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Singhal V, Kaur S, Haidar LA, Lee H, Bredella MA, Misra M. Differences in bone accrual over one year in young girls with obesity compared to Normal weight controls. Bone 2023; 172:116757. [PMID: 37030498 PMCID: PMC10198942 DOI: 10.1016/j.bone.2023.116757] [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: 09/30/2022] [Revised: 03/14/2023] [Accepted: 03/31/2023] [Indexed: 04/10/2023]
Abstract
Despite higher bone mineral density (BMD), women with obesity are at an increased risk of fracture compared to normal-weight women. Optimal adolescent bone accrual is critical for normal peak bone mass acquisition and future bone health. Whereas several studies have examined the impact of low body weight on bone accrual in youth, data are lacking regarding the impact of obesity on bone accrual. We examined bone accrual over one year in young women with moderate to severe obesity (OB) (n = 21) versus normal-weight controls (NWC) (n = 50). Participants were 13-25 years old. We used dual-energy X-ray absorptiometry to assess areal BMD (aBMD) and high resolution peripheral quantitative computed tomography (distal radius and tibia) to assess volumetric BMD (vBMD), bone geometry, and microarchitecture. Analyses were controlled for age and race. The mean age was 18.7 ± 2.7 years. OB and NWC were similar for age, race, height, and physical activity. OB had a higher BMI (p < 0.0001) and younger menarchal age (p = 0.022) than NWC. Over one year, OB did not demonstrate the increase in total hip BMD observed in NWC (p = 0.03). Increases in percent cortical area and cortical thickness, and cortical and total vBMD at the radius were lower in OB than in NWC (p ≤ 0.037). Groups did not differ for tibial bone accrual. We demonstrate that longitudinal bone accrual is impaired at the total hip and radial cortex in young women with obesity, raising concerns regarding their future bone health.
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Affiliation(s)
- Vibha Singhal
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; MGH Weight Center, Boston, MA, United States of America; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America.
| | - Snimarjot Kaur
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Lea Abou Haidar
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Hang Lee
- MGH Biostatistics Center and Harvard Medical School, Boston, MA, United States of America; Department of Medicine and Harvard Medical School, Boston, MA, United States of America
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Madhusmita Misra
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
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Zheng Y, Rajcsanyi LS, Kowalczyk M, Giuranna J, Herpertz-Dahlmann B, Seitz J, de Zwaan M, Herzog W, Ehrlich S, Zipfel S, Giel K, Egberts K, Burghardt R, Föcker M, Al-Lahham S, Hebebrand J, Fuhrer D, Tan S, Zwanziger D, Peters T, Hinney A. Lipocalin 2 - mutation screen and serum levels in patients with anorexia nervosa or obesity and in lean individuals. Front Endocrinol (Lausanne) 2023; 14:1137308. [PMID: 37025415 PMCID: PMC10071025 DOI: 10.3389/fendo.2023.1137308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/09/2023] [Indexed: 04/08/2023] Open
Abstract
CONTEXT The bone-derived adipokine lipocalin-2 is relevant for body weight regulation by stimulating the leptin-melanocortin pathway. OBJECTIVE We aimed to (i) detect variants in the lipocalin-2 gene (LCN2) which are relevant for body weight regulation and/or anorexia nervosa (AN); (ii) describe and characterize the impact of LCN2 and MC4R variants on circulating lipocalin-2 level. METHODS Sanger sequencing of the coding region of LCN2 in 284 children and adolescents with severe obesity or 287 patients with anorexia nervosa. In-silico analyses to evaluate functional implications of detected LCN2 variants. TaqMan assays for rare non-synonymous variants (NSVs) in additional independent study groups. Serum levels of lipocalin-2 were measured by ELISA in 35 females with NSVs in either LCN2 or MC4R, and 33 matched controls without NSVs in the two genes. RESULTS Fourteen LCN2-variants (five NSVs) were detected. LCN2-p.Leu6Pro and p.Gly9Val located in the highly conserved signal peptide region may induce functional consequences. The secondary structure change of lipocalin-2 due to LCN2-p.Val89Ile may decrease solubility and results in a low lipocalin-2 level in a heterozygotes carrier (female recovered from AN). Lean individuals had lower lipocalin-2 levels compared to patients with obesity (p = 0.033). CONCLUSION Lipocalin-2 levels are positively associated with body mass index (BMI). Single LCN2-variants might have a profound effect on lipocalin-2 levels.
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Affiliation(s)
- Yiran Zheng
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- *Correspondence: Yiran Zheng,
| | - Luisa Sophie Rajcsanyi
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Manuela Kowalczyk
- Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry – Division of Laboratory Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Johanna Giuranna
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of the RWTH Aachen, Aachen, Germany
| | - Jochen Seitz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of the RWTH Aachen, Aachen, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Wolfgang Herzog
- Department of Internal Medicine II, General Internal and Psychosomatic Medicine, University of Heidelberg, Heidelberg, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Department of Child and Adolescent Psychiatry, TU-Dresden, University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany
- Eating Disorders Research and Treatment Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Tübingen, Germany
- Centre of Excellence for Eating Disorders, University of Tübingen, Tübingen, Germany
| | - Katrin Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital, Tübingen, Germany
- Centre of Excellence for Eating Disorders, University of Tübingen, Tübingen, Germany
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Roland Burghardt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Oberberg Fachklinik Fasanenkiez, Berlin, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, University of Münster, Münster, Germany
| | - Saad Al-Lahham
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Fuhrer
- Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry – Division of Laboratory Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Tan
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Denise Zwanziger
- Department of Endocrinology, Diabetes and Metabolism and Clinical Chemistry – Division of Laboratory Research, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Triinu Peters
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anke Hinney
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Djafari F, Eslahi M, Zandi N, Pazoki B, Reza Amini M, Shab-Bidar S. The inverse association of body adiposity index and bone health in the older adults: A report from a developing country. Int J Clin Pract 2021; 75:e14718. [PMID: 34378289 DOI: 10.1111/ijcp.14718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 08/08/2021] [Indexed: 11/29/2022] Open
Abstract
The ageing process influences body composition and could be related to bone health. The current study was set out to evaluate the association between body adiposity index (BAI) and bone health in older adults. This is a cross-sectional study performed on 178 elderly persons (51 men and 127 women) with a mean age of 67.04 (range: 60-83) who was referred to the determined 25 health centres in Tehran. The anthropometric measurements were done. Further, serum 25-hydroxy vitamin D (25(OH)D), parathormone (PTH), high-sensitivity C-reactive protein (hs-CRP), osteocalcin and urine C-terminal telopeptide I (CTX-I) were collected. The mean of body mass index (P < .001), body weight (P = .002), body fat (P < .001), waist circumference (P < .001), hip circumference (P < .001), urine CTX-I concentration (P = .011), 25(OH)D (P = .030), was higher in the highest BAI category in comparison with the lowest one. BAI was negatively correlated with urine CTX-I concentration (r=-0.165, P = .028). Moreover, linear regression showed an inverse association between BAI with urine CTX-I (β = -0.165, P = .025) and 25(OH)D (β = -0.039, P = .029). Moreover, the percentage of body fat was positively associated with serum hs-CRP (β = 0.026, P = .002). Our study showed a significant inverse association between BAI with urinary CTX-I which shows the effect of obesity on bone health. This study suggests that more clinical and prospective studies for monitoring body fat may have some favourable impacts on bone health.
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Affiliation(s)
- Farhang Djafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Masoumeh Eslahi
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Nadia Zandi
- Tehran University of Medical Science (TUMS), Tehran, Iran
| | | | - Mohammad Reza Amini
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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Buckley JP, Kuiper JR, Lanphear BP, Calafat AM, Cecil KM, Chen A, Xu Y, Yolton K, Kalkwarf HJ, Braun JM. Associations of Maternal Serum Perfluoroalkyl Substances Concentrations with Early Adolescent Bone Mineral Content and Density: The Health Outcomes and Measures of the Environment (HOME) Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:97011. [PMID: 34585601 PMCID: PMC8480151 DOI: 10.1289/ehp9424] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Per- and polyfluoroalkyl substances (PFAS) may impair bone accrual and strength via endocrine disruption and nuclear receptor agonism, but human studies are primarily of adults or cross-sectional. OBJECTIVES We assessed associations of individual PFAS and their mixture during pregnancy with child bone mineral content (BMC) and areal bone mineral density (aBMD) at age 12 y. METHODS Among 206 mother-child pairs enrolled in a prospective cohort (2003-2006), we quantified perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorohexane sulfonic acid (PFHxS), and perfluorooctane sulfonic acid (PFOS) in maternal serum collected during gestation or delivery. When children were age 12 y, we performed dual energy X-ray absorptiometry and calculated BMC, aBMD, and bone mineral apparent density (BMAD) z -scores for six skeletal sites. We estimated covariate-adjusted z -score differences per doubling of individual PFAS using linear regression and assessed the PFAS mixture using quantile g-computation and Bayesian kernel machine regression. We explored whether associations were modified by child's sex or mediated by whole-body lean mass. RESULTS In covariate-adjusted models, we found that higher maternal serum concentrations of PFOA, PFNA, and the PFAS mixture were associated with lower total hip and forearm (one-third distal radius) BMC z -scores in children. Differences in forearm BMC z -scores were - 0.17 [95% confidence interval (CI): - 0.35 , 0.01] and - 0.24 (95% CI: - 0.44 , - 0.05 ) per doubling of PFOA and PFNA, respectively, and - 0.18 (95% CI: - 0.34 , - 0.02 ) per quartile increase in the PFAS mixture. Child's sex modified PFOA associations for some skeletal sites; for example, differences in spine BMAD z -score per doubling were - 0.31 (95% CI: - 0.58 , - 0.03 ) among males and 0.07 (95% CI: - 0.16 , 0.30) among females (modification p = 0.04 ). Except for PFNA among females, these associations were not mediated by whole-body lean mass. DISCUSSION Maternal PFAS concentrations during pregnancy may be associated with lower bone mineral accrual and strength in early adolescence. https://doi.org/10.1289/EHP9424.
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Affiliation(s)
- Jessie P. Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jordan R. Kuiper
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Antonia M. Calafat
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kim M. Cecil
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Philadelphia, Pennsylvania, USA
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Heidi J. Kalkwarf
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
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Baradaran Mahdavi S, Daniali SS, Farajzadegan Z, Bahreynian M, Riahi R, Kelishadi R. Association between maternal smoking and child bone mineral density: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:23538-23549. [PMID: 32314283 DOI: 10.1007/s11356-020-08740-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
Maternal smoking during pregnancy has detrimental effects on fetal development. The current review examined the differences in offspring's bone mineral density (BMD) between mothers smoked during pregnancy and those who did not. A systematic review and meta-analysis on the studies investigating the influence of maternal smoking during pregnancy on children or neonates' bone measures published up to October 30, 2018, was performed. BMD results measured at different body sites were pooled and then fixed or random effect models were used based on the presence of heterogeneity. The desired pooled effect size was the offspring's BMD mean difference with 95% confidence interval between smoker and non-smoker mothers. Sensitivity analysis was performed for birth weight and current weight, two important mediator/confounders causing heterogeneity. Overall, eight studies consisting of 17,931 participants aged from infancy to 18 years were included. According to the fixed effect model, the mean of BMD in offspring whose mothers smoked during pregnancy was 0.01 g/cm2 lower than those with non-smoker mothers (95% CI = - 0.02 to - 0.002). However, subgroup meta-analysis adjusted for birth weight and current weight demonstrated no significant mean difference between BMD of children with smoker and non-smoker mothers (d = 0.06, 95% CI = -0.04 to 0.16, p value = 0.25 and d = - 0.005, 95% CI = - 0.01 to 0.004, p value = 0.28, respectively). According to available studies, it is suggested that maternal smoking during pregnancy does not have direct effect on the offspring's BMD. Instead, this association might be confounded by other factors such as placental weight, birth weight, and current body size of children.
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Affiliation(s)
- Sadegh Baradaran Mahdavi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Student Research Committee, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyede Shahrbanoo Daniali
- Pediatric Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ziba Farajzadegan
- Department of Community Medicine, Faculty of Medicine, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Bahreynian
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran
| | - Roya Riahi
- Biostatistics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical science, Isfahan, Iran.
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Science, Isfahan, Iran.
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Cheng L, Pohlabeln H, Ahrens W, Russo P, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, De Henauw S, Moreno L, Page A, Hebestreit A. Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents. Bone 2020; 131:115162. [PMID: 31760215 DOI: 10.1016/j.bone.2019.115162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/20/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
Abstract
Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.
