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Ollila L, Oura P, Karppinen J, Niinimäki J, Junno JA. Association between vertebral cross-sectional area and lumbar disc displacement - a population-based study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:900-905. [PMID: 37452838 DOI: 10.1007/s00586-023-07853-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 05/30/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE Vertebral dimensions may constitute a potential risk factor for degenerative changes in the spine. Previous studies have found a positive association between vertebral height and both type 2 Modic changes and intervertebral disc height loss. Also, vertebral endplate size has been associated with disc degeneration. However, only a few studies have investigated the association between vertebral dimensions and lumbar disc displacement (LDD). This study aimed to investigate the association between vertebral cross-sectional area (CSA) and LDD among the general middle-aged Finnish population. We hypothesized that larger vertebral CSA is associated with LDD. MATERIALS AND METHODS The study was conducted by using data from the Northern Finland Birth Cohort 1966 (NFBC1966). At the age of 46, a subpopulation of NFBC1966 underwent clinical examinations including magnetic resonance imaging (MRI) (n = 1249). MRI scans were used to measure L4 CSA and evaluate the presence of LDD (bulge, protrusion, and extrusion/sequestration) in the adjacent discs. The association between L4 CSA and LDD was analysed using logistic regression, with adjustment for sex, education, body mass index, leisure-time physical activity, smoking, diet, and L4 height. RESULTS Larger L4 CSA was associated with LDD; an increase of 1 cm2 in vertebral CSA elevated the odds of LDD relative to no LDD by 10% (adjusted odds ratio 1.10, 95% CI 1.01-1.19). The association was similar among either sex. CONCLUSIONS Larger L4 vertebral CSA was associated with LDD in our study sample. Even though smaller vertebral size exposes our vertebrae to osteoporotic fractures, it simultaneously seems to protect us from LDD.
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Affiliation(s)
- Laura Ollila
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
| | - Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Rehabilitation Services of South Karelia Social and Health Care District, Valto Käkelän Katu 3, 53130, Lappeenranta, Finland
- Finnish Institute of Occupational Health, Aapistie 1, 90220, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Research Unit of Health Sciences and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Juho-Antti Junno
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
- Department of Archaeology, Faculty of Humanities, University of Oulu, Oulu, Finland
- Faculty of Medicine, Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
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Naidoo N, Khan R, Abdulwahab T, Almqvist KF, Lakshmanan J, Prithishkumar IJ. A novel reconstructive approach of the lumbar vertebral column from 2D MRI to 3D models. TRANSLATIONAL RESEARCH IN ANATOMY 2022. [DOI: 10.1016/j.tria.2022.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shaikh N, Zhang H, Brown SHM, Lari H, Lasry O, Street J, Wilson DR, Oxland T. Synchronous imaging of pelvic geometry and muscle morphometry: a pilot study of pelvic retroversion using upright MRI. Sci Rep 2021; 11:20127. [PMID: 34635683 PMCID: PMC8505414 DOI: 10.1038/s41598-021-99305-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 09/22/2021] [Indexed: 02/05/2023] Open
Abstract
This study investigated feasibility of imaging lumbopelvic musculature and geometry in tandem using upright magnetic resonance imaging (MRI) in asymptomatic adults, and explored the effect of pelvic retroversion on lumbopelvic musculature and geometry. Six asymptomatic volunteers were imaged (0.5 T upright MRI) in 4 postures: standing, standing pelvic retroversion, standing 30° flexion, and supine. Measures included muscle morphometry [cross-sectional area (CSA), circularity, radius, and angle] of the gluteus and iliopsoas, and pelvic geometry [pelvic tilt (PT), pelvic incidence (PI), sacral slope (SS), L3-S1 lumbar lordosis (LL)] L3-coccyx. With four volunteers repeating postures, and three raters assessing repeatability, there was generally good repeatability [ICC(3,1) 0.80-0.97]. Retroversion had level dependent effects on muscle measures, for example gluteus CSA and circularity increased (up to 22%). Retroversion increased PT, decreased SS, and decreased L3-S1 LL, but did not affect PI. Gluteus CSA and circularity also had level-specific correlations with PT, SS, and L3-S1 LL. Overall, upright MRI of the lumbopelvic musculature is feasible with good reproducibility, and the morphometry of the involved muscles significantly changes with posture. This finding has the potential to be used for clinical consideration in designing and performing future studies with greater number of healthy subjects and patients.
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Affiliation(s)
- Noor Shaikh
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada.,ICORD, University of British Columbia, Vancouver, Canada.,Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada
| | - Honglin Zhang
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, Canada
| | - Hamza Lari
- Department of Radiology, Vancouver General Hospital, Vancouver, Canada
| | - Oliver Lasry
- ICORD, University of British Columbia, Vancouver, Canada.,Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - John Street
- ICORD, University of British Columbia, Vancouver, Canada.,Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - David R Wilson
- ICORD, University of British Columbia, Vancouver, Canada.,Centre for Hip Health and Mobility, University of British Columbia, Vancouver, Canada.,Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Thomas Oxland
- ICORD, University of British Columbia, Vancouver, Canada. .,Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada. .,Department of Orthopaedics, University of British Columbia, Vancouver, Canada. .,University of British Columbia, ICORD, Blusson Spinal Cord Centre at VGH, 3rd Floor, 818 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada.
