in bone SoS at the distal radius and midshaft tibia from maturity less than 2.5 y from the peak height velocity age, with boys having lower SoS.
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Affiliation(s)
- Fátima Baptista
- Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Portugal.
| | - Lurdes M Rebocho
- Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Graça Cardadeiro
- Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Vera Zymbal
- Exercise and Health Laboratory, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, Portugal
| | - Nicoletta Rosati
- Center for Applied Mathematics and Economics (CEMAPRE) and Department of Mathematics, Instituto Superior de Economia e Gestão (ISEG), University of Lisbon, Portugal
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17
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Long-Term Examination of Bone Mineral Density in the Calcanei After Anterior Cruciate Ligament Reconstruction in Adolescents and Matched Adult Controls. Arthroscopy 2016; 32:615-23. [PMID: 26545306 DOI: 10.1016/j.arthro.2015.08.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 08/01/2015] [Accepted: 08/28/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE The aims were to evaluate the results 10 to 20 years after anterior cruciate ligament (ACL) reconstruction performed in adolescents in terms of bone mineral density (BMD) in the calcanei using the dual-energy x-ray absorptiometry (DXA) technique, activity level, and quality of life. METHODS A case-control study of adolescents who underwent ACL reconstruction between 1992 and 2002 was performed. The inclusion criterion was a unilateral ACL injury. The exclusion criteria were bilateral ACL injury, contralateral ACL reconstruction, posterior cruciate ligament injury, and previous or present fractures of either lower extremity. The BMD was measured in both calcanei using the DXA technique and compared with a control group of adult ACL-reconstructed patients and with a DXA reference database. The age of the control group was similar to that of the patient group at the time of BMD assessment, performed 60 months after reconstruction. Activity was measured with the Tegner activity scale. The EQ-5D was used to evaluate quality of life. RESULTS Thirty-two adolescents (11 boys and 21 girls), aged 12 to 16 years, with a symptomatic unilateral ACL rupture, underwent reconstruction at near skeletally mature age. Of these patients, 29 (91%) took part in the follow-up examination. The BMD values for the male patients were lower on the injured and non-injured sides (-15.2% [P = .02] and -11.8% [P = .05], respectively) compared with the control group. The values for the female patients were -0.8% (P = .84) and -2.2% (P = .69), respectively. Correspondingly, the BMD values for the male patients were lower on the injured and non-injured sides (-8.2% and -4.9%, respectively) compared with the male reference database. The BMD values for the female patients were higher on the injured and non-injured sides (4.1% and 4.3%, respectively) compared with the female reference database. In the control group, female patients had a significantly lower value for the Tegner activity scale preoperatively (median, 2.0; range, 0 to 5) than the female patients in the study group (median, 3.0; range, 2 to 8) (P = .006). In the study group, the Tegner activity scale at follow-up showed a significant correlation with the BMD on the injured side for male patients (ρ = 0.67, P = .03) but not on the non-injured side (ρ = 0.50, P = .14). In the control group, the Tegner activity scale at follow-up showed a significant correlation with the BMD on the non-injured side for female patients (ρ = 0.61, P = .03) but not on the injured side (ρ = 0.34, P = .25). The Tegner activity scale and EQ-5D showed no significant differences between the study groups. CONCLUSIONS In the long-term, the BMD in the calcanei of patients who were adolescents at the time of ACL reconstruction differed from that of a control group and a reference database. This study indicates that boys with an ACL injury and subsequent ACL reconstruction run a subsequent risk of a significantly lower BMD in their calcanei as adults and, consequently, an increased future fracture risk. LEVEL OF EVIDENCE Level III, case-control study.