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Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | | | - Luis Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009 Zaragoza, Spain
| | - Angie Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
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Bierhals IO, Dos Santos Vaz J, Bielemann RM, de Mola CL, Barros FC, Gonçalves H, Wehrmeister FC, Assunção MCF. Associations between body mass index, body composition and bone density in young adults: findings from a southern Brazilian cohort. BMC Musculoskelet Disord 2019; 20:322. [PMID: 31288773 PMCID: PMC6617655 DOI: 10.1186/s12891-019-2656-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/27/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the association of body composition components and obesity with bone density. METHODS Prospective study with data on 2968 members of the 1993 Pelotas Birth Cohort from follow-ups at 18 and 22 years of age. Areal bone mineral density (aBMD, g/cm2) was evaluated for whole body, lumbar spine, and femoral neck at 22 years using dual-energy X-ray absorptiometry. Simple and multiple linear regression, stratified by sex, were used to assess the effect of BMI, fat mass (FMI) and lean mass index (LMI), evaluated at 18 and 22 years, and obesity trajectories classified by FMI and categorized as "never", "only at 18 years", "only at 22 years" or "always" on aBMD. RESULTS Among men, the largest coefficients were observed for BMI, followed by lean mass and fat mass. Compared to fat mass, lean mass presented the largest coefficients for all sites, with the strongest associations observed for the femoral neck (β: 0.035 g/cm2; 95% CI: 0.031; 0.039 for both follow-ups), while the largest effect for FMI was observed for whole-body aBMD at 18 years (β: 0.019 g/cm2; 95% CI: 0.014; 0.024). Among women, the strongest associations were observed for LMI. The largest coefficients for LMI and FMI were observed for femoral neck at age 18, presented β: 0.030 g/cm2, 95% CI: 0.026, 0.034 for LMI and β: 0.012 g/cm2; 95% CI: 0.009; 0.015) for FMI. Men who were "always obese" according to FMI had smallest aBMD for spine (β: -0.014; 95%CI: - 0.029; - 0.001). Women who were obese "only at 18 years" had smallest aBMD for the whole-body (β: -0.013; 95%CI: - 0.023; - 0.002), whereas those who were obese "only at 22 years" had larger whole-body and femoral neck aBMD (β: 0.013; 95%CI: 0.009; 0.017 and β: 0.027; 95%CI: 0.016; 0.038, respectively) and those "always obese" for whole-body aBMD (β: 0.005; 95%CI: 0.001; 0.011) compared to the reference category. CONCLUSIONS The indexes were positively associated with aBMD in this sample. Fat mass had smaller positive influence on these outcomes than lean mass, suggesting the most important body composition component for bone density is the lean mass.
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Affiliation(s)
- Isabel Oliveira Bierhals
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil.
| | - Juliana Dos Santos Vaz
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Renata Moraes Bielemann
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Christian Loret de Mola
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Fernando Celso Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Fernando César Wehrmeister
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
| | - Maria Cecília Formoso Assunção
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160 - 3o andar, Pelotas/RS, 96020-220, Brazil
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Prenatal concentrations of perfluoroalkyl substances and bone health in British girls at age 17. Arch Osteoporos 2018; 13:84. [PMID: 30076472 PMCID: PMC6093196 DOI: 10.1007/s11657-018-0498-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 07/21/2018] [Indexed: 02/03/2023]
Abstract
UNLABELLED Prenatal exposures to perfluoroalkyl substances (PFAS) have been associated with developmental outcomes in offspring. We found that prenatal concentrations of some PFAS may be associated with reduced bone mass and size in 17-year-old British girls, although it is not clear whether these associations are driven by body size. PURPOSE PFAS are used to make protective coatings on common household products. Prenatal exposures have been associated with developmental outcomes in offspring. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the association between prenatal concentrations of PFAS and bone health in girls at 17 years of age and whether body composition can explain any associations. METHODS We measured concentrations of perfluorooctane sulfonate (PFOS), perfluorooctanoate (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) in maternal serum samples collected during pregnancy. We obtained bone health outcomes in the girls, such as bone mineral density, bone mineral content, bone area, and area-adjusted bone mineral content from whole-body dual-energy X-ray absorptiometry (DXA) scans. We used multivariable linear regression to explore associations between each PFAS and each bone health outcome with adjustment for important confounders such as girls' age at clinic visit, maternal education, and gestational age at sample collection. We also controlled for girls' height and lean mass to explore the role body composition had on observed associations. RESULTS Prenatal PFOS, PFOA, PFHxS, and PFNA concentrations were associated with inverse effects on bone size and mass after adjusting for important confounders. Conversely, PFNA was positively associated with area-adjusted bone mineral content. However, most significant associations attenuated after additional controlling for height and lean mass. CONCLUSIONS Prenatal concentrations of some PFAS may be associated with reduced bone mass and size in adolescent girls, although it is not clear whether these associations are driven by body size.
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Khadilkar AV, Sanwalka N, Mughal MZ, Chiplonkar S, Khadilkar V. Indian girls have higher bone mineral content per unit of lean body than boys through puberty. J Bone Miner Metab 2018; 36:364-371. [PMID: 28580516 DOI: 10.1007/s00774-017-0843-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
Abstract
Our aim is to describe changes in the muscle-bone unit assessed as a ratio of bone mineral content (BMC) to lean body mass (LBM) through puberty at total body and various skeletal sites in Indian boys and girls. A cross-sectional study was conducted (888 children, 480 boys, aged 5-17 years) in Pune, India. Pubertal staging was assessed. BMC, LBM and fat percentage at the arms, legs, android, gynoid and total body (less the head) were assessed by dual energy X-ray absorptiometry. The amount of BMC per unit LBM (BMC/LBM) was computed. Changes in mean BMC/LBM at 5 Tanner (pubertal) stages after adjustment for age and fat percentage were calculated. In boys, adjusted BMC/LBM was significantly higher with successive Tanner stages [legs (TS-II vs TS-I), android (TS-III vs TS-II, TS-IV vs TS-III) and gynoid region (TS-III vs TS-II and TS-II vs TS-I) (p < 0.05)]. In girls, adjusted BMC/LBM was significantly higher with successive Tanner stages at total body, legs and gynoid (TS-III vs TS-II; TS-II vs TS-I; TS-V vs TS-IV), arms (TS-I to TS-V) and android regions (TS-V vs TS-IV) (p < 0.05). Boys had significantly higher adjusted BMC/LBM than girls at earlier Tanner stages (TS-I to TS-III), whereas girls had significantly higher adjusted BMC/LBM than boys at later Tanner stages (TS-IV, TS-V) (p < 0.05). Indian boys and girls showed higher total and regional body, and age- and fat percentage-adjusted BMC/LBM with successive pubertal stages. Girls had higher BMC/LBM than boys which may possibly act as a reservoir for later demands of pregnancy and lactation.
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Affiliation(s)
- Anuradha V Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Block 5, Lower Ground Floor, 32, Sassoon Road, Pune, 411001, Maharashtra, India.
| | | | - M Zulf Mughal
- Royal Manchester Children's Hospital, Manchester, UK
| | - Shashi Chiplonkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Block 5, Lower Ground Floor, 32, Sassoon Road, Pune, 411001, Maharashtra, India
| | - Vaman Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Block 5, Lower Ground Floor, 32, Sassoon Road, Pune, 411001, Maharashtra, India
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Kelley JC, Stettler-Davis N, Leonard MB, Hill D, Wrotniak BH, Shults J, Stallings VA, Berkowitz R, Xanthopoulos MS, Prout-Parks E, Klieger SB, Zemel BS. Effects of a Randomized Weight Loss Intervention Trial in Obese Adolescents on Tibia and Radius Bone Geometry and Volumetric Density. J Bone Miner Res 2018; 33:42-53. [PMID: 28884881 PMCID: PMC8527854 DOI: 10.1002/jbmr.3288] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/31/2017] [Accepted: 09/06/2017] [Indexed: 01/06/2023]
Abstract
Obese adolescents have increased fracture risk, but effects of alterations in adiposity on bone accrual and strength in obese adolescents are not understood. We evaluated 12-month changes in trabecular and cortical volumetric bone mineral density (vBMD) and cortical geometry in obese adolescents undergoing a randomized weight management program, and investigated the effect of body composition changes on bone outcomes. Peripheral quantitative computed tomography (pQCT) of the radius and tibia, and whole-body dual-energy X-ray absorptiometry (DXA) scans were obtained at baseline, 6 months, and 12 months in 91 obese adolescents randomized to standard care versus behavioral intervention for weight loss. Longitudinal models assessed effects of body composition changes on bone outcomes, adjusted for age, bone length, and African-American ancestry, and stratified by sex. Secondary analyses included adjustment for physical activity, maturation, vitamin D, and inflammatory biomarkers. Baseline body mass index (BMI) was similar between intervention groups. Twelve-month change in BMI in the standard care group was 1.0 kg/m2 versus -0.4 kg/m2 in the behavioral intervention group (p < 0.01). Intervention groups were similar in bone outcomes, so they were combined for subsequent analyses. For the tibia, BMI change was not associated with change in vBMD or structure. Greater baseline lean body mass index (LBMI) associated with higher cortical vBMD in males, trabecular vBMD in females, and polar section modulus (pZ) and periosteal circumference (Peri-C) in both sexes. In females, change in LBMI positively associated with gains in pZ and Peri-C. Baseline visceral adipose tissue (VFAT) was inversely associated with pZ in males and cortical vBMD in females. Change in VFAT did not affect bone outcomes. For the radius, BMI and LBMI changes positively associated with pZ in males. Thus, in obese adolescents, weight loss intervention with modest changes in BMI was not detrimental to radius or tibia bone strength, and changes in lean, but not adiposity, measures were beneficial to bone development. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Jennifer C Kelley
- Division of Endocrinology and Diabetes, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
| | | | - Mary B Leonard
- Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Douglas Hill
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Pediatric Advanced Care Team, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Brian H Wrotniak
- Department of Physical Therapy, D'Youville College, Buffalo, NY, USA
| | - Justine Shults
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Biostatistics and Data Management, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Virginia A Stallings
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Robert Berkowitz
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Melissa S Xanthopoulos
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elizabeth Prout-Parks
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadephia, Philadelphia, PA, USA
| | - Sarah B Klieger
- Biostatistical and Data Management Core, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Babette S Zemel
- Department of Pediatrics, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadephia, Philadelphia, PA, USA
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11
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The Association of Fat and Lean Tissue With Whole Body and Spine Bone Mineral Density Is Modified by HIV Status and Sex in Children and Youth. Pediatr Infect Dis J 2018; 37:71-77. [PMID: 28817419 PMCID: PMC5725259 DOI: 10.1097/inf.0000000000001715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND HIV-infected (HIV-pos) male children/youth showed lower bone mineral density at sexual maturity than HIV-uninfected (HIV-neg) females. It is not known whether complications of HIV disease, including abnormal body fat distribution, contribute to lower bone accrual in male HIV-pos adolescents. METHODS In a cross-sectional study, we evaluated the relationship between body composition (fat and lean mass) and bone mass in HIV-pos and HIV-neg children/youth and determined if it is modified by HIV status and sex. We used generalized estimating equations to simultaneously model the effect of fat/lean mass on multiple bone outcomes, including total body bone mineral density and bone mineral content and spine bone mineral density. We evaluated effect modification by HIV and sex. RESULTS The analysis cohort consisted of 143 HIV-neg and 236 HIV-pos, of whom 55% were black non-Hispanic and 53% were male. Ages ranged from 7 to < 25 years. Half of the children/youth were at Tanner stage 1 and 20% at Tanner 5. Fat mass was more strongly positively correlated with bone mass in HIV-neg than HIV-pos children/youth and these relationships were more evident for total body bone than spine outcomes. Within HIV strata, fat mass and bone were more correlated in female than male children/youth. The relationship between lean mass and bone varied by sex, but not by HIV status. CONCLUSIONS HIV disease diminishes the positive relationship of greater fat mass on bone mass in children/youth. Disruptions in body fat distribution, which are common in HIV disease, may have an impact on bone accretion during pubertal development.