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Fourth lumbar vertebral parameters in predicting the gender, height and age in Iranian population. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2021. [DOI: 10.1016/j.fsir.2021.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Autio E, Oura P, Karppinen J, Paananen M, Junno JA, Niinimäki J. The association between physical activity and vertebral dimension change in early adulthood - The Northern Finland Birth Cohort 1986 study. Bone Rep 2021; 14:101060. [PMID: 33981808 PMCID: PMC8085667 DOI: 10.1016/j.bonr.2021.101060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/04/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022] Open
Abstract
Small vertebral size is a well-known risk factor for vertebral fractures. To help understanding the factors behind vertebral size, we aimed to investigate whether physical activity and participation in high-impact exercise are associated with the growth rate of the vertebral cross-sectional area (CSA) among young adults. To conduct our study, we utilized the Northern Finland Birth Cohort 1986 as our study population (n = 375). Questionnaire data about physical activity was obtained at 16, 18 and 19 years of age and lumbar magnetic resonance imaging scans at two timepoints, 20 and 30 years of age. We used generalized estimating equation (GEE) models to conduct the analyses. We did not find any statistically significant associations between vertebral CSA, physical activity, and high-impact exercise in our study sample. We conclude that neither physical activity nor high-impact sports seem to influence the change in vertebral CSA among young adults. Physical activity does not influence the growth rate of the vertebral body. High-impact sports are not associated with the change in vertebral CSA among adults. The study was conducted using longitudinal MRI data.
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Affiliation(s)
- Elsi Autio
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Petteri Oura
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - Markus Paananen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juho-Antti Junno
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Anatomy, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Archaeology, Faculty of Humanities, University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Department of Radiology, Oulu University Hospital, Oulu, Finland
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Oura P, Junno JA, Autio E, Karppinen J, Niinimäki J. Baseline anthropometric indices predict change in vertebral size in early adulthood - A 10-year follow-up MRI study. Bone 2020; 138:115506. [PMID: 32603909 DOI: 10.1016/j.bone.2020.115506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/19/2020] [Accepted: 06/19/2020] [Indexed: 11/25/2022]
Abstract
The vertebral cross-sectional area (CSA) has an independent effect on vertebral strength. Recent evidence has shown that vertebral dimensions significantly increase in the third decade of life, and that lifestyle factors such as body size and composition are clearly associated with vertebral CSA. This study aimed to test the hypothesis that general anthropometric traits (stature, total body mass, lean body mass, fat mass, body mass index, waist circumference), each objectively measured at baseline, predict the change in vertebral CSA over the subsequent decade. A representative sample of young Northern Finnish adults was used (n = 371) with repeated magnetic resonance imaging (MRI) scans from ~20 and ~30 years (baseline and follow-up, respectively). Vertebral CSA was measured from the MRI scans with high reliability and low measurement error. The statistical analysis was performed using linear regression models adjusted for sex and exact length of MRI interval. According to the regression models, in descending order of effect size, lean body mass (standardized beta coefficient 0.243 [95% confidence interval 0.065-0.420]), total body mass (0.158 [0.043-0.273]), body mass index (0.125 [0.026-0.224]), waist circumference (0.119 [0.010-0.228]), and fat mass (0.104 [0.004-0.205]) were positively and significantly associated with CSA gain over the follow-up, whereas stature (0.079 [-0.066-0.224]) was not associated with CSA change. The results of this study suggest that anthropometric indices may be used for estimating subsequent change in vertebral size. In particular, greater lean body mass seems to be beneficial for vertebral size and thus potentially also for vertebral strength. Future studies should aim to replicate these associations in a dataset with longitudinal anthropometric trajectories and identify the potential common factors that influence both anthropometric traits and vertebral CSA gain.