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18
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Guo B, Xu Y, Gong J, Tang Y, Shang J, Xu H. Reference data and percentile curves of body composition measured with dual energy X-ray absorptiometry in healthy Chinese children and adolescents. J Bone Miner Metab 2015; 33:530-9. [PMID: 25319556 DOI: 10.1007/s00774-014-0615-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 06/26/2014] [Indexed: 11/28/2022]
Abstract
Measurements of body composition by dual-energy X-ray absorptiometry (DXA) have evident value in evaluating skeletal and muscular status in growing children and adolescents. This study aimed to generate age-related trends for body composition in Chinese children and adolescents, and to establish gender-specific reference percentile curves for the assessment of muscle-bone status. A total of 1541 Chinese children and adolescents aged from 5 to 19 years were recruited from southern China. Bone mineral content (BMC), lean mass (LM) and fat mass (FM) were measured for total body and total body less head (TBLH). After 14 years, total body LM was significantly higher in boys than girls (p < 0.001). However, total body FM was significantly higher in girls than boys in age groups 13-19 years (p < 0.01). Both LM and FM were consistent independent predictors of total body and subcranial bone mass in both sexes, even after adjustment for the well-known predictors of BMC. The results of multiple linear regression identified LM as the stronger predictor of total body and subcranial skeleton BMC while the fat mass contributed less. For all the subjects, significant positive correlations were observed between total body LM, height, total body BMC and subcranial BMC (p < 0.01). Subcranial BMC had a better correlation with LM than total body BMC. We have also presented gender-specific percentile curves for LM-for-height and BMC-for-LM which could be used to evaluate and follow various pediatric disorders with skeletal manifestations in this population.
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Affiliation(s)
- Bin Guo
- Department of Nuclear Medicine, The First Affiliated Hospital, Jinan University, No.613, West Huangpu Road, Guangzhou, 510630, China
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19
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Lumbar disc herniation surgery in children: outcome and gender differences. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015. [PMID: 26198707 DOI: 10.1007/s00586-015-4149-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Lumbar disc herniation (LDH) in children is rare. Few studies have evaluated the outcome of surgery and none in a prospective study design. PURPOSE To evaluate preoperative disability and postoperative outcome in children operated on for LDH. METHODS Through a 10-year period, 74 children aged <18 years were included in SweSpine register for LDH with pre- and perioperative data registered, 48 with 1-year follow-up data. Demographics and outcome measurements were described according to the SweSpine protocol. RESULTS All patients reported preoperatively severe impairment in terms of pain, quality of life and function, girls to a higher extent. Significant postoperative improvement was seen in all patients, leaving no patients dissatisfied with outcome. The PROMS were 1 year after surgery within normal ranges, but remained slightly lower for girls. CONCLUSION Operative treatment of LDH in growing individuals leads to very good outcome with high degree of patient satisfaction.
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20
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Buttazzoni C, Rosengren BE, Karlsson C, Dencker M, Nilsson JÅ, Karlsson MK. A Pediatric Bone Mass Scan has Poor Ability to Predict Peak Bone Mass: An 11-Year Prospective Study in 121 Children. Calcif Tissue Int 2015; 96:379-88. [PMID: 25716719 DOI: 10.1007/s00223-015-9965-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 02/09/2015] [Indexed: 10/24/2022]
Abstract
This 11-year prospective longitudinal study examined how a pre-pubertal pediatric bone mass scan predicts peak bone mass. We measured bone mineral content (BMC; g), bone mineral density (BMD; g/cm(2)), and bone area (cm(2)) in femoral neck, total body and lumbar spine by dual-energy X-ray absorptiometry in a population-based cohort including 65 boys and 56 girls. At baseline all participants were pre-pubertal with a mean age of 8 years (range 6-9), they were re-measured at a mean 11 years (range 10-12) later. The participants were then mean 19 years (range 18-19), an age range that corresponds to peak bone mass in femoral neck in our population. We calculated individual BMC, BMD, and bone size Z scores, using all participants at each measurement as reference and evaluated correlations between the two measurements. Individual Z scores were also stratified in quartiles to register movements between quartiles from pre-pubertal age to peak bone mass. The correlation coefficients (r) between pre-pubertal and young adulthood measurements for femoral neck BMC, BMD, and bone area varied between 0.37 and 0.65. The reached BMC value at age 8 years explained 42 % of the variance in the BMC peak value; the corresponding values for BMD were 31 % and bone area 14 %. Among the participants with femoral neck BMD in the lowest childhood quartile, 52 % had left this quartile at peak bone mass. A pediatric bone scan with a femoral neck BMD value in the lowest quartile had a sensitivity of 47 % [95 % confidence interval (CI) 28, 66] and a specificity of 82 % (95 % CI 72, 89) to identify individuals who would remain in the lowest quartile at peak bone mass. The pre-pubertal femoral neck BMD explained only 31 % of the variance in femoral neck peak bone mass. A pre-pubertal BMD scan in a population-based sample has poor ability to predict individuals who are at risk of low peak bone mass.