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12
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Styner M, Pagnotti GM, McGrath C, Wu X, Sen B, Uzer G, Xie Z, Zong X, Styner MA, Rubin CT, Rubin J. Exercise Decreases Marrow Adipose Tissue Through ß-Oxidation in Obese Running Mice. J Bone Miner Res 2017; 32:1692-1702. [PMID: 28436105 PMCID: PMC5550355 DOI: 10.1002/jbmr.3159] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 03/17/2017] [Accepted: 04/20/2017] [Indexed: 12/23/2022]
Abstract
The relationship between marrow adipose tissue (MAT) and bone health is poorly understood. We used running exercise to ask whether obesity-associated MAT can be attenuated via exercise and whether this correlates with gains in bone quantity and quality. C57BL/6 mice were divided into diet-induced obesity (DIO, n = 14) versus low-fat diet (LFD, n = 14). After 3 months, 16-week-old mice were allocated to an exercise intervention (LFD-E, DIO-E) or a control group (LFD, DIO) for 6 weeks (4 groups, n = 7/group). Marrow adipocyte area was 44% higher with obesity (p < 0.0001) and after exercise 33% lower in LFD (p < 0.0001) and 39% lower in DIO (p < 0.0001). In LFD, exercise did not affect adipocyte number; however, in DIO, the adipocyte number was 56% lower (p < 0.0001). MAT was 44% higher in DIO measured by osmium-μCT, whereas exercise associated with reduced MAT (-23% in LFD, -48% in DIO, p < 0.05). MAT was additionally quantified by 9.4TMRI, and correlated with osmium-µCT (r = 0.645; p < 0.01). Consistent with higher lipid beta oxidation, perilipin 3 (PLIN3) rose with exercise in tibial mRNA (+92% in LFD, +60% in DIO, p < 0.05). Tibial µCT-derived trabecular bone volume (BV/TV) was not influenced by DIO but responded to exercise with an increase of 19% (p < 0.001). DIO was associated with higher cortical periosteal and endosteal volumes of 15% (p = 0.012) and 35% (p < 0.01), respectively, but Ct.Ar/Tt.Ar was lower by 2.4% (p < 0.05). There was a trend for higher stiffness (N/m) in DIO, and exercise augmented this further. In conclusion, obesity associated with increases in marrow lipid-measured by osmium-μCT and MRI-and partially due to an increase in adipocyte size, suggesting increased lipid uptake into preexisting adipocytes. Exercise associated with smaller adipocytes and less bone lipid, likely invoking increased ß-oxidation and basal lipolysis as evidenced by higher levels of PLIN3. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Maya Styner
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Gabriel M Pagnotti
- Department of Biomedical Engineering, State University of New York, Stony Brook, Stony Brook, NY, USA
| | - Cody McGrath
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Xin Wu
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Buer Sen
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Gunes Uzer
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
- Department of Mechanical and Biomedical Engineering, Boise State University, Boise, ID, USA
| | - Zhihui Xie
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
| | - Xiaopeng Zong
- Department of Radiology and Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, USA
| | - Martin A Styner
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Clinton T Rubin
- Department of Biomedical Engineering, State University of New York, Stony Brook, Stony Brook, NY, USA
| | - Janet Rubin
- Department of Medicine, Division of Endocrinology and Metabolism, University of North Carolina, Chapel Hill, NC, USA
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13
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Gállego Suárez C, Singer BH, Gebremariam A, Lee JM, Singer K. The relationship between adiposity and bone density in U.S. children and adolescents. PLoS One 2017; 12:e0181587. [PMID: 28723934 PMCID: PMC5517060 DOI: 10.1371/journal.pone.0181587] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/03/2017] [Indexed: 11/21/2022] Open
Abstract
Objective In adults, obesity has been associated with several health outcomes including increased bone density. Our objective was to evaluate the association between percent body fat and fat mass with bone mineral density (BMD) in a nationally representative population of children and adolescents. Study design A total of 8,348 participants 8–18 years of age from the National Health and Nutrition Examination Survey (NHANES) 1999–2006 had whole body DXA scans performed. We conducted linear regressions to examine the relationship between percent body fat and fat mass with outcome variables of total body, pelvic and lumbar spine areal BMD (aBMD), controlling for lean body mass and assessing for gender and race/ethnicity interactions. Results We found evidence of gender and race/ethnicity interactions with percent body fat and total fat mass for the different BMD areas. Generally, there were decreases in total body aBMD (p<0.001) and lumbar spine aBMD (p<0.001) with increasing percent body fat and total fat mass, with less consistent patterns for pelvic aBMD. Conclusion Our findings of regional differences in the relationship of adiposity to aBMD in children and adolescents with significant interactions by gender and race/ethnicity emphasizes the need for further investigations to understand the impact of adiposity on bone health outcomes.
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Affiliation(s)
- Cecilia Gállego Suárez
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Endocrinology and Metabolism, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Benjamin H. Singer
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Achamyeleh Gebremariam
- Child Health Evaluation and Research Unit (CHEAR), Department of Pediatrics and Communicable Diseases. University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Joyce M. Lee
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Endocrinology and Metabolism, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- Child Health Evaluation and Research Unit (CHEAR), Department of Pediatrics and Communicable Diseases. University of Michigan Medical School, Ann Arbor, Michigan, United States of America
| | - Kanakadurga Singer
- Department of Pediatrics and Communicable Diseases, Division of Pediatric Endocrinology and Metabolism, University of Michigan Medical School, Ann Arbor, Michigan, United States of America
- * E-mail:
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14
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VLACHOPOULOS DIMITRIS, UBAGO-GUISADO ESTHER, BARKER ALANR, METCALF BRADS, FATOUROS IOANNISG, AVLONITI ALEXANDRA, KNAPP KARENM, MORENO LUISA, WILLIAMS CRAIGA, GRACIA-MARCO LUIS. Determinants of Bone Outcomes in Adolescent Athletes at Baseline. Med Sci Sports Exerc 2017; 49:1389-1396. [DOI: 10.1249/mss.0000000000001233] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Taylor PN, Sayers A, Okosieme O, Das G, Draman MS, Tabasum A, Abusahmin H, Rahman M, Stevenson K, Groom A, Northstone K, Woltersdorf W, Taylor A, Ring S, Lazarus JH, Gregory JW, Rees A, Timpson N, Dayan CM. Maturation in Serum Thyroid Function Parameters Over Childhood and Puberty: Results of a Longitudinal Study. J Clin Endocrinol Metab 2017; 102:2508-2515. [PMID: 28472343 PMCID: PMC5505201 DOI: 10.1210/jc.2016-3605] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 04/24/2017] [Indexed: 01/19/2023]
Abstract
CONTEXT Serum thyroid hormone levels differ between children and adults, but have not been studied longitudinally through childhood. OBJECTIVE To assess changes in thyroid-stimulating hormone (TSH) and thyroid hormone levels over childhood and their interrelationships. DESIGN Cohort study. SETTING The Avon Longitudinal Study of Parents and Children, a population-based birth cohort. PARTICIPANTS A total of 4442 children who had thyroid function measured at age 7, and 1263 children who had thyroid function measured at age 15. Eight hundred eighty-four children had measurements at both ages. MAIN OUTCOME MEASURES Reference ranges for TSH, free tri-iodothyronine (FT3), free thyroxine (FT4), their longitudinal stability, and interrelationships. RESULTS Children at age 7 years had a higher FT3 [6.17 pmol/L, standard deviation (SD) 0.62] than children at age 15 (5.83 pmol/L, SD 0.74); P < 0.0001 with 23.2% of children at age 7 having FT3 above the adult reference range. Higher FT3 levels at age 7 in boys (P = 0.0001) and girls (P = 0.04) were associated with attainment of a more advanced pubertal stage at age 13. TSH was positively associated with FT3 at age 7 and age 15 even after adjusting for confounders. In contrast, TSH was negatively associated with FT4. CONCLUSIONS There are substantial changes in TSH and thyroid hormone levels over childhood, in particular for FT3, which appear to relate to pubertal readiness. Our data provide increased insight into the evolution of the pituitary-thyroid axis over childhood and may have implications for determining optimal ranges for thyroid hormone replacement in children.
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Affiliation(s)
- Peter N. Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom
- Department of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, United Kingdom
| | - Adrian Sayers
- Department of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, United Kingdom
- Musculoskeletal Research Unit, University of Bristol, Learning and Research, Southmead Hospital, Westbury on Trym, Bristol BS10 5NB, United Kingdom
| | - Onyebuchi Okosieme
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom
- Endocrinology and Diabetes Department, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil CF47 9DT, United Kingdom
| | - Gautam Das
- Endocrinology and Diabetes Department, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil CF47 9DT, United Kingdom
| | - Mohd S. Draman
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom
| | - Arshiya Tabasum
- Endocrinology and Diabetes Department, University Hospital of Wales, Cardiff CF14 4XN, United Kingdom
| | - Hussam Abusahmin
- Endocrinology and Diabetes Department, University Hospital of Wales, Cardiff CF14 4XN, United Kingdom
| | - Mohammad Rahman
- Endocrinology and Diabetes Department, University Hospital of Wales, Cardiff CF14 4XN, United Kingdom
| | - Kirsty Stevenson
- Department of Biochemistry, Bristol Royal Infirmary University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, United Kingdom
| | - Alix Groom
- Department of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, United Kingdom
| | - Kate Northstone
- Department of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, United Kingdom
| | - Wolf Woltersdorf
- Department of Biochemistry, Bristol Royal Infirmary University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, United Kingdom
- Facharzt für Laboratoriumsmedizin Geschäftsleiter MVZ Labor, Dr. Reising-Ackermann and Kollegen Strümpellstrasse, 40 04289 Leipzig, Germany
| | - Andrew Taylor
- Department of Biochemistry, Royal United Hospital, Bath BA1 3NG, United Kingdom
| | - Susan Ring
- Department of Social and Community Medicine, University of Bristol, Bristol BS8 2BN, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, United Kingdom
| | - John H. Lazarus
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom
| | - John W. Gregory
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom
| | - Aled Rees
- Endocrinology and Diabetes Department, University Hospital of Wales, Cardiff CF14 4XN, United Kingdom
- Neuroscience and Mental Health Research, Cardiff University School of Medicine, Cardiff CF24 4HQ, United Kingdom
| | - Nicholas Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, United Kingdom
| | - Colin M. Dayan
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom
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Kelley JC, Crabtree N, Zemel BS. Bone Density in the Obese Child: Clinical Considerations and Diagnostic Challenges. Calcif Tissue Int 2017; 100:514-527. [PMID: 28105511 PMCID: PMC5395312 DOI: 10.1007/s00223-016-0233-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 12/29/2016] [Indexed: 12/29/2022]
Abstract
The prevalence of obesity in children has reached epidemic proportions. Concern about bone health in obese children, in part, derives from the potentially increased fracture risk associated with obesity. Additional risk factors that affect bone mineral accretion, may also contribute to obesity, such as low physical activity and nutritional factors. Consequences of obesity, such as inflammation, insulin resistance, and non-alcoholic fatty liver disease, may also affect bone mineral acquisition, especially during the adolescent years when rapid increases in bone contribute to attaining peak bone mass. Further, numerous pediatric health conditions are associated with excess adiposity, altered body composition, or endocrine disturbances that can affect bone accretion. Thus, there is a multitude of reasons for considering clinical assessment of bone health in an obese child. Multiple diagnostic challenges affect the measurement of bone density and its interpretation. These include greater precision error, difficulty in positioning, and the effects of increased lean and fat tissue on bone health outcomes. Future research is required to address these issues to improve bone health assessment in obese children.
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Affiliation(s)
- Jennifer C Kelley
- Division of Endocrinology and Diabetes, Monroe Carell, Jr Children's Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Nicola Crabtree
- Department of Endocrinology and Diabetes, Birmingham Children's Hospital, Birmingham, UK
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Room 1560, Philadelphia, PA, 19104, USA.
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Soft tissues, areal bone mineral density and hip geometry estimates in active young boys: the PRO-BONE study. Eur J Appl Physiol 2017; 117:833-842. [DOI: 10.1007/s00421-017-3568-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 02/10/2017] [Indexed: 01/20/2023]
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18
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Holroyd CR, Osmond C, Barker DJ, Ring SM, Lawlor DA, Tobias JH, Smith GD, Cooper C, Harvey NC. Placental Size Is Associated Differentially With Postnatal Bone Size and Density. J Bone Miner Res 2016; 31:1855-1864. [PMID: 26999363 PMCID: PMC5010780 DOI: 10.1002/jbmr.2840] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/16/2016] [Accepted: 03/11/2016] [Indexed: 11/06/2022]
Abstract
We investigated relationships between placental size and offspring adolescent bone indices using a population-based, mother-offspring cohort. The Avon Longitudinal Study of Parents and Children (ALSPAC) recruited pregnant women from the southwest of England between 1991 and 1993. There were 12,942 singleton babies born at term who survived at least the first 12 months. From these, 8933 placentas were preserved in formaldehyde, with maternal permission for their use in research studies. At the approximate age of 15.5 years, the children underwent a dual-energy X-ray absorptiometry (DXA) scan (measurements taken of the whole body minus head bone area [BA], bone mineral content [BMC], and areal bone mineral density [aBMD]). A peripheral quantitative computed tomography (pQCT) scan (Stratec XCT2000L; Stratec, Pforzheim, Germany) at the 50% tibial site was performed at this visit and at approximately age 17.7 years. In 2010 a sample of 1680 placentas were measured and photographed. To enable comparison of effect size across different variables, predictor and outcome variables were standardized to Z-scores and therefore results may be interpreted as partial correlation coefficients. Complete placental, DXA, and pQCT data were available for 518 children at age 15.5 years. After adjustment for gender, gestational age at birth, and age at time of pQCT, the placental area was positively associated with endosteal circumference (β [95% CI]: 0.21 [0.13, 0.30], p < 0.001), periosteal circumference (β [95% CI]: 0.19 [0.10, 0.27], p < 0.001), and cortical area (β [95% CI]: 0.10 [0.01, 0.18], p = 0.03), and was negatively associated with cortical density (β [95% CI]: -0.11 [-0.20, -0.03], p = 0.01) at age 15.5 years. Similar relationships were observed for placental volume, and after adjustment for additional maternal and offspring covariates. These results suggest that previously observed associations between placental size and offspring bone development persist into older childhood, even during puberty, and that placental size is differentially related to bone size and volumetric density. © 2016 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | - Clive Osmond
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - David Jp Barker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sue M Ring
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Debbie A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jon H Tobias
- Academic Rheumatology, Musculoskeletal Research Unit, Avon Orthopaedic Centre, Bristol, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK. .,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK. .,NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Nuffield Orthopaedic Centre, Headington, Oxford, UK.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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19
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Correa-Rodríguez M, Rio-Valle JS, González-Jiménez E, Rueda-Medina B. The Effects of Body Composition, Dietary Intake, and Physical Activity on Calcaneus Quantitative Ultrasound in Spanish Young Adults. Biol Res Nurs 2016; 18:439-44. [PMID: 26933147 DOI: 10.1177/1099800416634884] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Identifying modifiable factors that influence bone gain during early adulthood in order to maximize peak bone mass (PBM) is a potential primary strategy in the prevention of osteoporosis in later life. The present study examined the relationships between body composition, dietary intake and physical activity (PA), and bone health measured by quantitative ultrasound (QUS) at the right calcaneus. The study population consisted of 781 Spanish men and women (age 19.1 ± 3.6). Body composition, dietary intake, PA, and bone strength were assessed. Calcaneus QUS was significantly correlated with age, height, weight, body mass index, lean mass, fat mass, protein intake, and moderate and high PA. No significant correlation between calcium intake and broadband ultrasound attenuation (BUA, dB/MHz) was detected. Linear regression analyses revealed that independent variables accounted for 18.8% of the total variance of calcaneus BUA (p = .000). Lean mass and high PA were significant predictors of BUA variance in young adults (p = .000 and p = .045, respectively). Results indicate that lifestyle choices and their consequences during early adulthood could influence bone mass, particularly PA and lean mass. Furthermore, this study provides novel data about bone mass as indicated by the QUS measurements at the time of PBM acquisition.