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Affiliation(s)
- Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Juho-Antti Junno
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Anatomy, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Archaeology, Faculty of Humanities, University of Oulu, Oulu, Finland
| | - Elsi Autio
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; Finnish Institute of Occupational Health, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Radiology, Oulu University Hospital, Oulu, Finland
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Korpinen N, Oura P, Väre T, Niskanen M, Niinimäki J, Karppinen J, Junno JA. Temporal Trends in Vertebral Dimensions - a case study from Finland. Sci Rep 2020; 10:1635. [PMID: 32005864 PMCID: PMC6994481 DOI: 10.1038/s41598-020-58340-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 01/03/2020] [Indexed: 11/16/2022] Open
Abstract
Vertebral fractures and other back problems represent a major, increasing worldwide health problem. This has increased the need to better understand the reasons behind this phenomenon. In addition to a reduction in bone mineral density and overall size of the vertebral body, research has indicated a possible association between the shape of the endplate and spinal disorders. As one previous study has shown changes in vertebral body dimensions between contemporary people and their medieval counterparts, we wanted to examine the potential temporal trends in vertebral size and dimensions in Finnish samples of archaeological and contemporary individuals. To conduct this study, we utilized three archaeological populations from the 16th–19th century and clinical materials from two population-based Finnish birth cohorts. As the average height of people has increased greatly since the first time period, we also height-adjusted the dimensions to provide a clearer picture of the dimensional changes that have occurred in the later temporal group. Our results were in agreement with those of the earlier study. The archaeological samples had a larger vertebral size than the contemporary population when height was adjusted for. Vertebral mediolateral width in particular had decreased, and the shape of the vertebral body had changed.
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Affiliation(s)
- Niina Korpinen
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland.
| | - Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Tiina Väre
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland
| | - Markku Niskanen
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - Juho-Antti Junno
- Faculty of Humanities, Department of Archaeology, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Faculty of Medicine, Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Faculty of Medicine, Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland
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Korpinen N, Keisu A, Niinimäki J, Karppinen J, Niskanen M, Junno JA, Oura P. Body mass estimation from dimensions of the fourth lumbar vertebra in middle-aged Finns. Leg Med (Tokyo) 2019; 40:5-16. [PMID: 31279223 DOI: 10.1016/j.legalmed.2019.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/30/2019] [Accepted: 06/28/2019] [Indexed: 01/22/2023]
Abstract
Although body mass is not a stable trait over the lifespan, information regarding body size assists the forensic identification of unknown individuals. In this study, we aimed to study the potential of using the fourth lumbar vertebra (L4) for body mass estimation among contemporary Finns. Our sample comprised 1158 individuals from the Northern Finland Birth Cohort 1966 who had undergone measurements of body mass at age 31 and 46 and lumbar magnetic resonance imaging (MRI) at age 46. MRI scans were used to measure the maximum and minimum widths, depths, and heights of the L4 body. Their means and sum were calculated together with vertebral cross-sectional area (CSA) and volume. Ordinary least squares (OLS) and reduced major axis (RMA) regression was used to produce equations for body mass among the full sample (n = 1158) and among normal-weight individuals (n = 420). In our data, body mass was associated with all the L4 size parameters (R = 0.093-0.582, p ≤ 0.019 among the full sample; R = 0.243-0.696, p ≤ 0.002 among the normal-weight sample). RMA regression models seemed to fit the data better than OLS, with vertebral CSA having the highest predictive value in body mass estimation. In the full sample, the lowest standard errors were 6.1% (95% prediction interval ±9.6 kg) and 7.1% (±9.1 kg) among men and women, respectively. In the normal-weight sample, the lowest errors were 4.9% (±6.9 kg) and 4.7% (±5.7 kg) among men and women, respectively. Our results indicate that L4 dimensions are potentially useful in body mass estimation, especially in cases with only the axial skeleton available.
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Affiliation(s)
- Niina Korpinen
- Department of Archaeology, Faculty of Humanities, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland
| | - Asla Keisu
- Cancer Research and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Faculty of Medicine, University of Oulu and Oulu University Hospital, PO Box 5000, FI-90014 Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Faculty of Medicine, University of Oulu and Oulu University Hospital, PO Box 5000, FI-90014 Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland; Finnish Institute of Occupational Health, Aapistie 1, FI-90220 Oulu, Finland
| | - Markku Niskanen
- Department of Archaeology, Faculty of Humanities, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland
| | - Juho-Antti Junno
- Department of Archaeology, Faculty of Humanities, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland; Cancer Research and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland
| | - Petteri Oura
- Medical Research Center Oulu, Faculty of Medicine, University of Oulu and Oulu University Hospital, PO Box 5000, FI-90014 Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, PO Box 5000, FI-90014 Oulu, Finland.