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Affiliation(s)
- Christian Buttazzoni
- Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skåne University Hospital, Lund University, 205 02, Malmō, Sweden,
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21
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Liberato SC, Maple-Brown L, Bressan J. Association between bone mineralization, body composition, and cardiorespiratory fitness level in young Australian men. J Clin Densitom 2015; 18:187-91. [PMID: 25534275 DOI: 10.1016/j.jocd.2014.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/13/2014] [Accepted: 10/28/2014] [Indexed: 11/26/2022]
Abstract
The critical age for attainment of peak bone mineralization is however 20-30 yr, but few studies have investigated bone mineralization and its association with body composition and cardiorespiratory fitness level in young men. This study aimed to investigate relationships between age, bone mineral measurements, body composition measurements, and cardiorespiratory fitness level in a group of young healthy Australian men. Thirty-five healthy men aged 18-25 yr had anthropometric measures, body composition, and cardiorespiratory fitness level assessed. Bone mineral content was significantly associated with height, body mass and lean mass, and bone mineral density positively correlated with lean mass and body mass. Bone mineral measurements did not correlate with fat mass, percentage of fat mass, or cardiorespiratory fitness level. Age was directly correlated with total body mass, body fat, and percentage of fat mass. Body mineral measurements correlated with lean mass but not with fat mass or with cardiorespiratory fitness in this group of young healthy men. Positive association between body fat and age in such young group suggests that more studies with young men are warranted and may help inform strategies to optimize increase in bone mineral measurements.
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Affiliation(s)
- Selma Coelho Liberato
- Wellbeing and Chronic Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
| | - Louise Maple-Brown
- Wellbeing and Chronic Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Josefina Bressan
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Nachshon L, Goldberg MR, Schwartz N, Sinai T, Amitzur-Levy R, Elizur A, Eisenberg E, Katz Y. Decreased bone mineral density in young adult IgE-mediated cow's milk–allergic patients. J Allergy Clin Immunol 2014; 134:1108-1113.e3. [DOI: 10.1016/j.jaci.2014.06.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Revised: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 12/26/2022]
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Nakavachara P, Pooliam J, Weerakulwattana L, Kiattisakthavee P, Chaichanwattanakul K, Manorompatarasarn R, Chokephaibulkit K, Viprakasit V. A normal reference of bone mineral density (BMD) measured by dual energy X-ray absorptiometry in healthy thai children and adolescents aged 5-18 years: a new reference for Southeast Asian Populations. PLoS One 2014; 9:e97218. [PMID: 24847716 PMCID: PMC4029563 DOI: 10.1371/journal.pone.0097218] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 04/16/2014] [Indexed: 11/19/2022] Open
Abstract
Ethnic-specific normative data of bone mineral density (BMD) is essential for the accurate interpretation of BMD measurement. There have been previous reports of normative BMD data for Caucasian and Asian children including Japanese, Chinese, Korean and Indian. However, the normative BMD data for Southeast Asian including Thai children and adolescents are not currently available. The goals of our study were 1) to establish normative data of BMD, bone mineral content (BMC), bone area (BA) and lean body mass (LBM) for healthy Thai children and adolescents; aged 5–18 years measured by dual energy X-ray absorptiometry (DXA, Lunar Prodigy) and 2) to evaluate the relationships between BMD vs. age, sex, puberty, weight, height, calcium intake and the age of menarche in our population. Gender and age-specific BMD (L2-4; LS and total body; TB), BMADLS (apparent BMD of the lumbar spine), BMC (L2-4 and total body), BA (L2-4 and total body) and LBM were evaluated in 367 children (174 boys and 193 girls). All parameters increased progressively with age. A rapid increase in BMD, BMC and BMADLS was observed at earlier ages in girls. Gender and Tanner stage-specific BMD normative data were also generated. The dynamic changes of BMD values from childhood to early and late puberty of Thai children appeared to be consistent with those of Caucasian and Asian populations. Using a multiple-regression, weight and Tanner stage significantly affected BMDLS, BMDTB and BMADLS in both genders. Only in girls, height was found to have significant influence on BMDTB and BMADLS. The positive correlation between BMD and several demographic parameters, except the calcium intake, was observed. In summary, we established a normal BMD reference for Thai children and adolescents and this will be of useful for clinicians and researchers to appropriately assess BMD in Thais and other Southeast Asian children.