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20
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Taylor PN, Richmond R, Davies N, Sayers A, Stevenson K, Woltersdorf W, Taylor A, Groom A, Northstone K, Ring S, Okosieme O, Rees A, Nitsch D, Williams GR, Smith GD, Gregory JW, Timpson NJ, Tobias JH, Dayan CM. Paradoxical Relationship Between Body Mass Index and Thyroid Hormone Levels: A Study Using Mendelian Randomization. J Clin Endocrinol Metab 2016; 101:730-8. [PMID: 26595101 PMCID: PMC4880123 DOI: 10.1210/jc.2015-3505] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/18/2015] [Indexed: 11/19/2022]
Abstract
CONTEXT Free T3 (FT3) has been positively associated with body mass index (BMI) in cross-sectional studies in healthy individuals. This is difficult to reconcile with clinical findings in pathological thyroid dysfunction. OBJECTIVE We aimed to investigate whether childhood adiposity influences FT3 levels. DESIGN Mendelian randomization using genetic variants robustly associated with BMI. SETTING Avon Longitudinal Study of Parents and Children, a population-based birth cohort. PARTICIPANTS A total of 3014 children who had thyroid function measured at age 7, who also underwent dual x-ray absorptiometry scans at ages 9.9 and 15.5 years and have genetic data available. MAIN OUTCOME MEASURES FT3. RESULTS Observationally at age 7 years, BMI was positively associated with FT3: β-standardized (β-[std]) = 0.12 (95% confidence interval [CI]: 0.08, 0.16), P = 4.02 × 10(-10); whereas FT4 was negatively associated with BMI: β-(std) = -0.08 (95% CI: -0.12, -0.04), P = 3.00 × 10(-5). These differences persisted after adjustment for age, sex, and early life environment. Genetic analysis indicated 1 allele change in BMI allelic score was associated with a 0.04 (95% CI: 0.03, 0.04) SD increase in BMI (P = 6.41 × 10(-17)). At age 7, a genetically determined increase in BMI of 1.89 kg/m(2) was associated with a 0.22 pmol/L (95% CI: 0.07, 0.36) increase in FT3 (P = .004) but no substantial change in FT4 0.01 mmol/L, (95% CI: -0.37, 0.40), P = .96. CONCLUSION Our analysis shows that children with a genetically higher BMI had higher FT3 but not FT4 levels, indicating that higher BMI/fat mass has a causal role in increasing FT3 levels. This may explain the paradoxical associations observed in observational analyses. Given rising childhood obesity levels, this relationship merits closer scrutiny.
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Affiliation(s)
- Peter N Taylor
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Rebecca Richmond
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Neil Davies
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Adrian Sayers
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Kirsty Stevenson
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Wolfram Woltersdorf
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Andrew Taylor
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Alix Groom
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Kate Northstone
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Susan Ring
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Onyebuchi Okosieme
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Aled Rees
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Dorothea Nitsch
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Graham R Williams
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - George Davey Smith
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - John W Gregory
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Nicholas J Timpson
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Jonathan H Tobias
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
| | - Colin M Dayan
- Thyroid Research Group (P.N.T., O.O., J.W.G., C.M.D.) and Institute of Molecular and Experimental Medicine (A.R.), Cardiff University School of Medicine, Cardiff, CF14 4XN United Kingdom; Medical Research Council Integrative Epidemiology Unit (R.R., N.D., G.D.S., N.J.T.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Social and Community Medicine (A.S., A.G., K.N., S.R.), University of Bristol, Bristol, BS8 2BN United Kingdom; Department of Biochemistry (K.S.), Bristol Royal Infirmary University Hospitals Bristol National Health Service Foundation Trust, Bristol, BS2 8HW United Kingdom; Geschäftsleiter Medizinisches Versorgungszentrum Labor Dr. Reising-Ackermann und Kollegen (W.W.), D-04289 Leipzig, Germany; Department of Biochemistry (A.T.), Royal United Hospital, Bath, BA1 3NG United Kingdom; Department of Non-Communicable Disease Epidemiology (D.N.), Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, CF14 4XN United Kingdom; Molecular Endocrinology Group (G.R.W.), Department of Medicine, Imperial College London, London, WC1E 7HT United Kingdom; and Musculoskeletal Research Unit (J.H.T.), University of Bristol, Learning and Research Southmead Hospital, Westbury on Trym, Bristol, BS10 5NB United Kingdom
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21
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Abstract
PURPOSE OF REVIEW The purpose of this review is to summarize the recent clinical findings surrounding the muscle-bone relationships in children, while considering muscle adiposity, endocrine factors, and lifestyle influences (i.e., diet and exercise) involved in pediatric musculoskeletal development. RECENT FINDINGS Positive relationships between cortical bone geometry and muscle mass, size and function have been reported. Prospective studies in particular have helped clarify some of the inconsistent relationships between muscle and cortical bone volumetric density. Muscle fat is associated with impaired glucose handling and muscular functionality, which may in turn have a downstream effect on cortical bone growth during adolescence. Lifestyle factors such as healthful diets and higher impact physical activities can promote optimal skeletal development by improving the muscular phenotype and endocrine profile. SUMMARY Muscle and bone are two intricately-related tissue types; however, factors such as sex, maturation, study design, and outcome measures studied can modify this relationship. Further research is warranted to understand the impact of muscle adiposity on cardiometabolic health, muscle function and, subsequently, pediatric musculoskeletal development and fracture risk. Following age-specific diet and physical activity recommendations should be a major focus in obtaining optimal muscle and bone development throughout maturation.
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Affiliation(s)
- Joseph M Kindler
- aDepartment of Foods and Nutrition, College of Family and Consumer Sciences, University of Georgia, Athens bDepartment of Cellular Biology and Anatomy, Medical College of Georgia, Georgia Regents University, Augusta, Georgia, USA
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22
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Viljakainen HT, Valta H, Lipsanen-Nyman M, Saukkonen T, Kajantie E, Andersson S, Mäkitie O. Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity. Calcif Tissue Int 2015; 97:364-75. [PMID: 26139232 DOI: 10.1007/s00223-015-0031-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 06/23/2015] [Indexed: 12/26/2022]
Abstract
Childhood obesity is associated with compromised bone health. We studied bone characteristics and their determinants in obese young adults. The study included 68 subjects with early-onset severe obesity and 73 normal-weight controls. Data on physical activity (PA), diet and smoking were collected. Bone characteristics were measured using peripheral QCT. The obese and control subjects were similar in age (mean 19.6 ± 2.6 years) and height but BMIs differed (39.7 and 22.6 kg/m(2)). A clustering of unhealthy lifestyles was marked: Obese subjects reported less supervised PA in childhood, adolescence and currently (p < 0.03) and were more likely to smoke (p = 0.005), and had a lower healthy eating index (HEI) (p = 0.007) but similar alcohol consumption compared with controls. In obese women, all crude bone characteristics were higher than in controls; in men, the differences were smaller. Associations of lifestyle factors with bone characteristics were tested using partial correlations. Independently of BMI, supervised PA in adolescence and alcohol consumption were related positively to bone characteristics in both groups. HEI associated positively with bone characteristics only in controls, while smoking was a positive determinant of bone characteristics only in obese subjects. The multivariate model showed that the contribution of lifestyle factors to bone characteristics was minimal compared with BMI. Early-onset obesity is accompanied by poor dietary quality, sedentary lifestyle, and more frequent smoking, but the overall contribution of these lifestyle factors to bone strength is limited. Bone strength is more likely to be compromised in men and in unloaded bone sites in subjects with early-onset severe obesity. The impact of obesity-related endocrine changes on bone characteristics need to be evaluated in future studies.
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Affiliation(s)
- H T Viljakainen
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.
| | - H Valta
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
| | - M Lipsanen-Nyman
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
| | - T Saukkonen
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
- Novo Nordisk Pharma Oy, Espoo, Finland
| | - E Kajantie
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
- Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Obstetrics and Gynecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - S Andersson
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
| | - O Mäkitie
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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23
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Marwaha RK, Garg MK, Bhadra K, Tandon N. Bone mineral content has stronger association with lean mass than fat mass among Indian urban adolescents. Indian J Endocrinol Metab 2015; 19:608-615. [PMID: 26425468 PMCID: PMC4566339 DOI: 10.4103/2230-8210.163174] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION There are conflicting reports on the relationship of lean mass (LM) and fat mass (FM) with bone mineral content (BMC). Given the high prevalence of Vitamin D deficiency in India, we planned the study to evaluate the relationship between LM and FM with BMC in Indian children and adolescents. The objective of the study was to evaluate the relationship of BMC with LM and FM. MATERIALS AND METHODS Total and regional BMC, LM, and FM using dual energy X-ray absorptiometry and pubertal staging were assessed in 1403 children and adolescents (boys [B]: 826; girls [G]: 577). BMC index, BMC/LM and BMC/FM ratio, were calculated. RESULTS The age ranged from 5 to 18 years, with a mean age of 13.2 ± 2.7 years. BMC adjusted for height (BMC index and BMC/height ratio) was comparable in both genders. There was no difference in total BMC between genders in the prepubertal group but were higher in more advanced stages of pubertal maturation. The correlation of total as well as regional BMC was stronger for LM (B: Total BMC - 0.880, trunk - 0.715, leg - 0.894, arm - 0.891; G: Total BMC - 0.827, leg - 0.846, arm - 0.815 (all value indicate r (2), P < 0.0001 for all) when compared with FM (B: Total BMC - 0.776, trunk - 0.676, leg - 0.772, arm - 0.728; G: Total BMC - 0.781, leg - 0.741, arm - 0.689; all P < 0.0001) except at trunk BMC (LM - 0.682 vs. FM - 0.721; all P < 0.0001), even after controlling for age, height, pubertal stage, and biochemical parameters. CONCLUSIONS BMC had a stronger positive correlation with LM than FM.
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Affiliation(s)
- Raman K. Marwaha
- Senior Consultant Endocrinology and Scientific Advisor (Projects), ILSI-India, New Delhi, India
| | - M. K. Garg
- Commandant and Consultant, Department of Medicine and Endocrinology, Military Hospital, Shillong, Meghalaya, India
| | - Kuntal Bhadra
- Thyroid Research Centre, Institute of Nuclear Medicine and Allied Sciences, New Delhi, India
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Pollock NK. Childhood obesity, bone development, and cardiometabolic risk factors. Mol Cell Endocrinol 2015; 410:52-63. [PMID: 25817542 PMCID: PMC4444415 DOI: 10.1016/j.mce.2015.03.016] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/21/2015] [Accepted: 03/21/2015] [Indexed: 12/29/2022]
Abstract
Osteoporosis and obesity are both major public health concerns. It has long been considered that these are distinct disorders rarely found in the same individual; however, emerging evidence supports an important interaction between adipose tissue and the skeleton. Whereas overweight per se may augment bone strength, animal studies suggest that the metabolic impairment that accompanies obesity is detrimental to bone. Obesity during childhood, a critical time for bone development, likely has profound and lasting effects on bone strength and fracture risk. This notion has received little attention in children and results are mixed, with studies reporting that bone strength development is enhanced or impaired by obesity. Whether obesity is a risk factor for osteoporosis or childhood bone health, in general, remains an important clinical question. Here, we will focus on clarifying the controversial relationships between childhood obesity and bone strength development, and provide insights into potential mechanisms that may regulate the effect of excess adiposity on bone.
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Affiliation(s)
- Norman K Pollock
- Department of Pediatrics, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA.