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Oura P, Auvinen J, Paananen M, Junno JA, Niinimäki J, Karppinen J, Nurkkala M. Dairy- and supplement-based calcium intake in adulthood and vertebral dimensions in midlife-the Northern Finland Birth Cohort 1966 Study. Osteoporos Int 2019; 30:985-994. [PMID: 30656368 PMCID: PMC6502777 DOI: 10.1007/s00198-019-04843-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 01/04/2019] [Indexed: 12/13/2022]
Abstract
UNLABELLED Among a representative sample of 1064 Northern Finns, we studied the association of dairy- and supplement-based calcium intake in adulthood with vertebral size in midlife. Inadequate calcium intake (< 800 mg/day) from age 31 to 46 predicted small vertebral size and thus decreased spinal resilience among women but not men. INTRODUCTION Small vertebral size predisposes individuals to fractures, which are common among aging populations. Although previous studies have associated calcium (Ca) intake with enhanced bone geometry in the appendicular skeleton, few reports have addressed the axial skeleton or the vertebrae in particular. We aimed to investigate the association of dairy- and supplement-based Ca intake in adulthood with vertebral cross-sectional area (CSA) in midlife. METHODS A sample of 1064 individuals from the Northern Finland Birth Cohort 1966 had undergone lumbar magnetic resonance imaging at the age of 46, and provided self-reported data on diet and Ca intake (dairy consumption and use of Ca supplements) at the ages of 31 and 46. We assessed the association between Ca intake (both continuous and categorized according to local recommended daily intake) and vertebral CSA, using generalized estimating equation and linear regression models with adjustments for body mass index, diet, vitamin D intake, education, leisure-time physical activity, and smoking. RESULTS Women with inadequate Ca intake (< 800 mg/day) over the follow-up had 3.8% smaller midlife vertebral CSA than women with adequate Ca intake (p = 0.009). Ca intake among men showed no association with vertebral CSA. CONCLUSIONS Inadequate Ca intake (< 800 mg/day) from the age of 31 to 46 predicts small vertebral size and thus decreased spinal resilience among middle-aged women. Future studies should confirm these findings and investigate the factors underlying the association of low Ca intake in women but not in men with smaller vertebral size.
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Affiliation(s)
- P Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.
| | - J Auvinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - M Paananen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - J-A Junno
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - J Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - J Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Finnish Institute of Occupational Health, Aapistie 1, FI-90220, Oulu, Finland
| | - M Nurkkala
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. Box 365, FI-90101, Oulu, Finland
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Autio E, Oura P, Karppinen J, Paananen M, Niinimäki J, Junno JA. Changes in vertebral dimensions in early adulthood - A 10-year follow-up MRI-study. Bone 2019; 121:196-203. [PMID: 30099153 DOI: 10.1016/j.bone.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 10/28/2022]
Abstract
Previous studies have shown that vertebral height increases until the early twenties, but very few studies have been conducted on other vertebral dimensions. Growth in vertebral size is believed to take place in elderly age but not in early adulthood. In this study, we wanted to clarify the potential changes in the dimensions of the lumbar vertebrae during early adulthood. We used the Northern Finland Birth Cohort 1986 as our study material, with a final sample size of 375 individuals. We performed lumbar magnetic resonance imaging (MRI) when the participants were 20 and 30 years of age (baseline and follow-up, respectively). We recorded the width, depth, height, and cross-sectional area (CSA) of the fourth lumbar vertebra (L4) using the MRI scans. We used generalized estimating equation (GEE) models to analyse the data. Men had 7.6%-26.5% larger vertebral dimensions than women at both baseline and follow-up. The GEE models demonstrated that all the studied dimensions increased during the follow-up period among both sexes (p < 0.001). Men had a higher growth rate in vertebral depth and CSA than women (p < 0.001). Among women, small vertebral width (p = 0.001), depth (p = 0.05) and height (p = 0.02) at baseline were associated with a higher vertebral growth rate during the follow-up than among those with large dimensions at baseline. Among men, small baseline width was associated with higher vertebral growth rate (p = 0.001). Our results clearly indicate that vertebral dimensions increase after 20 years of age among both sexes.
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Affiliation(s)
- Elsi Autio
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland.
| | - Petteri Oura
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland; Finnish Institute of Occupational Health, Oulu, Finland
| | - Markus Paananen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Jaakko Niinimäki
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Radiology, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Juho-Antti Junno
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Anatomy, Faculty of Medicine, University of Oulu, Oulu, Finland; Department of Archaeology, Faculty of Humanities, University of Oulu, Oulu, Finland
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Oura P, Nurkkala M, Auvinen J, Niinimäki J, Karppinen J, Junno JA. The Association of Body Size, Shape and Composition with Vertebral Size in Midlife - The Northern Finland Birth Cohort 1966 Study. Sci Rep 2019; 9:3944. [PMID: 30850701 PMCID: PMC6408584 DOI: 10.1038/s41598-019-40880-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 02/22/2019] [Indexed: 01/17/2023] Open
Abstract
Small vertebral size increases the risk of osteoporotic vertebral fractures. Obese individuals have larger vertebral size and potentially lower fracture risk than lean individuals, but scarce data exist on the association between vertebral size and anthropometric measures beyond height, weight, and body mass index (BMI). Here, we evaluated several anthropometric measures (height, weight, BMI, waist circumference, hip circumference, waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], fat mass [FM], lean body mass [LBM], percentage FM [%FM], percentage LBM [%LBM]) as predictors of vertebral cross-sectional area (CSA). We used a representative sample from the Northern Finland Birth Cohort 1966 (n = 1087), with anthropometric measurements from the ages of 31 and 46, bioimpedance analysis from the age of 46, and lumbar magnetic resonance imaging from the age of 46 years. In our data, height and LBM correlated most strongly with vertebral CSA among both sexes (0.469 ≤ r ≤ 0.514), while WHR, WHtR, %FM, and %LBM had the weakest correlations with vertebral CSA (|r| ≤ 0.114). We conclude that height and LBM have the highest, yet only moderate correlations with vertebral size. High absolute LBM, rather than FM or abdominal mass accumulation, correlates with large vertebral size and thus potentially also with lower osteoporotic vertebral fracture risk.