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Affiliation(s)
- Pairunyar Nakavachara
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
- * E-mail:
| | - Julaporn Pooliam
- Clinical Epidemiological Unit, Office for Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Linda Weerakulwattana
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pornpimol Kiattisakthavee
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Katharee Chaichanwattanakul
- Division of Pediatric Endocrinology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Racahnee Manorompatarasarn
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kulkanya Chokephaibulkit
- Division of Pediatric Infectious Diseases, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Vip Viprakasit
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Abstract
Growth charts for weight and height have provided the basis for assessment of children's nutritional status for over half a century, with charts for body mass index (BMI) introduced in the 1990s. However, BMI does not provide information on the proportions of fat and lean mass; and within the past decade, growth charts for children's body composition have been produced by using techniques such as skinfold thicknesses, body circumferences, bioelectrical impedance analysis (BIA), and dual-energy X-ray absorptiometry (DXA). For public health research, BIA and skinfold thicknesses show negligible average bias but have wider limits of agreement than specialized techniques. For patients, DXA is the best individual method, but multicomponent models remain ideal because they address perturbations in lean mass composition. Data can be expressed in age- and sex-specific SD scores, in some cases adjusting for height. Most such reference data derive from high-income countries, but techniques such as air-displacement plethysmography allow infant body composition growth charts to be developed in low- and middle-income settings, where the data may improve understanding of the effects of low birth weight, wasting, and stunting on body composition. Recent studies suggest that between-population variability in body composition may derive in part from genetic factors, suggesting a universal human body composition reference may not be viable. Body composition growth charts may be extended into adult life to evaluate changes in fat and lean mass through the entire life course. These reference data will improve the understanding of the association between growth, body composition, health, and disease.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, University College London Institute of Child Health, London, UK
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Cöster MC, Rosengren BE, Karlsson C, von Schevelow T, Magnusson H, Brudin L, Karlsson MK. Bone mass and anthropometry in patients with osteoarthritis of the foot and ankle. Foot Ankle Surg 2014; 20:52-6. [PMID: 24480501 DOI: 10.1016/j.fas.2013.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 09/10/2013] [Accepted: 10/14/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with hip and knee osteoarthritis (OA) have high bone mineral density (BMD) and high BMI. If the same accounts for patients with foot or ankle OA is unknown. METHODS We measured BMD and femoral neck (FN) width by dual-energy X-ray absorptiometry in 42 women and 19 men with idiopathic OA in the foot or ankle, and in 99 women and 82 men as controls. RESULTS Women with OA had significant higher BMI than controls. Women with OA had higher BMI-adjusted BMD (p<0.01) and smaller BMI-adjusted FN width (p<0.01) than controls. Men with OA had higher BMI adjusted-BMD (p<0.05) and smaller BMI-adjusted FN width (p<0.01) than controls. CONCLUSION Patients with OA in the foot or ankle have higher BMD and smaller bone size than being expected by their BMI. This phenotype may provide unfavourable forces across the joint and is hypothetically important for development of OA.
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Affiliation(s)
- M C Cöster
- Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö; Department of Orthopedics, Kalmar Hospital, Kalmar, Sweden.