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25
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van den Hooven EH, Heppe DHM, Kiefte-de Jong JC, Medina-Gomez C, Moll HA, Hofman A, Jaddoe VWV, Rivadeneira F, Franco OH. Infant dietary patterns and bone mass in childhood: the Generation R Study. Osteoporos Int 2015; 26:1595-604. [PMID: 25792489 PMCID: PMC4428841 DOI: 10.1007/s00198-015-3033-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 01/08/2015] [Indexed: 12/13/2022]
Abstract
UNLABELLED Early life nutrition affects peak bone mass attainment. In this prospective cohort study, children with high adherence to a "dairy and whole grains" pattern in infancy had higher bone mineral density at the age of 6 years. Although the observed effects are small, our study provides insight into mechanisms linking early nutrition to bone acquisition in childhood. INTRODUCTION Nutrition in early life may affect peak bone mass attainment. Previous studies on childhood nutrition and skeletal health mainly focused on individual nutrients, which does not consider the cumulative effects of nutrients. We investigated the associations between dietary patterns in infancy and childhood bone health. METHODS This study included 2850 children participating in a population-based prospective cohort study. Dietary information was obtained from a food frequency questionnaire at the age of 13 months. Using principal component analysis, three major dietary patterns were extracted, explaining in total 30% of the variation in dietary intake. At the age of 6 years, a total body dual-energy X-ray absorptiometry (DXA) scan was performed, and bone mineral density (BMD), bone mineral content (BMC), area-adjusted BMC (aBMC), and bone area (BA) were analyzed. RESULTS Higher adherence score to a "dairy and whole grains" pattern was positively associated with BMD and aBMC, but not with BMC and BA. Accordingly, children in the highest quartile of the "dairy and whole grains" pattern had higher BMD (difference 3.98 mg/cm(2), 95% confidence interval (CI) 0.36 to 7.61) and aBMC (difference 4.96 g, 95% CI 1.27 to 8.64) than children in the lowest quartile. Stratification for vitamin D supplementation showed that the positive associations between the "dairy and whole grains" pattern and bone outcomes were only observed in children who did not receive vitamin D supplementation. A "potatoes, rice, and vegetables" and a "refined grains and confectionery" pattern were not consistently associated with bone outcomes. CONCLUSIONS An infant dietary pattern characterized by high intakes of dairy and cheese, whole grains, and eggs is positively associated with bone development in childhood. Further research is needed to investigate the consequences for bone health in later life.
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Affiliation(s)
- E H van den Hooven
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA, Rotterdam, The Netherlands,
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26
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Leonard MB, Zemel BS, Wrotniak BH, Klieger SB, Shults J, Stallings VA, Stettler N. Tibia and radius bone geometry and volumetric density in obese compared to non-obese adolescents. Bone 2015; 73:69-76. [PMID: 25497572 PMCID: PMC4540475 DOI: 10.1016/j.bone.2014.12.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 10/27/2014] [Accepted: 12/03/2014] [Indexed: 11/23/2022]
Abstract
Childhood obesity is associated with biologic and behavioral characteristics that may impact bone mineral density (BMD) and structure. The objective was to determine the association between obesity and bone outcomes, independent of sexual and skeletal maturity, muscle area and strength, physical activity, calcium intake, biomarkers of inflammation, and vitamin D status. Tibia and radius peripheral quantitative CT scans were obtained in 91 obese (BMI>97th percentile) and 51 non-obese adolescents (BMI>5th and <85th percentiles). Results were converted to sex- and race-specific Z-scores relative to age. Cortical structure, muscle area and muscle strength (by dynamometry) Z-scores were further adjusted for bone length. Obese participants had greater height Z-scores (p<0.001), and advanced skeletal maturity (p<0.0001), compared with non-obese participants. Tibia cortical section modulus and calf muscle area Z-scores were greater in obese participants (1.07 and 1.63, respectively, both p<0.0001). Tibia and radius trabecular and cortical volumetric BMD did not differ significantly between groups. Calf muscle area and strength Z-scores, advanced skeletal maturity, and physical activity (by accelerometry) were positively associated with tibia cortical section modulus Z-scores (all p<0.01). Adjustment for muscle area Z-score attenuated differences in tibia section modulus Z-scores between obese and non-obese participants from 1.07 to 0.28. After multivariate adjustment for greater calf muscle area and strength Z-scores, advanced maturity, and less moderate to vigorous physical activity, tibia section modulus Z-scores were 0.32 (95% CI -0.18, 0.43, p=0.06) greater in obese, vs. non-obese participants. Radius cortical section modulus Z-scores were 0.45 greater (p=0.08) in obese vs. non-obese participants; this difference was attenuated to 0.14 with adjustment for advanced maturity. These findings suggest that greater tibia cortical section modulus in obese adolescents is attributable to advanced skeletal maturation and greater muscle area and strength, while less moderate to vigorous physical activities offset the positive effects of these covariates. The impact of obesity on cortical structure was greater at weight bearing sites.
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Affiliation(s)
- Mary B Leonard
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, USA.
| | - Babette S Zemel
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Brian H Wrotniak
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Physical Therapy, D'Youville College, Buffalo, NY, USA
| | - Sarah B Klieger
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Justine Shults
- Department of Physical Therapy, D'Youville College, Buffalo, NY, USA
| | - Virginia A Stallings
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Farr JN, Amin S, LeBrasseur NK, Atkinson EJ, Achenbach SJ, McCready LK, Joseph Melton L, Khosla S. Body composition during childhood and adolescence: relations to bone strength and microstructure. J Clin Endocrinol Metab 2014; 99:4641-8. [PMID: 25243571 PMCID: PMC4255129 DOI: 10.1210/jc.2014-1113] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
CONTEXT Numerous studies have examined the association of body composition with bone development in children and adolescents, but none have used micro-finite element (μFE) analysis of high-resolution peripheral quantitative computed tomography images to assess bone strength. OBJECTIVE This study sought to examine the relations of appendicular lean mass (ALM) and total body fat mass (TBFM) to bone strength (failure load) at the distal radius and tibia. DESIGN, PARTICIPANTS, AND SETTING This was a cross-sectional study of 198 healthy 8- to <15-year-old boys (n = 109) and girls (n = 89) performed in a Clinical Research Unit. RESULTS After adjusting for bone age, height, fracture history, ALM, and TBFM, multiple linear regression analyses in boys and girls, separately, showed robust positive associations between ALM and failure loads at both the distal radius (boys: β = 0.92, P < .001; girls: β = 0.66, P = .001) and tibia (boys: β = 0.96, P < .001; girls: β = 0.66, P < .001). By contrast, in both boys and girls the relationship between TBFM and failure load at the distal radius was virtually nonexistent (boys: β = -0.07; P = .284; girls: β = -0.03; P = .729). At the distal tibia, positive, albeit weak, associations were observed between TBFM and failure load in both boys (β = 0.09, P = .075) and girls (β = 0.17, P = .033). CONCLUSIONS Our data highlight the importance of lean mass for optimizing bone strength during growth, and suggest that fat mass may have differential relations to bone strength at weight-bearing vs non-weight-bearing sites in children and adolescents. These observations suggest that the strength of the distal radius does not commensurately increase with excess gains in adiposity during growth, which may result in a mismatch between bone strength and the load experienced by the distal forearm during a fall. These findings may explain, in part, why obese children are over-represented among distal forearm fracture cases.
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Affiliation(s)
- Joshua N Farr
- Division of Endocrinology, Department of Medicine (J.N.F., L.K.M., S.K.); Division of Epidemiology, Department of Health Sciences Research (S.A., L.J.M.); Division of Rheumatology, Department of Medicine (S.A.); Department of Physical Medicine and Rehabilitation (N.K.L); and Division of Biomedical Statistics and Informatics, Department of Health Sciences Research (E.J.A., S.J.A.); Mayo Clinic College of Medicine, Rochester, Minnesota, 55905
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28
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Steer CD, Sayers A, Kemp J, Fraser WD, Tobias JH. Birth weight is positively related to bone size in adolescents but inversely related to cortical bone mineral density: findings from a large prospective cohort study. Bone 2014; 65:77-82. [PMID: 24840816 PMCID: PMC4073227 DOI: 10.1016/j.bone.2014.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 05/09/2014] [Accepted: 05/10/2014] [Indexed: 11/24/2022]
Abstract
To examine the influence of intrauterine environment on subsequent bone development, we investigated the relationship between birth weight and cortical bone parameters, and the role of puberty, bone resorption and insulin as possible mediators. Bone outcomes were obtained from mid-tibial pQCT scans performed at age 15.5 years in 1960 males and 2192 females from the ALSPAC birth cohort. Birth weight was positively related to periosteal circumference (PC) [beta=0.40 (0.34, 0.46)], which was largely but not completely attenuated after adjustment for height and weight [beta=0.07 (0.02, 0.12)] (SD change in outcome per 1 kg increase in birth weight with 95% CI). Based on our height and weight adjusted model, the association was stronger in females compared to males (P=0.02 for gender interaction), and persisted in 2842 participants with equivalent results at age 17.7 years. Conversely, birth weight was inversely related to cortical bone mineral density (BMDC) at age 15.5 years after adjusting for height and weight [beta=-0.18 (-0.23, -0.13)], with a stronger association in males compared to females (P=0.01 for gender interaction), but an equivalent association was not seen at 17.7 years. In further analyses performed on data from age 15.5 years, the association between birth weight and PC was unaffected by adjustment for puberty (Tanner stage at age 13.5 years), bone resorption (fasting beta-carboxyterminal cross linking telopeptide (βCTX) at age 15.5 years) or insulin (fasting insulin at age 15.5 years). In contrast, the association with BMDC was attenuated by approximately 30% after adjustment for puberty or bone resorption, and by 50% after adjustment for both factors combined. We conclude that the inverse relationship between birth weight and BMDC is in part mediated by effects of puberty and bone resorption, which may help to explain the transitory nature of this association, in contrast to the more persisting relationship with PC.
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Affiliation(s)
- Colin D Steer
- Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, UK
| | - Adrian Sayers
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK
| | - John Kemp
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, UK; University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Queensland, Australia
| | | | - Jon H Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, UK.
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Laddu DR, Farr JN, Lee VR, Blew RM, Stump C, Houtkooper L, Lohman TG, Going SB. Muscle density predicts changes in bone density and strength: a prospective study in girls. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2014; 14:195-204. [PMID: 24879023 PMCID: PMC4414028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE We sought to determine whether muscle density, an index of skeletal muscle fat content, was predictive of 2-year changes in weight-bearing bone parameters in young girls. METHODS Two-year prospective data from 248 girls, aged 8-13 years at baseline. Peripheral quantitative computed tomography was used to measure changes in bone strength indices (bone strength index [BSI, mg(2)/mm(4)] and strength-strain index [SSIp, mm(3)]) and volumetric bone mineral density [vBMD, mg/cm(3)] at distal metaphyseal and diaphyseal regions of the femur and tibia, as well as calf and thigh muscle density (mg/cm(3)), and muscle cross-sectional area (MCSA, mm(2)), indices of skeletal muscle fat content and muscle force production, respectively. RESULTS After controlling for potential confounders, greater gains in femur BSI (44%, P<0.002), total femur vBMD (114%, P<0.04) and femur trabecular vBMD (306%, P<0.002) occurred in girls in the lowest versus the highest groups of baseline thigh muscle density. Greater gains in tibial BSI (25%, P<0.03) and trabecular vBMD (190%, P<0.002) were also observed in the lowest versus the highest baseline calf muscle density groups. CONCLUSION Baseline muscle density is a significant predictor of changes in bone density and bone strength in young girls during a period of rapid skeletal development.
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Affiliation(s)
- D R Laddu
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
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30
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Matsuzaki M, Kuper H, Kulkarni B, Radhakrishna KV, Viljakainen H, Taylor AE, Sullivan R, Bowen L, Tobias JH, Ploubidis GB, Wells JC, Prabhakaran D, Davey Smith G, Ebrahim S, Ben-Shlomo Y, Kinra S. Life-course determinants of bone mass in young adults from a transitional rural community in India: the Andhra Pradesh Children and Parents Study (APCAPS). Am J Clin Nutr 2014; 99:1450-9. [PMID: 24695898 PMCID: PMC4021785 DOI: 10.3945/ajcn.113.068791] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Undernutrition and physical inactivity are both associated with lower bone mass. OBJECTIVE This study aimed to investigate the combined effects of early-life undernutrition and urbanized lifestyles in later life on bone mass accrual in young adults from a rural community in India that is undergoing rapid socioeconomic development. DESIGN This was a prospective cohort study of participants of the Hyderabad Nutrition Trial (1987-1990), which offered balanced protein-calorie supplementation to pregnant women and preschool children younger than 6 y in the intervention villages. The 2009-2010 follow-up study collected data on current anthropometric measures, bone mineral density (BMD) measured by dual-energy X-ray absorptiometry, blood samples, diet, physical activity, and living standards of the trial participants (n = 1446, aged 18-23 y). RESULTS Participants were generally lean and had low BMD [mean hip BMD: 0.83 (women), 0.95 (men) g/cm²; lumbar spine: 0.86 (women), 0.93 (men) g/cm²]. In models adjusted for current risk factors, no strong evidence of a positive association was found between BMD and early-life supplementation. On the other hand, current lean mass and weight-bearing physical activity were positively associated with BMD. No strong evidence of an association was found between BMD and current serum 25-hydroxyvitamin D or dietary intake of calcium, protein, or calories. CONCLUSIONS Current lean mass and weight-bearing physical activity were more important determinants of bone mass than was early-life undernutrition in this population. In transitional rural communities from low-income countries, promotion of physical activity may help to mitigate any potential adverse effects of early nutritional disadvantage.