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Affiliation(s)
- Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland. .,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland. .,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.
| | - Marjukka Nurkkala
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute, P.O. Box 365, FI-90101, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Finnish Institute of Occupational Health, Aapistie 1, FI-90220, Oulu, Finland
| | - Juho-Antti Junno
- Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland.,Department of Archaeology, Faculty of Humanities, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
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12
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Estimation of stature from dimensions of the fourth lumbar vertebra in contemporary middle-aged Finns. Forensic Sci Int 2018; 292:71-77. [PMID: 30273914 DOI: 10.1016/j.forsciint.2018.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/03/2018] [Accepted: 09/07/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Accurate stature estimation plays an essential role in the identification of unknown deceased individuals. For cases in which conventional methods of stature estimation are not applicable, we studied the stature estimation potential of the fourth lumbar vertebra (L4) among a large living sample of representative contemporary Finns. We also generated stature estimation equations for the middle-aged Finnish population. MATERIAL AND METHODS Our study population comprised the Northern Finland Birth Cohort 1966 for which lumbar magnetic resonance imaging (MRI) scans and objective measurements of stature were available from midlife (n=1358). After screening the MRI scans for vertebral pathologies, we measured the maximum and minimum widths, depths and heights of the L4 body with high precision and reliability. We then calculated their sums and means together with approximations of vertebral cross-sectional area and volume. By constructing simple and multiple linear regression models around the L4 parameters, we generated equations for stature prediction, and investigated their accuracy on the basis of the adjusted R squared (R2) and standard error of the estimate (SEE) values of the models. RESULTS The multiple linear regression models of the mean width, depth and height of L4 yielded the highest prediction accuracies with the lowest prediction errors (for the entire sample, R2=0.621 and SEE=5.635cm; for men, R2=0.306 and SEE=5.125cm; for women, R2=0.367 and SEE=4.640cm). CONCLUSION When conventional methods for estimating stature are not applicable, the lumbar vertebrae may be utilized for this purpose. Relatively accurate stature estimates can be given on the basis of only L4 dimensions.
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Abstract
STUDY DESIGN A population-based birth cohort study. OBJECTIVE To investigate the association between gravidity, parity, and vertebral geometry among middle-aged women. SUMMARY OF BACKGROUND DATA Vertebral size is a recognized determinant of vertebral fracture risk. Yet, only a few lifestyle factors that influence vertebral size are known. Pregnancy is a labile period that may affect the maternal vertebral size or shape. The lumbar lordosis angle is permanently deepened by pregnancy, but it remains unclear whether vertebral shape or size contribute to this deepened angle. METHODS We aimed to investigate whether gravidity and parity were associated with vertebral cross-sectional area (CSA) and height ratio (anterior height to posterior height) among 705 middle-aged women from the Northern Finland Birth Cohort 1966. We measured the corpus of their fourth lumbar vertebra using magnetic resonance imaging of the lumbar spine at the age of 46. Gravidity and parity were elicited using a questionnaire also at the age of 46. Linear regression analysis was used with adjustments for body mass index, vertebral CSA (height ratio models), and vertebral height (CSA models). We also ran a subgroup analysis that did not include nulliparous women, and we compared nulliparous women with grand multiparous women. RESULTS The models found no statistically significant associations between the predictors and outcomes. Crude and adjusted results were highly similar, and the subgroup analyses provided analogous results. CONCLUSION Pregnancy, or even multiple pregnancies, do not seem to have long-term effects on vertebral geometry. In order to enhance the prevention of vertebral fractures, future studies should aim to reveal more lifestyle determinants of vertebral size. LEVEL OF EVIDENCE 3.