| | - B E Rosengren
- Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö
| | - C Karlsson
- Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö
| | - T von Schevelow
- Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö
| | - H Magnusson
- Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö
| | - L Brudin
- Department of Orthopedics, Kalmar Hospital, Kalmar, Sweden
| | - M K Karlsson
- Department of Orthopedics and Clinical Sciences, Lund University, Skåne University Hospital, Malmö
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Meyer U, Ernst D, Zahner L, Schindler C, Puder JJ, Kraenzlin M, Rizzoli R, Kriemler S. 3-Year follow-up results of bone mineral content and density after a school-based physical activity randomized intervention trial. Bone 2013; 55:16-22. [PMID: 23510752 DOI: 10.1016/j.bone.2013.03.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Revised: 03/07/2013] [Accepted: 03/09/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND As an important modifiable lifestyle factor in osteoporosis prevention, physical activity has been shown to positively influence bone mass accrual during growth. We have previously shown that a nine month general school based physical activity intervention increased bone mineral content (BMC) and density (aBMD) in primary school children. From a public health perspective, a major key issue is whether these effects persist during adolescence. We therefore measured BMC and aBMD three years after cessation of the intervention to investigate whether the beneficial short-term effects persisted. METHODS All children from 28 randomly selected first and fifth grade classes (intervention group (INT): 16 classes, n=297; control group (CON): 12 classes, n=205) who had participated in KISS (Kinder-und Jugendsportstudie) were contacted three years after cessation of the intervention program. The intervention included daily physical education with daily impact loading activities over nine months. Measurements included anthropometry, vigorous physical activity (VPA) by accelerometers, and BMC/aBMD for total body, femoral neck, total hip, and lumbar spine by dual-energy X-ray absorptiometry (DXA). Sex- and age-adjusted Z-scores of BMC or aBMD at follow-up were regressed on intervention (1 vs. 0), the respective Z-score at baseline, gender, follow-up height and weight, pubertal stage at follow-up, previous and current VPA, adjusting for clustering within schools. RESULTS 377 of 502 (75%) children participated in baseline DXA measurements and of those, 214 (57%) participated to follow-up. At follow-up INT showed significantly higher Z-scores of BMC at total body (adjusted group difference: 0.157 units (0.031-0.283); p=0.015), femoral neck (0.205 (0.007-0.402); p=0.042) and at total hip (0.195 (0.036 to 0.353); p=0.016) and higher Z-scores of aBMD for total body (0.167 (0.016 to 0.317); p=0.030) compared to CON, representing 6-8% higher values for children in the INT. No differences could be found for the remaining bone parameters. For the subpopulation with baseline VPA (n=163), effect sizes became stronger after baseline VPA adjustment. After adjustment for baseline and current VPA (n=101), intervention effects were no longer significant, while effect sizes remained the same as without adjustment for VPA. CONCLUSION Beneficial effects on BMC of a nine month general physical activity intervention appeared to persist over three years. Part of the maintained effects may be explained by current physical activity.
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Affiliation(s)
- Ursina Meyer
- Swiss Tropical and Public Health Institute, 4053 Basel, Switzerland.
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27
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Atherton RR, Williams JE, Wells JCK, Fewtrell MS. Use of fat mass and fat free mass standard deviation scores obtained using simple measurement methods in healthy children and patients: comparison with the reference 4-component model. PLoS One 2013; 8:e62139. [PMID: 23690932 PMCID: PMC3656861 DOI: 10.1371/journal.pone.0062139] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 03/19/2013] [Indexed: 12/03/2022] Open
Abstract
Background Clinical application of body composition (BC) measurements for individual children has been limited by lack of appropriate reference data. Objectives (1) To compare fat mass (FM) and fat free mass (FFM) standard deviation scores (SDS) generated using new body composition reference data and obtained using simple measurement methods in healthy children and patients with those obtained using the reference 4-component (4-C) model; (2) To determine the extent to which scores from simple methods agree with those from the 4-C model in identification of abnormal body composition. Design FM SDS were calculated for 4-C model, dual-energy X-ray absorptiometry (DXA; GE Lunar Prodigy), BMI and skinfold thicknesses (SFT); and FFM SDS for 4CM, DXA and bioelectrical impedance analysis (BIA; height2/Z)) in 927 subjects aged 3.8–22.0 y (211 healthy, 716 patients). Results DXA was the most accurate method for both FM and FFM SDS in healthy subjects and patients (mean bias (limits of agreement) FM SDS 0.03 (±0.62); FFM SDS −0.04 (±0.72)), and provided best agreement with the 4-C model in identifying abnormal BC (SDS ≤−2 or ≥2). BMI and SFTs were reasonable predictors of abnormal FM SDS, but poor in providing an absolute value. BIA was comparable to DXA for FFM SDS and in identifying abnormal subjects. Conclusions DXA may be used both for research and clinically to determine FM and FFM SDS. BIA may be used to assess FFM SDS in place of DXA. BMI and SFTs can be used to measure adiposity for groups but not individuals. The performance of simpler techniques in monitoring longitudinal BC changes requires investigation. Ultimately, the most appropriate method should be determined by its predictive value for clinical outcome.