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Affiliation(s)
- Mika Matsuzaki
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Hannah Kuper
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Bharati Kulkarni
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - K V Radhakrishna
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Heli Viljakainen
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Amy E Taylor
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Ruth Sullivan
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Liza Bowen
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Jon H Tobias
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - George B Ploubidis
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Jonathan C Wells
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Dorairaj Prabhakaran
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - George Davey Smith
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Shah Ebrahim
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Yoav Ben-Shlomo
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
| | - Sanjay Kinra
- From the Departments of Non-communicable Disease Epidemiology (MM, RS, SE, and SK), the Department of Medical Statistics (GBP), and Clinical Research (HK), London School of Hygiene and Tropical Medicine, London, United Kingdom; the Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia (BK); the National Institute of Nutrition, Hyderabad, India (BK and KVR); the Musculoskeletal Research Unit, School of Clinical Sciences (HV and JHT) and the School of Social and Community Medicine (AET, YB-S, and GDS), University of Bristol, Bristol, United Kingdom; St George's University, London, United Kingdom (LB); the Childhood Nutrition Research Centre, UCL Institute of Child Health, London, United Kingdom (JCW); the Centre for Chronic Disease Control, New Delhi, India (DP); and the South Asia Network for Chronic Disease, Public Health Foundation of India, New Delhi, India (SE)
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Kâ K, Rousseau MC, Lambert M, O'Loughlin J, Henderson M, Tremblay A, Alos N, Nicolau B. Association between lean and fat mass and indicators of bone health in prepubertal caucasian children. Horm Res Paediatr 2014; 80:154-62. [PMID: 23988728 DOI: 10.1159/000354043] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 06/22/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Childhood and adolescence are critical periods for bone growth. The independent association between lean and fat mass and indicators of bone health in children is not yet known. We aim to examine the association between each of lean and fat mass and indicators of bone health in 8- to 10-year-old prepubertal Caucasian children. METHODS We present a cross-sectional analysis of baseline data from the QUebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort which study the natural history of obesity. Study participants (n = 483) included prepubertal children aged 8-10 years and their biological parents. Whole-body bone mineral content (BMC, g), bone area (cm²), bone mineral density (BMD, g/cm²), lean mass (kg), and fat mass (kg) were measured by dual-energy X-ray absorptiometry. Data analyses include multiple linear regressions adjusted for potential confounding variables. RESULTS A 1-kg increase in lean mass was associated with 28.42 g, 19.88 cm², and 0.007 g/cm² increase in whole-body BMC, bone area and BMD respectively. A 1-kg increase in fat mass was associated with 9.32 g, 8.02 cm², and 0.002 g/cm² increase in whole-body BMC, bone area and BMD, respectively. CONCLUSION Increasing lean mass in children may help optimize bone acquisition and prevent future osteoporosis.
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Affiliation(s)
- Khady Kâ
- Oral Health and Society Unit, Faculty of Dentistry, McGill University, Montreal, Que., Canada
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32
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Zhu K, Briffa K, Smith A, Mountain J, Briggs AM, Lye S, Pennell C, Straker L, Walsh JP. Gender differences in the relationships between lean body mass, fat mass and peak bone mass in young adults. Osteoporos Int 2014; 25:1563-70. [PMID: 24647886 DOI: 10.1007/s00198-014-2665-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 08/19/2013] [Indexed: 12/18/2022]
Abstract
UNLABELLED The relationships between fat mass and bone mass in young adults are unclear. In 1,183 young Australians, lean body mass had a strong positive relationship with total body bone mass in both genders. Fat mass was a positive predictor of total body bone mass in females, with weaker association in males. INTRODUCTION Body weight and lean body mass are established as major determinants of bone mass, but the relationships between fat mass (including visceral fat) and peak bone mass in young adults are unclear. The aim of this study was to evaluate the associations between bone mass in young adults and three body composition measurements: lean body mass, fat mass and trunk-to-limb fat mass ratio (a surrogate measure of visceral fat). METHODS Study participants were 574 women and 609 men aged 19-22 years from the Raine study. Body composition, total body bone mineral content (TBBMC), bone area and areal bone mineral density (TBBMD) were measured using DXA. RESULTS In multivariate linear regression models with height, lean body mass, fat mass and trunk-to-limb fat mass ratio as predictor variables, lean mass was uniquely associated with the largest proportion of variance of TBBMC and TBBMD in males (semi-partial R(2) 0.275 and 0.345, respectively) and TBBMC in females (semi-partial R(2) 0.183). Fat mass was a more important predictor of TBBMC and TBBMD in females (semi-partial R(2) 0.126 and 0.039, respectively) than males (semi-partial R(2) 0.006 and 0.018, respectively). Trunk-to-limb fat mass ratio had a weak, negative association with TBBMC and bone area in both genders (semi-partial R(2) 0.004 to 0.034). CONCLUSIONS Lean body mass has strong positive relationship with total body bone mass in both genders. Fat mass may play a positive role in peak bone mass attainment in women but the association was weaker in men; different fat compartments may have different effects.
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Affiliation(s)
- K Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia,
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Kemp JP, Sayers A, Paternoster L, Evans DM, Deere K, St Pourcain B, Timpson NJ, Ring SM, Lorentzon M, Lehtimäki T, Eriksson J, Kähönen M, Raitakari O, Laaksonen M, Sievänen H, Viikari J, Lyytikäinen LP, Smith GD, Fraser WD, Vandenput L, Ohlsson C, Tobias JH. Does bone resorption stimulate periosteal expansion? A cross-sectional analysis of β-C-telopeptides of type I collagen (CTX), genetic markers of the RANKL pathway, and periosteal circumference as measured by pQCT. J Bone Miner Res 2014; 29:1015-24. [PMID: 24014423 PMCID: PMC4138988 DOI: 10.1002/jbmr.2093] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 08/30/2013] [Accepted: 09/03/2013] [Indexed: 01/18/2023]
Abstract
We hypothesized that bone resorption acts to increase bone strength through stimulation of periosteal expansion. Hence, we examined whether bone resorption, as reflected by serum β-C-telopeptides of type I collagen (CTX), is positively associated with periosteal circumference (PC), in contrast to inverse associations with parameters related to bone remodeling such as cortical bone mineral density (BMDC ). CTX and mid-tibial peripheral quantitative computed tomography (pQCT) scans were available in 1130 adolescents (mean age 15.5 years) from the Avon Longitudinal Study of Parents and Children (ALSPAC). Analyses were adjusted for age, gender, time of sampling, tanner stage, lean mass, fat mass, and height. CTX was positively related to PC (β=0.19 [0.13, 0.24]) (coefficient=SD change per SD increase in CTX, 95% confidence interval)] but inversely associated with BMDC (β=-0.46 [-0.52,-0.40]) and cortical thickness [β=-0.11 (-0.18, -0.03)]. CTX was positively related to bone strength as reflected by the strength-strain index (SSI) (β=0.09 [0.03, 0.14]). To examine the causal nature of this relationship, we then analyzed whether single-nucleotide polymorphisms (SNPs) within key osteoclast regulatory genes, known to reduce areal/cortical BMD, conversely increase PC. Fifteen such genetic variants within or proximal to genes encoding receptor activator of NF-κB (RANK), RANK ligand (RANKL), and osteoprotegerin (OPG) were identified by literature search. Six of the 15 alleles that were inversely related to BMD were positively related to CTX (p<0.05 cut-off) (n=2379). Subsequently, we performed a meta-analysis of associations between these SNPs and PC in ALSPAC (n=3382), Gothenburg Osteoporosis and Obesity Determinants (GOOD) (n=938), and the Young Finns Study (YFS) (n=1558). Five of the 15 alleles that were inversely related to BMD were positively related to PC (p<0.05 cut-off). We conclude that despite having lower BMD, individuals with a genetic predisposition to higher bone resorption have greater bone size, suggesting that higher bone resorption is permissive for greater periosteal expansion.
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Affiliation(s)
- John P Kemp
- MRC Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK
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Adams JE, Engelke K, Zemel BS, Ward KA. Quantitative computer tomography in children and adolescents: the 2013 ISCD Pediatric Official Positions. J Clin Densitom 2014; 17:258-74. [PMID: 24792821 DOI: 10.1016/j.jocd.2014.01.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 01/14/2014] [Indexed: 12/24/2022]
Abstract
In 2007, International Society of Clinical Densitometry Pediatric Positions Task Forces reviewed the evidence for the clinical application of peripheral quantitative computed tomography (pQCT) in children and adolescents. At that time, numerous limitations regarding the clinical application of pQCT were identified, although its use as a research modality for investigation of bone strength was highlighted. The present report provides an updated review of evidence for the clinical application of pQCT, as well as additional reviews of whole body QCT scans of the central and peripheral skeletons, and high-resolution pQCT in children. Although these techniques remain in the domain of research, this report summarizes the recent literature and evidence of the clinical applicability and offers general recommendations regarding the use of these modalities in pediatric bone health assessment.
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Affiliation(s)
- Judith E Adams
- Department of Clinical Radiology, The Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester, England, UK.
| | - Klaus Engelke
- Institute of Medical Physics, University of Erlangen, Erlangen, Germany and Synarc A/S, Germany
| | - Babette S Zemel
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kate A Ward
- MRC Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK
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Going S, Lee V, Blew R, Laddu D, Hetherington-Rauth M. Top 10 research questions related to body composition. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2014; 85:38-48. [PMID: 24749235 DOI: 10.1080/02701367.2013.875446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
An understanding of body composition is crucial to understanding human health, disease, and function. Research in body composition has focused on the development of assessment methods, description of normal changes in body composition with growth and development and aging, and the changes that occur in body composition in response to challenges ranging from illness to planned interventions. Each focus is significant, and in a sense, they are interdependent, because technological advances allow more sophisticated questions to be addressed, which in turn drives the development of better methods. Significant advances have been made in each area, although perhaps surprisingly basic questions remain. For example, growth trajectories are often estimated from cross-sectional data, given the resources needed for long-term observational studies, and thus, longitudinal descriptive data are still needed. Along with advances in laboratory methods, development of field methods remains relevant for screening and clinical practice. Despite recognition of wide interindividual differences in intervention response, average outcomes continue to be emphasized. With technological advances, it is now possible to examine genetic along with nongenetic factors that underlie changes in body composition, and these techniques need to be applied in long-term, well-controlled trials. In this article, we review 10 key questions in related areas in which research is needed to continue to advance the field.
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Abstract
AbstractThe aim of this study was to determine the relative contributions of fat mass and lean mass to the variability of bone mineral density (BMD) of the lumbar spine and proximal 1/3 forearm in Bulgarian women. 180 women aged 21 through 76 years participated (mean age 50.8 ± 9.7 years). 130 of them were postmenopausal. Lumbar spine and forearm BMD were measured by dual-energy X-ray absorptiometry, followed by a whole-body scan for body composition examination (Hologic QDR 4500 A device, software version 1.26). The strongest linear correlation was found with body weight (r2=0.231, p<0.001). Using this model, 18.1 % of the variability of lumbar spine BMD was attributable to fat mass and 16.0 % to lean mass. The relative influence of fat mass on L1-L4 BMD was greater than that of lean mass (standardized regression coefficient 0.291 versus 0.199). There were weak correlations of body weight, fat and lean mass with the forearm BMD. Lean mass correlated slightly better (r=0.187, p=0.050) to forearm BMD than fat mass (r=0.162, p=0.055). In conclusion, the differentiation between fat and lean mass does not strengthen the BMD correlations beyond that with total body weight.
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Abstract
Historically, obesity was thought to be advantageous for maintaining healthy bones due to the greater bone mineral density observed in overweight individuals. However, recent observations of increased fracture in some obese individuals have led to concern that common metabolic complications of obesity, such as type 2 diabetes, metabolic syndrome, impaired glucose tolerance, insulin resistance, hyperglycemia, and inflammation may be associated with poor bone health. In support of this hypothesis, greater visceral fat, a hallmark of insulin resistance and metabolic syndrome, is associated with lower bone mineral density. Research is needed to determine if and how visceral fat and/or poor metabolic health are causally associated with bone health. Clinicians should consider adding a marker metabolic health, such as waist circumference or fasting plasma glucose concentration, to other known risk factors for osteoporosis and fracture.
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Affiliation(s)
- Barbara A Gower
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA.
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Deere K, Sayers A, Viljakainen HT, Lawlor DA, Sattar N, Kemp JP, Fraser WD, Tobias JH. Distinct relationships of intramuscular and subcutaneous fat with cortical bone: findings from a cross-sectional study of young adult males and females. J Clin Endocrinol Metab 2013; 98:E1041-9. [PMID: 23533224 PMCID: PMC3752522 DOI: 10.1210/jc.2013-1272] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 03/20/2013] [Indexed: 11/19/2022]
Abstract
CONTEXT Intracellular fat within muscle and visceral tissue has been suggested to adversely influence bone development. OBJECTIVE The aim of the study was to evaluate associations between im fat, as reflected by muscle density as measured by peripheral quantitative computed tomography, and cortical bone parameters in young adults. DESIGN/SETTING/PARTICIPANTS We conducted a cross-sectional analysis of 1703 males and 2243 females aged 17.8 years from the Avon Longitudinal Study of Parents and Children. OUTCOME MEASURES We measured cortical bone parameters from midtibial peripheral quantitative computed tomography scans. RESULTS Muscle density (inversely related to im fat) was inversely associated with periosteal circumference (PC) (beta = -0.07 [95% confidence interval (CI), -0.1, -0.04]), cortical bone mineral density (BMDC) (beta = -0.21 [95% CI, -0.26, -0.17]), and cortical thickness (CT) (beta = -0.37 [95% CI, -0.42, -0.33]) (males and females combined, adjusted for age, height, gender, and muscle cross-sectional area). In contrast, sc fat area was positively associated with PC (beta = 0.10 [95% CI, 0.07, 0.12]), but no association was seen with BMDC or CT. To examine the role of candidate intermediary metabolic pathways, analyses were repeated after adjustment for insulin, C-reactive protein, and β-C-telopeptides of type I collagen. Whereas similar associations were observed after adjustment for insulin and C-reactive protein, the association between muscle density and BMDC was partially attenuated by adjustment for β-C-telopeptides of type I collagen (beta = -0.14 [95% CI, -0.20, -0.08]). CONCLUSION Although im and sc fat were both positively associated with cortical bone mass, the nature of these relationships differed in that im fat was predominantly associated with CT and BMDC, whereas sc fat was mainly associated with PC. These relationships were largely independent of candidate metabolic pathways, such as altered bone resorption, insulin resistance, or inflammation.