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Oura P, Karppinen J, Niinimäki J, Junno JA. Sex estimation from dimensions of the fourth lumbar vertebra in Northern Finns of 20, 30, and 46 years of age. Forensic Sci Int 2018; 290:350.e1-350.e6. [DOI: 10.1016/j.forsciint.2018.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/03/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
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15
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Oura P, Junno JA, Auvinen J, Niinimäki J, Karppinen J, Ojaniemi M, Paananen M. Body Mass Index Trajectories From Birth to Midlife and Vertebral Dimensions in Midlife: the Northern Finland Birth Cohort 1966 Study. JBMR Plus 2018; 3:37-44. [PMID: 30680362 DOI: 10.1002/jbm4.10065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/02/2018] [Accepted: 05/19/2018] [Indexed: 01/08/2023] Open
Abstract
Vertebral fracture risk is higher among individuals with small vertebral dimensions. Obesity is a global health problem and may also contribute to bone size and fracture risk. In this work we report the association between life course body mass index (BMI) and vertebral cross-sectional area (CSA) in midlife. The Northern Finland Birth Cohort 1966 study with its 46-year follow-up provided the material for this study. A subsample of 780 individuals had attended lumbar magnetic resonance imaging (MRI) at the age of 46 years, and had records of objectively measured BMI from the ages of 0, 7, 15, 31, and 46 years. Of these, MRI-derived data on vertebral size was available for 682 individuals. We identified latent lifelong BMI trajectories by performing latent class growth modeling (LCGM) on the BMI data, and then used sex-stratified linear regression models to compare the identified trajectory groups in terms of midlife vertebral CSA. Gestational age, education years, adult height, lifelong physical activity, lifelong smoking history, and adulthood diet were assessed as potential confounders. Three distinct trajectory groups ("stable slim," "stable average," and "early onset overweight") were identified among both sexes. Comparisons to the stable slim trajectory revealed that vertebral CSA was significantly (p < 0.001) larger among the stable average and early onset overweight trajectories (69.8 and 118.6 mm2 larger among men, 57.7 and 106.1 mm2 larger among women, respectively). We conclude that lifelong BMI has a positive association with midlife vertebral size among both sexes. Future studies should characterize the mediating factors of this association.
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Affiliation(s)
- Petteri Oura
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine University of Oulu Oulu Finland.,Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland
| | - Juho-Antti Junno
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland.,Cancer and Translational Medicine Research Unit, Faculty of Medicine University of Oulu Oulu Finland.,Department of Archaeology, Faculty of Humanities University of Oulu Oulu Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland.,Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland
| | - Jaakko Niinimäki
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine University of Oulu Oulu Finland.,Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland
| | - Jaro Karppinen
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland.,Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland.,Finnish Institute of Occupational Health Oulu Finland
| | - Marja Ojaniemi
- PEDEGO Research Unit, Faculty of Medicine University of Oulu Oulu Finland.,Department of Children and Adolescents Oulu University Hospital Oulu Finland
| | - Markus Paananen
- Center for Life Course Health Research, Faculty of Medicine University of Oulu Oulu Finland.,Medical Research Center Oulu Oulu University Hospital and University of Oulu Oulu Finland
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16
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Gilsanz V, Wren TAL, Ponrartana S, Mora S, Rosen CJ. Sexual Dimorphism and the Origins of Human Spinal Health. Endocr Rev 2018; 39:221-239. [PMID: 29385433 PMCID: PMC5888211 DOI: 10.1210/er.2017-00147] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/24/2018] [Indexed: 12/26/2022]
Abstract
Recent observations indicate that the cross-sectional area (CSA) of vertebral bodies is on average 10% smaller in healthy newborn girls than in newborn boys, a striking difference that increases during infancy and puberty and is greatest by the time of sexual and skeletal maturity. The smaller CSA of female vertebrae is associated with greater spinal flexibility and could represent the human adaptation to fetal load in bipedal posture. Unfortunately, it also imparts a mechanical disadvantage that increases stress within the vertebrae for all physical activities. This review summarizes the potential endocrine, genetic, and environmental determinants of vertebral cross-sectional growth and current knowledge of the association between the small female vertebrae and greater risk for a broad array of spinal conditions across the lifespan.
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Affiliation(s)
- Vicente Gilsanz
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027.,Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027.,Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Tishya A L Wren
- Department of Orthopaedic Surgery, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Skorn Ponrartana
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California 90027
| | - Stefano Mora
- Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Clifford J Rosen
- Center for Clinical and Translational Research, Maine Medical Center Research Institute, Scarborough, Maine 04074
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17
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Brassey CA, O'Mahoney TG, Chamberlain AT, Sellers WI. A volumetric technique for fossil body mass estimation applied to Australopithecus afarensis. J Hum Evol 2018; 115:47-64. [DOI: 10.1016/j.jhevol.2017.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 07/26/2017] [Accepted: 07/26/2017] [Indexed: 12/27/2022]
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18
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Oura P, Paananen M, Niinimäki J, Tammelin T, Auvinen J, Korpelainen R, Karppinen J, Junno JA. High-impact exercise in adulthood and vertebral dimensions in midlife - the Northern Finland Birth Cohort 1966 study. BMC Musculoskelet Disord 2017; 18:433. [PMID: 29110646 PMCID: PMC5674855 DOI: 10.1186/s12891-017-1794-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 10/31/2017] [Indexed: 11/10/2022] Open
Abstract
Background Vertebral size and especially cross-sectional area (CSA) are independently associated with vertebral fracture risk. Previous studies have suggested that physical activity and especially high-impact exercise may affect vertebral strength. We aimed to investigate the association between high-impact exercise at 31 and 46 years of age and vertebral dimensions in midlife. Methods We used a subsample of 1023 individuals from the Northern Finland Birth Cohort 1966 study with records of self-reported sports participation from 31 and 46 years and MRI-derived data on vertebral dimensions from 46 years. Based on the sports participation data, we constructed three impact categories (high, mixed, low) that represented longitudinal high-impact exercise activity in adulthood. We used linear regression and generalized estimating equation (GEE) models to analyse the association between high-impact exercise and vertebral CSA, with adjustments for vertebral height and body mass index. Results Participation in high-impact sports was associated with large vertebral CSA among women but not men. The women in the 'mixed' group had 36.8 (95% confidence interval 11.2–62.5) mm2 larger CSA and the women in the 'high' group 43.2 (15.2–71.1) mm2 larger CSA than the 'low' group. Conclusions We suggest that participation (≥ 1/week) in one or more high-impact sports in adulthood is associated with larger vertebral size, and thus increased vertebral strength, among middle-aged women.