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Affiliation(s)
- Rachel R. Atherton
- Childhood Nutrition Research Centre, UCL (University College London) Institute of Child Health, London, United Kingdom
| | - Jane E. Williams
- Childhood Nutrition Research Centre, UCL (University College London) Institute of Child Health, London, United Kingdom
| | - Jonathan C. K. Wells
- Childhood Nutrition Research Centre, UCL (University College London) Institute of Child Health, London, United Kingdom
| | - Mary S. Fewtrell
- Childhood Nutrition Research Centre, UCL (University College London) Institute of Child Health, London, United Kingdom
- * E-mail:
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28
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Normative data and percentile curves of bone mineral density in healthy Iranian children aged 9-18 years. Arch Osteoporos 2013; 8:114. [PMID: 23297104 DOI: 10.1007/s11657-012-0114-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 11/23/2012] [Indexed: 02/03/2023]
Abstract
UNLABELLED We provide the first reference values for bone mineral content and bone mineral density according to age and sex in Iranian children and adolescents. The prevalence of hypovitaminosis D was high, and levels of physical activity were low in our sample. Multiple regression analyses showed age, BMI, and Tanner stage to be the main indicators of bone mineral apparent density. PURPOSE Normal bone structure is formed in childhood and adolescence. The potential determinants which interact with genetic factors to influence bone density include gender, nutritional, lifestyle, and hormonal factors. This study aimed to evaluate bone mineral content (BMC) and the bone mineral density (BMD) and factors that may interfere with it in Iranian children. METHODS In this cross-sectional study, 476 healthy Iranian children and adolescents (235 girls and 241 boys) aged 9-18 years old participated. BMC and BMD of the lumbar spine, femoral neck, and total body were measured by dual-energy X-ray absorptiometry using a Hologic Discovery device, and bone mineral apparent density (BMAD) of the lumbar spine and the femoral neck were calculated. RESULTS We present percentile curves by age derived separately for BMC, BMD, and BMAD of the lumbar spine, left femoral neck, and total body excluding the head for boys and girls. Maximum accretion of BMC and BMD was observed at ages of 11-13 years (girls) and 12-15 years (boys).The prevalence of hypovitaminosis D was high and physical activity was low in our participants. However, in multiple regression analyses, age, BMI, and Tanner stage were the main indicators of BMD and BMAD CONCLUSION: These normative data aid in the evaluation of bone density in Iranian children and adolescents. Further research to evaluate the evolution of BMD in Iranian children and adolescents is needed to identify the reasons for significant differences in bone density values between Iranian populations and their Western counterparts.
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Wells JCK, Williams JE, Chomtho S, Darch T, Grijalva-Eternod C, Kennedy K, Haroun D, Wilson C, Cole TJ, Fewtrell MS. Body-composition reference data for simple and reference techniques and a 4-component model: a new UK reference child. Am J Clin Nutr 2012; 96:1316-26. [PMID: 23076617 DOI: 10.3945/ajcn.112.036970] [Citation(s) in RCA: 134] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A routine pediatric clinical assessment of body composition is increasingly recommended but has long been hampered by the following 2 factors: a lack of appropriate techniques and a lack of reference data with which to interpret individual measurements. Several techniques have become available, but reference data are needed. OBJECTIVE We aimed to provide body-composition reference data for use in clinical practice and research. DESIGN Body composition was measured by using a gold standard 4-component model, along with various widely used reference and bedside methods, in a large, representative sample of British children aged from 4 to ≥20 y. Measurements were made of anthropometric variables (weight, height, 4 skinfold thicknesses, and waist girth), dual-energy X-ray absorptiometry, body density, bioelectrical impedance, and total body water, and 4-component fat and fat-free masses were calculated. Reference charts and SD scores (SDSs) were constructed for each outcome by using the lambda-mu-sigma method. The same outcomes were generated for the fat-free mass index and fat mass index. RESULTS Body-composition growth charts and SDSs for 5-20 y were based on a final sample of 533 individuals. Correlations between SDSs by using different techniques were ≥0.68 for adiposity outcomes and ≥0.80 for fat-free mass outcomes. CONCLUSIONS These comprehensive reference data for pediatric body composition can be used across a variety of techniques. Together with advances in measurement technologies, the data should greatly enhance the ability of clinicians to assess and monitor body composition in routine clinical practice and should facilitate the use of body-composition measurements in research studies.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, University College London Institute of Child Health, London, United Kingdom.