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Affiliation(s)
- K Deere
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol BS10 5NB, United Kingdom
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How does bone quality differ between healthy-weight and overweight adolescents and young adults? Clin Orthop Relat Res 2013; 471:1214-25. [PMID: 23001501 PMCID: PMC3586045 DOI: 10.1007/s11999-012-2576-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Overweight youth have greater bone mass than their healthy-weight peers but sustain more fractures. However, it is unclear whether and how excess body fat influences bone quality in youth. QUESTIONS/PURPOSES We determined whether overweight status correlated with three-dimensional aspects of bone quality influencing bone strength in adolescent and young adult females and males. METHODS We categorized males (n=103; mean age, 17 years) and females (n=85; mean age, 18 years) into healthy-weight and overweight groups. We measured lean mass (LM) and fat mass (FM) with dual-energy x-ray absorptiometry (DXA). We used high-resolution peripheral quantitative CT to assess the distal radius (7% site) and distal tibia (8% site). Bone quality measures included total bone mineral density (Tt.BMD), total area (Tt.Ar), trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), separation (Tb.Sp), and thickness (Tb.Th). We used multiple regression to compare bone quality between healthy-weight and overweight adolescents adjusting for age, ethnicity, limb length, LM, and FM. RESULTS Overweight males had higher (10%-21%) Tt.BMD, BV/TV, and Tb.N and lower Tb.Sp at the tibia and lower Tt.Ar at the radius than healthy-weight males. No differences were observed between overweight and healthy-weight females. LM attenuated the differences in bone quality between groups in males while FM negatively predicted Tt.BMD, BV/TV, Tb.N, and Tb.Th. CONCLUSIONS Our data suggest overweight males have enhanced bone quality compared with healthy-weight males; however, when group differences are interpreted in the context of the mechanostat theory, it appears bone quality of overweight adolescents adapts to LM and not to greater FM.
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Osborne DL, Weaver CM, McCabe LD, McCabe GP, Novotny R, Van Loan MD, Going S, Matkovic V, Boushey CJ, Savaiano DA. Body size and pubertal development explain ethnic differences in structural geometry at the femur in Asian, Hispanic, and white early adolescent girls living in the U.S. Bone 2012; 51:888-95. [PMID: 22944607 PMCID: PMC3491564 DOI: 10.1016/j.bone.2012.08.125] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Revised: 08/16/2012] [Accepted: 08/18/2012] [Indexed: 12/21/2022]
Abstract
UNLABELLED Variation in structural geometry is present in adulthood, but when this variation arises and what influences this variation prior to adulthood remains poorly understood. Ethnicity is commonly the focus of research of skeletal integrity and appears to explain some of the variation in quantification of bone tissue. However, why ethnicity explains variation in skeletal integrity is unclear. METHODS Here we examine predictors of bone cross sectional area (CSA) and section modulus (Z), measured using dual-energy X-ray absorptiometry (DXA) and the Advanced Hip Analysis (AHA) program at the narrow neck of the femur in adolescent (9-14 years) girls (n=479) living in the United States who were classified as Asian, Hispanic, or white if the subject was 75% of a given group based on parental reported ethnicity. Protocols for measuring height and weight follow standardized procedures. Total body lean mass (LM) and total body fat mass (FM) were quantified in kilograms using DXA. Total dietary and total dairy calcium intakes from the previous month were estimated by the use of an electronic semi-quantitative food frequency questionnaire (eFFQ). Physical activity was estimated for the previous year by a validated self-administered modifiable activity questionnaire for adolescents with energy expenditure calculated from the metabolic equivalent (MET) values from the Compendium of Physical Activities. Multiple regression models were developed to predict CSA and Z. RESULTS Age, time from menarche, total body lean mass (LM), total body fat mass (FM), height, total calcium, and total dairy calcium all shared a significant (p<0.05), positive relationship with CSA. Age, time from menarche, LM, FM, and height shared significant (p<0.05), positive relationships with Z. For both CSA and Z, LM was the most important covariate. Physical activity was not a significant predictor of geometry at the femoral neck (p≥0.339), even after removing LM as a covariate. After adjusting for covariates, ethnicity was not a significant predictor in regression models for CSA and Z. CONCLUSION Variability in bone geometry at the narrow neck of the femur is best explained by body size and pubertal maturation. After controlling for these covariates there were no differences in bone geometry between ethnic groups.
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Affiliation(s)
- D L Osborne
- Dept. of Anthropology, University of Nebraska, Lincoln, NE 68588, USA.
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Sayers A, Fraser WD, Lawlor DA, Tobias JH. 25-Hydroxyvitamin-D3 levels are positively related to subsequent cortical bone development in childhood: findings from a large prospective cohort study. Osteoporos Int 2012; 23:2117-28. [PMID: 22080378 PMCID: PMC3406315 DOI: 10.1007/s00198-011-1813-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 09/19/2011] [Indexed: 11/30/2022]
Abstract
UNLABELLED In exploring relationships between vitamin D status in childhood and cortical bone, little relationship was observed with plasma concentrations of 25-hydroxyvitamin-D(2) [25(OH)D(2)], whereas 25-hydroxyvitamin-D(3) [25(OH)D(3)] was positively related to cortical bone mineral content (BMC(C)) and cortical thickness, suggesting D(3) exerts a beneficial effect on cortical bone development in contrast to D(2). INTRODUCTION The study is aimed to determine whether vitamin D status in childhood is related to cortical bone development by examining prospective relationships between plasma concentrations of 25(OH)D(2) and 25(OH)D(3) at 7.6, 9.9 or 11.8 years and peripheral quantitative computed tomography (pQCT) measurements of the mid-tibia at age 15.5 years, in children from the Avon Longitudinal Study of Parents and Children. METHODS Relationships between vitamin D status and pQCT outcomes were analysed by bootstrap linear regression, adjusted for age, sex, body composition, socioeconomic position and physical activity, in 2,247 subjects in whom all covariates were available. 25(OH)D(3) was also adjusted for season and 25(OH)D(2), and 25(OH)D(2) for 25(OH)D(3). RESULTS 25(OH)D(3) was positively related to BMC(C) [0.066(0.009,0.122), P = 0.02], whereas no association was seen with 25(OH)D(2) [-0.008(-0.044,0.027), P = 0.7] [beta (with 95% CI) represents SD changes per doubling of vitamin D], P = 0.03 for difference in associations of 25(OH)D(2) and 25(OH)D(3) with BMC(C). There were also differences in associations with cortical geometry, since 25(OH)D(3) was positively related to cortical thickness [0.11(0.04, 0.19), P = 0.002], whereas no association was seen with 25(OH)D(2) [-0.04(-0.08,0.009), P = 0.1], P = 0.0005 for difference. These relationships translated into differences in biomechanical strength as reflected by buckling ratio, which was positively related to 25(OH)D(2) [0.06(0.01,0.11), P = 0.02] indicating less resistance to buckling, but inversely related to 25(OH)D(3) [-0.1(-0.19,-0.02), P = 0.03], P = 0.001 for difference. CONCLUSIONS In contrast to 25(OH)D(2), 25(OH)D(3) was positively related to subsequent cortical bone mass and predicted strength. In vitamin D-deficient children in whom supplementation is being considered, our results suggest that D(3) should be used in preference to D(2).
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Affiliation(s)
- A. Sayers
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
- Musculoskeletal Research Unit, Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB UK
| | - W. D. Fraser
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - D. A. Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J. H. Tobias
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
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Lawlor DA, Sattar N, Sayers A, Tobias JH. The association of fasting insulin, glucose, and lipids with bone mass in adolescents: findings from a cross-sectional study. J Clin Endocrinol Metab 2012; 97:2068-76. [PMID: 22492875 PMCID: PMC3387416 DOI: 10.1210/jc.2011-2721] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
CONTEXT It is unclear whether variation in insulin resistance mediates the positive association of fat mass with bone mass in children/adolescents. OBJECTIVE Our objective was to examine whether markers linked to insulin resistance [fasting insulin, glucose, triglycerides, and high-density lipoprotein cholesterol (HDLc)] are associated with bone mass in adolescents, and if they are, to examine whether they mediate the fat mass-bone mass association. DESIGN AND SETTING We conducted a cross-sectional analysis in participants from the Avon Longitudinal Study of Parents and Children. PARTICIPANTS Participants included 2305 (1100 male) individuals of mean age 15.5 yr. OUTCOME MEASURES We evaluated total body less head bone mineral content (BMC) (grams), bone area (BA) (square centimeters), and bone mineral density (BMD) (grams per square centimeter) from a dual-energy x-ray absorptiometry scan. RESULTS Fat mass, fasting insulin, and triglycerides were positively associated with BMD, BMC, and BA; HDLc was inversely associated with these outcomes. For example, the adjusted mean difference in BMC per 1 sd fasting insulin was 45 g (95% confidence interval = 17-73 g) in males and 50 g (95% confidence interval = 28-72 g) in females. When the associations of fat mass with outcomes were adjusted for markers of insulin resistance, they were largely unchanged. Associations of triglycerides and HDLc with outcomes were attenuated to the null when they were adjusted for fat mass, whereas those of insulin changed direction; i.e. with adjustment for fat mass, higher fasting insulin was associated with lower BMD, BMC, and BA. CONCLUSIONS Fasting insulin, glucose, and lipids do not appear to mediate the positive association of fat mass with bone mass in children/adolescents. The inverse association of fasting insulin with BMD, BMC, and BA once fat mass has been controlled for needs further study.
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Affiliation(s)
- Debbie A Lawlor
- Medical Research Council Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove BS8 2BN, United Kingdom.
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Boyd A, Golding J, Macleod J, Lawlor DA, Fraser A, Henderson J, Molloy L, Ness A, Ring S, Davey Smith G. Cohort Profile: the 'children of the 90s'--the index offspring of the Avon Longitudinal Study of Parents and Children. Int J Epidemiol 2012; 42:111-27. [PMID: 22507743 PMCID: PMC3600618 DOI: 10.1093/ije/dys064] [Citation(s) in RCA: 2049] [Impact Index Per Article: 170.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The Avon Longitudinal Study of Parents and Children (ALSPAC) is a transgenerational
prospective observational study investigating influences on health and development across
the life course. It considers multiple genetic, epigenetic, biological, psychological,
social and other environmental exposures in relation to a similarly diverse range of
health, social and developmental outcomes. Recruitment sought to enrol pregnant women in
the Bristol area of the UK during 1990–92; this was extended to include additional
children eligible using the original enrolment definition up to the age of 18 years. The
children from 14 541 pregnancies were recruited in 1990–92, increasing to
15 247 pregnancies by the age of 18 years. This cohort profile describes the index
children of these pregnancies. Follow-up includes 59 questionnaires (4 weeks–18
years of age) and 9 clinical assessment visits (7–17 years of age). The resource
comprises a wide range of phenotypic and environmental measures in addition to biological
samples, genetic (DNA on 11 343 children, genome-wide data on 8365 children,
complete genome sequencing on 2000 children) and epigenetic (methylation sampling on 1000
children) information and linkage to health and administrative records. Data access is
described in this article and is currently set up as a supported access resource. To date,
over 700 peer-reviewed articles have been published using ALSPAC data.
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Affiliation(s)
- Andy Boyd
- School of Social and Community Medicine, University of Bristol, Bristol, UK.
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Gracia-Marco L, Ortega FB, Jiménez-Pavón D, Rodríguez G, Castillo MJ, Vicente-Rodríguez G, Moreno LA. Adiposity and bone health in Spanish adolescents. The HELENA study. Osteoporos Int 2012; 23:937-47. [PMID: 21562873 DOI: 10.1007/s00198-011-1649-3] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 04/18/2011] [Indexed: 11/30/2022]
Abstract
UNLABELLED While the association of lean mass (LM) with bone mass is well understood, the association of fat mass (FM) with bone mass is controversial. Our results support that adolescents with higher levels of adiposity have greater bone mass, but this association is fully explained by their higher levels of LM. INTRODUCTION We aimed (1) to study the independent association of FM and LM with bone mass and (2) to study the differences in bone mass by weight status in adolescents, after controlling for relevant confounders, such as physical activity (PA), calcium intake, and LM. METHODS Participants were 330 adolescents (167 boys, 12.5-17.5 years) from the HELENA study. The relationships of FM (DXA, n = 330; BodPod, n = 282) and LM (DXA, n = 330) with different bone variables (whole body, total hip, lumbar spine, and femoral neck) were analyzed by linear regression, and differences between weight status were analyzed by ANCOVA. RESULTS Fat mass (DXA) was positively associated with bone variables in both sexes, after adjustment for height, calcium intake, and sexual maturation. Additional adjustment by PA slightly increases the associations. However, adjustment for LM inverted these associations. Similar results were obtained using BodPod instead of DXA for assessing FM. Overweight/obese adolescents had higher BMC than their non-overweight peers in most of regions studied. Additional adjustment for PA slightly increased the differences between weight status groups, while adjusting for LM inverted the associations. LM was strong and positively associated with all bone variables in both sexes. Additional adjustment for PA or FM did not change the results. CONCLUSIONS Adolescents with higher levels of adiposity have greater bone mass, but this association is explained by their higher levels of LM.