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Affiliation(s)
- Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. .,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. .,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.
| | - Markus Paananen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Tuija Tammelin
- LIKES-Research Center for Sport and Health Sciences, Rautpohjankatu 8, 40700, Jyväskylä, Finland
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
| | - Raija Korpelainen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Department of Sports and Exercise Medicine, Oulu Deaconess Institute, Albertinkatu 18A, 90100, Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Finnish Institute of Occupational Health, Kastelli Research Center, Aapistie 1, 90220, Oulu, Finland
| | - Juho-Antti Junno
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland.,Department of Archaeology, Faculty of Humanities, University of Oulu, P.O. Box 8000, 90014, Oulu, Finland
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19
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Oura P, Paananen M, Ojaniemi M, Auvinen J, Junno JA, Karppinen J, Niinimäki J. Effect of early life physical growth on midlife vertebral dimensions - The Northern Finland Birth Cohort 1966 study. Bone 2017; 101:172-178. [PMID: 28479496 DOI: 10.1016/j.bone.2017.05.006] [Citation(s) in RCA: 11] [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: 02/07/2017] [Revised: 04/05/2017] [Accepted: 05/03/2017] [Indexed: 12/21/2022]
Abstract
Small vertebral size is an independent risk factor for osteoporotic vertebral fractures. Physical growth in early life is related to bone health in later life, but the relationship of early growth versus vertebral size has been inconclusively studied. Utilizing the Northern Finland Birth Cohort 1966 with a 47-year follow-up, we investigated how physical growth in early life is associated with midlife vertebral dimensions. We obtained several physical growth parameters of 1) birth (gestational age, length, weight, BMI), 2) infancy and childhood (peak height velocity (PHV), peak weight velocity (PWV), adiposity peak (AP), adiposity rebound (AR)), and 3) puberty (BMI at growth spurt take-off (TO), PHV, height change). We also studied 4) the ages at which AP, AR, pubertal TO and pubertal PHV occurred. The outcome variable, vertebral cross-sectional area (CSA), was obtained from magnetic resonance imaging scans at the mean age of 46.7years (n=517). Sex-stratified linear regression analyses were used with adjustments for gestational age, smoking, and education. Birth length/weight/BMI, and adult height/weight/BMI were also used as covariates, depending on the model. According to our results, birth weight (p≤0.006) and infant PWV (p≤0.001) were positively associated with midlife vertebral CSA among both sexes. Length/height variables were associated with vertebral size only before including adult height in the models, and became non-significant thereafter. Among women, BMIs at birth, AP, AR, and pubertal TO were positively associated with midlife vertebral CSA (p<0.05), whereas among men, only high BMI at AR was associated with large vertebral size (p=0.028). Gestational age and timing of growth were not associated with future vertebral CSA. We conclude that early life weight gain is positively associated with midlife vertebral CSA, and suggest that adult height may mediate the effect of height gain on vertebral size.
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Affiliation(s)
- Petteri Oura
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland.