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Katzmarzyk PT, Shen W, Baxter-Jones A, Bell JD, Butte NF, Demerath EW, Gilsanz V, Goran MI, Hirschler V, Hu HH, Maffeis C, Malina RM, Müller MJ, Pietrobelli A, Wells JCK. Adiposity in children and adolescents: correlates and clinical consequences of fat stored in specific body depots. Pediatr Obes 2012; 7:e42-61. [PMID: 22911903 DOI: 10.1111/j.2047-6310.2012.00073.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 05/22/2012] [Indexed: 12/11/2022]
Abstract
The 2011 Pennington Biomedical Research Center's Scientific Symposium focused on adiposity in children and adolescents. The symposium was attended by 15 speakers and other invited experts. The specific objectives of the symposium were to (i) integrate the latest published and unpublished findings on the laboratory and clinical assessment of depot-specific adiposity in children and adolescents, (ii) understand the variation in depot-specific adiposity and related health outcomes associated with age, sex, maturation, ethnicity and other factors and (iii) identify opportunities for incorporating new markers of abdominal obesity into clinical practice guidelines for obesity in children and adolescents. This symposium provided an overview of important new advances in the field and identified directions for future research. The long-term goal of the symposium is to aid in the early identification of children and adolescents who are at increased health risk because of obesity and obesity-related conditions.
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Affiliation(s)
- P T Katzmarzyk
- Pennington Biomedical Research Center, Baton Rouge, LA 70808-4124, USA.
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Wan W, Deng X, Archer KJ, Sun SS. Pubertal pathways and the relationship to anthropometric changes in childhood: The Fels longitudinal study. OPEN JOURNAL OF PEDIATRICS 2012; 2:10.4236/ojped.2012.22020. [PMID: 24307981 PMCID: PMC3846359 DOI: 10.4236/ojped.2012.22020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine the relationship of the initial manifestation of pubertal development in children to anthropometric measurements recorded during the early childhood and adolescence. METHODS The Fels Longitudinal study is an observational study of growth and development of healthy white children. A total of 109 boys and 75 girls with serial self-assessments of Tanner stages of genital/breast and pubic hair developments provided data for a longitudinal analysis with a linear mixed model. RESULTS About 11.0% of boys and 22.7% of girls witnessed the appearance of pubic hair (adrenarche) prior to the onset of genital/breast growth (gonadarche/thelarche) and about 13.7% of boys and 22.7% of girls experienced the onset of gonadarche/thelarche prior to adrenarche. The remaining 75.3% of boys and 54.7% of girls were concordant for adrenarche and gonadarche/thelarche. During the first two years of life, boys and girls with earlier gonadarche and thelarche than adrenarche were found to have more rapid weight gain than those with earlier adrenarche than gonadarche/thelarche. During early childhood from age 2 - 7 years, those girls with early thelarche had higher body mass index (BMI) and waist circumference to height ratio (waist/height) than those with early adrenarche. In children of ages 8 - 20, girls with early gonadarche had higher BMI z-scores than those with early adrenarche. CONCLUSION Girls with early thelarche and later adrenarche, have more rapid mean weight gain during the first two years of life, higher BMI and waist/height during early childhood, and higher BMI z-scores during adolescence. Boys with early gonadarche and later adrenarche experienced more rapid weight gain during the first two years of life than boys with early adrenarche and later gonadarche. In other words, girls with early thelarche are more likely to be triggered by early accumulation of fat mass than those with early adrenarche.
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Affiliation(s)
- Wen Wan
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, USA
| | - Xiaoyan Deng
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, USA
| | - Kellie J. Archer
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, USA
| | - Shumei S. Sun
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, USA
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Disseldorp LM, Nieuwenhuis MK, Van Baar ME, Mouton LJ. Physical Fitness in People After Burn Injury: A Systematic Review. Arch Phys Med Rehabil 2011; 92:1501-10. [DOI: 10.1016/j.apmr.2011.03.025] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 02/25/2011] [Accepted: 03/02/2011] [Indexed: 10/17/2022]
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