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Affiliation(s)
- L Gracia-Marco
- GENUD Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, 50009 Zaragoza, Spain.
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Sudhagoni RG, Wey HE, Djira GD, Specker BL. Longitudinal effects of fat and lean mass on bone accrual in infants. Bone 2012; 50:638-42. [PMID: 22154840 DOI: 10.1016/j.bone.2011.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 11/04/2011] [Accepted: 11/16/2011] [Indexed: 11/18/2022]
Abstract
There are conflicting reports on the influence of lean and fat mass on bone accrual during childhood. No infant's studies have been reported that describe the influence of changes in body composition with changes in bone accrual during the first year of life. The objective of this research was to test the hypothesis that greater gains in lean mass will have a positive effect on bone mineral content (BMC) accrual, while greater gains in fat mass will have a negative effect on BMC accrual in infants. Longitudinal data from 3 previous infant studies were used. Linear mixed models, adjusting for age, sex, dietary calcium, and length were used to investigate longitudinal and cross-sectional associations between total body BMC and lean and fat mass in the individual studies and in a combined analysis. In both individual and combined analyses, we found that lean and fat mass were positively associated with whole body BMC accrual (all, P<0.001). The cross-sectional association of BMC and dietary calcium was negative in one study (P<0.05). No differences in BMC change between sexes were observed in three studies. Our results showed positive cross-sectional and longitudinal associations between total body BMC and lean mass in infants. In contradiction to our hypothesis for fat mass, we found a positive cross-sectional and longitudinal association between total body BMC and fat mass in infants.
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Affiliation(s)
- Ramu G Sudhagoni
- Ethel Austin Martin Program in Human Nutrition, South Dakota State University, Brookings, SD 57007, USA
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Sayers A, Lawlor DA, Sattar N, Tobias JH. The association between insulin levels and cortical bone: findings from a cross-sectional analysis of pQCT parameters in adolescents. J Bone Miner Res 2012; 27:610-8. [PMID: 22095452 PMCID: PMC3378703 DOI: 10.1002/jbmr.1467] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Recent studies suggest that patients with type 2 diabetes mellitus are at increased risk of fracture, possibly because hyperinsulinemia is a risk factor for low bone mineral density, which may in turn be a consequence of a lipotoxic effect of visceral and/or intramuscular fat on bone. In the current study, we investigated whether insulin plays a role in cortical bone development by performing a cross-sectional study based on the Avon Longitudinal Study of Parents and Children (ALSPAC), where we examined associations between fasting insulin levels and peripheral quantitative computed tomography (pQCT) parameters as assessed at the mid-tibia in 2784 boys and girls with a mean age 15.5 years. In particular, we wished to examine whether associations that we observed were independent of body composition, including intramuscular fat. We found that insulin was inversely related to cortical bone mineral density (BMD(C)) after adjustment for age and after further adjustment for height, muscle cross-sectional area (MCSA), subcutaneous fat (SAT), and muscle density (MD), which is inversely related to intramuscular fat (-0.018, 95% confidence interval [CI] -0.030, -0.006, p < 0.0001). Insulin was positively related to periosteal circumference (PC) after adjusting for age (0.015, 95% CI 0.003, 0.027, p = 0.015; beta = change per 50% increase in insulin), but this changed to an inverse association after additional adjustment for height and body composition (-0.013, 95% CI -0.022, -0.003, p = 0.008). Path analyses revealed inverse associations between insulin and PC via a direct pathway (-0.012, 95% CI -0.022, -0.003, p = 0.01) and via MD (-0.002, 95% CI -0.004, -0.001, p = 0.0004), and positive associations between insulin and PC via SAT (0.013, 95% CI 0.009, 0.016, p < 0.0001) and MCSA (0.015, 95% CI 0.010, 0.020, p < 0.0001). In conclusion, we found an inverse relationship between insulin and PC via intramuscular fat, suggesting a lipotoxic effect on bone. However, an inverse association between insulin and both PC and BMD(C) persisted after adjusting for all body composition variables, suggesting insulin also acts to inhibit bone development via additional pathways yet to be elucidated.
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Affiliation(s)
- Adrian Sayers
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
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Farr JN, Funk JL, Chen Z, Lisse JR, Blew RM, Lee VR, Laudermilk M, Lohman TG, Going SB. Skeletal muscle fat content is inversely associated with bone strength in young girls. J Bone Miner Res 2011; 26:2217-25. [PMID: 21544865 PMCID: PMC4414314 DOI: 10.1002/jbmr.414] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Childhood obesity is an established risk factor for metabolic disease. The influence of obesity on bone development, however, remains controversial and may depend on the pattern of regional fat deposition. Therefore, we examined the associations of regional fat compartments of the calf and thigh with weight-bearing bone parameters in girls. Data from 444 girls aged 9 to 12 years from the Jump-In: Building Better Bones study were analyzed. Peripheral quantitative computed tomography (pQCT) was used to assess bone parameters at metaphyseal and diaphyseal sites of the femur and tibia along with subcutaneous adipose tissue (SAT, mm(2) ) and muscle density (mg/cm(3) ), an index of skeletal muscle fat content. As expected, SAT was positively correlated with total-body fat mass (r = 0.87-0.89, p < .001), and muscle density was inversely correlated with total-body fat mass (r = -0.24 to -0.28, p < .001). Multiple linear regression analyses with SAT, muscle density, muscle cross-sectional area, bone length, maturity, and ethnicity as independent variables showed significant associations between muscle density and indices of bone strength at metaphyseal (β = 0.13-0.19, p < .001) and diaphyseal (β = 0.06-0.09, p < .01) regions of the femur and tibia. Associations between SAT and indices of bone strength were nonsignificant at all skeletal sites (β = 0.03-0.05, p > .05), except the distal tibia (β = 0.09, p = .03). In conclusion, skeletal muscle fat content of the calf and thigh is inversely associated with weight-bearing bone strength in young girls.
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Affiliation(s)
- Joshua N. Farr
- Department of Physiological Sciences, University of Arizona, Tucson, AZ, USA
| | - Janet L. Funk
- Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | | | - Robert M. Blew
- Department of Physiological Sciences, University of Arizona, Tucson, AZ, USA
| | - Vinson R. Lee
- Department of Physiological Sciences, University of Arizona, Tucson, AZ, USA
| | - Monica Laudermilk
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Timothy G. Lohman
- Department of Physiological Sciences, University of Arizona, Tucson, AZ, USA
| | - Scott B. Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
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Macdonald-Wallis C, Tobias JH, Davey Smith G, Lawlor DA. Parental smoking during pregnancy and offspring bone mass at age 10 years: findings from a prospective birth cohort. Osteoporos Int 2011; 22:1809-19. [PMID: 20967424 PMCID: PMC3092913 DOI: 10.1007/s00198-010-1415-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2010] [Accepted: 09/08/2010] [Indexed: 11/26/2022]
Abstract
UNLABELLED We investigated an intrauterine influence of maternal smoking during pregnancy on childhood bone mass. Daughters, but not sons, of mothers who smoked had higher bone mass at age 10years. This appears to be due to familial factors related to parental smoking influencing increased offspring adiposity rather than a direct intrauterine effect. INTRODUCTION Neonatal studies have demonstrated an adverse relationship between maternal smoking in pregnancy and foetal bone mineral accrual. We aimed to investigate an intrauterine influence of maternal smoking during pregnancy on offspring bone mass at mean age 9.9 years. METHODS We compared associations of maternal and paternal smoking in pregnancy with offspring total body less head (TBLH) and spine bone mineral content (BMC), bone area (BA), bone mineral density (BMD) and area-adjusted BMC (ABMC) in 7,121 children in the Avon Longitudinal Study of Parents and Children. RESULTS Maternal smoking in any trimester was associated with increased TBLH BMC, BA and BMD in girls (mean difference [95% CI] (sex-specific SD scores), 0.13 [0.05-0.22], 0.13 [0.04-0.21], 0.13 [0.04-0.22], respectively) but not boys (0.01 [-0.07-0.09], 0.00 [-0.08-0.08], 0.04 [-0.05-0.12]), and also with spine BMC, BA and BMD in girls (0.13 [0.03-0.23], 0.12 [0.03-0.22], 0.10 [0.00-0.21]) but not boys (0.03 [-0.06-0.12], 0.00 [-0.09-0.09], 0.05 [-0.04-0.14]), but not with ABMC. Paternal smoking associations were similar, with no statistical evidence for a difference between maternal and paternal effects. Maternal associations increased on adjustment for offspring birth weight and gestational age, but attenuated to the null after adjustment for current height and weight. CONCLUSIONS We found little evidence that maternal smoking was related to bone mass in boys. In girls, maternal smoking associations were similar to those of paternal smoking, suggesting that these were attributable to shared familial characteristics, not intrauterine mechanisms.
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Affiliation(s)
- C Macdonald-Wallis
- MRC Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK.
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Zhao J, Bradfield JP, Li M, Zhang H, Mentch FD, Wang K, Sleiman PMA, Kim CE, Glessner JT, Frackelton EC, Chiavacci RM, Berkowitz RI, Zemel BS, Hakonarson H, Grant SFA. BMD-associated variation at the Osterix locus is correlated with childhood obesity in females. Obesity (Silver Spring) 2011; 19:1311-4. [PMID: 21212767 DOI: 10.1038/oby.2010.324] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent genome wide association studies (GWAS) have revealed a number of genetic variants robustly associated with bone mineral density (BMD) and/or osteoporosis. Evidence from epidemiological and clinical studies has shown an association between BMD and BMI, presumably as a consequence of bone loading. We investigated the 23 previously published BMD GWAS-derived loci in the context of childhood obesity by leveraging our existing genome-wide genotyped European American cohort of 1106 obese children (BMI ≥ 95th percentile) and 5997 controls (BMI < 95th percentile). Evidence of association was only observed at one locus, namely Osterix (SP7), with the G allele of rs2016266 being significantly over-represented among childhood obesity cases (P = 2.85 × 10(-3)). When restricting these analyses to each gender, we observed strong association between rs2016266 and childhood obesity in females (477 cases and 2867 controls; P = 3.56 × 10(-4)), which survived adjustment for all tests applied. However, no evidence of association was observed among males. Interestingly, Osterix is the only GWAS locus uncovered to date that has also been previously implicated in the determination of BMD in childhood. In conclusion, these findings indicate that a well established variant at the Osterix locus associated with increased BMD is also associated with childhood obesity primarily in females.
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Affiliation(s)
- Jianhua Zhao
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Sayers A, Mattocks C, Deere K, Ness A, Riddoch C, Tobias JH. Habitual levels of vigorous, but not moderate or light, physical activity is positively related to cortical bone mass in adolescents. J Clin Endocrinol Metab 2011; 96:E793-802. [PMID: 21325463 PMCID: PMC3085207 DOI: 10.1210/jc.2010-2550] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
CONTEXT The intensity of habitual physical activity (PA) needed to affect skeletal development in childhood is currently unclear. OBJECTIVE To examine associations between light PA, moderate PA, and vigorous PA (as assessed by accelerometry), and tibial cortical bone mass (BMC(C)) as measured by peripheral quantitative computed tomography. DESIGN/SETTING Cross-sectional analysis based on the Avon Longitudinal Study of Parents and Children. PARTICIPANTS A total of 1748 boys and girls (mean age 15.5 yr) participated in the study. OUTCOME MEASURES We measured BMC(C), cortical bone mineral density, periosteal circumference, and endosteal circumference by tibial peripheral quantitative computed tomography. RESULTS Multivariable models, adjusted for height and other activity levels, indicated vigorous PA was positively related to BMC(C) (P = 0.0001). There was little evidence of a relationship with light PA or moderate PA (both P ≥ 0.7). In path analyses, the relationship between vigorous PA and BMC(C) [0.082 (95% confidence interval [CI]: 0.037, 0.128), P = 0.0004] (SD change per doubling of vigorous PA) was minimally attenuated by adjusting for body composition [0.070 (95% CI: 0.026, 0.115), P = 0.002]. In analyses adjusted for body composition, the relationship between vigorous PA and BMC(C) was explained by the periosteal circumference pathway [0.043 (95% CI: 0.004, 0.082), P = 0.03] and the endosteal circumference adjusted for periosteal circumference pathway [0.031 (95% CI: 0.011, 0.050), P = 0.002], while there was little contribution from the cortical bone mineral density pathway (P = 0.3). CONCLUSIONS Vigorous day-to-day PA is associated with indices of BMC(C) and geometry in adolescents, whereas light or moderate PA has no detectable association. Therefore, promoting PA in childhood is unlikely to benefit skeletal development unless high-impact activities are also increased.
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Affiliation(s)
- A Sayers
- Musculoskeletal Research Unit, School of Clinical Sciences, University of Bristol, Bristol BS10 5NB, United Kingdom
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