| | - Markus Paananen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - Marja Ojaniemi
- PEDEGO Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Department of Children and Adolescents, Oulu University Hospital, P.O. Box 23, FI-90029 Oulu, Finland
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - Juho-Antti Junno
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Cancer and Translational Medicine Research Unit, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Department of Archaeology, Faculty of Humanities, University of Oulu, P.O. Box 8000, FI-90014 Oulu, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Center for Life Course Health Research, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Finnish Institute of Occupational Health, Kastelli Research Center, Aapistie 1, FI-90220 Oulu, Finland
| | - Jaakko Niinimäki
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
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20
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Effects of Leisure-Time Physical Activity on Vertebral Dimensions in the Northern Finland Birth Cohort 1966. Sci Rep 2016; 6:27844. [PMID: 27282350 PMCID: PMC4901287 DOI: 10.1038/srep27844] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/18/2016] [Indexed: 11/09/2022] Open
Abstract
Vertebral fractures are a common burden amongst elderly and late middle aged people. Vertebral cross-sectional area (CSA) is a major determinant of vertebral strength and thus associated with vertebral fracture risk. Previous studies suggest that physical activity affects vertebral CSA. We aimed to investigate the relationship between leisure-time physical activity (LTPA) from adolescence to middle age and vertebral dimensions in adulthood. We utilized the Northern Finland Birth Cohort 1966, of which 1188 subjects had records of LTPA at 14, 31 and 46 years, and had undergone lumbar magnetic resonance imaging (MRI) at the mean age of 47 years. Using MRI data, we measured eight dimensions of the L4 vertebra. Socioeconomic status, smoking habits, height and weight were also recorded at 14, 31 and 46 years. We obtained lifetime LTPA (14-46 years of age) trajectories using latent class analysis, which resulted in three categories (active, moderately active, inactive) in both genders. Linear regression analysis was used to analyze the association between LTPA and vertebral CSA with adjustments for vertebral height, BMI, socioeconomic status and smoking. High lifetime LTPA was associated with larger vertebral CSA in women but not men. Further research is needed to investigate the factors behind the observed gender-related differences.
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Junno JA, Paananen M, Karppinen J, Niinimäki J, Niskanen M, Maijanen H, Väre T, Järvelin MR, Nieminen MT, Tuukkanen J, Ruff C. Age-related trends in vertebral dimensions. J Anat 2015; 226:434-9. [PMID: 25913516 DOI: 10.1111/joa.12295] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2015] [Indexed: 11/29/2022] Open
Abstract
Several studies have demonstrated age-related changes in vertebral dimensions. Vertebral size has been reported to increase among elderly adults, with periosteal apposition resulting in increased cross-sectional area (CSA) of the vertebral corpus combined with reduction in bone mineral density. These changes in CSA are observed to be sex-specific, as the pronounced increase of vertebral CSA is found only in elderly males. However, the reduction in bone mineral density in old age is apparent within both sexes. It is thus hypothesized that higher fracture risk in elderly women is a result of their incapacity to increase vertebral size and thus adapt to bone mineral reduction. In this study, our aim was to explore whether the onset of these changes could be ascribed to specific age intervals and whether the proposed differences between the sexes are as great as previously suggested. To conduct this study we utilized two large early 20th century skeletal collections known as Terry and Bass (n = 181). We also utilized data from two lumbar spine magnetic resonance imaging samples as a modern-day reference (n = 497). Age, sex and ethnicity of all individuals were known. Vertebral CSA was determined by measuring three width and length dimensions from the corpus of the fourth lumbar vertebra (L4). Our results indicate only a moderate association between age and vertebral CSA. This association was observed to be relatively similar in both sexes, and we thus conclude that there is no clear sex-specific compensatory mechanism for age-related bone loss in vertebral size.
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Affiliation(s)
- Juho-Antti Junno
- Department of Anatomy and Cell Biology, Medical Research Center Oulu, University of Oulu, Oulu, Finland.,Department of Archaeology, University of Oulu, Oulu, Finland.,Center for Functional Anatomy and Evolution, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Markus Paananen
- Centre for Life Course Epidemiology and Systems Medicine, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Jaro Karppinen
- Centre for Life Course Epidemiology and Systems Medicine, Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.,Finnish Institute of Occupational Health, Work and Health Ability and Disability Prevention Centre, Oulu, Finland
| | - Jaakko Niinimäki
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Center for Medical Imaging, Physics and Technology Research, University of Oulu, Oulu, Finland
| | - Markku Niskanen
- Department of Archaeology, University of Oulu, Oulu, Finland
| | - Heli Maijanen
- Department of Archaeology, University of Oulu, Oulu, Finland
| | - Tiina Väre
- Department of Archaeology, University of Oulu, Oulu, Finland
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences, Public Health and General Practice, University of Oulu, Oulu, Finland.,Biocenter Oulu, University of Oulu, Oulu, Finland.,National Institute of Health and Welfare, Oulu, Finland.,Department of Biostatistics and Epidemiology, Faculty of Medicine, School of Public Health, Imperial College, London, UK
| | - Miika T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Center for Medical Imaging, Physics and Technology Research, University of Oulu, Oulu, Finland
| | - Juha Tuukkanen
- Department of Anatomy and Cell Biology, Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Christopher Ruff
- Center for Functional Anatomy and Evolution, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Influence of physical activity on vertebral strength during late adolescence. Spine J 2013; 13:184-9. [PMID: 23332389 DOI: 10.1016/j.spinee.2012.11.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 03/13/2012] [Accepted: 11/27/2012] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Reduced vertebral strength is a clear risk factor for vertebral fractures. Men and women with vertebral fractures often have reduced vertebral size and bone mineral density (BMD). Vertebral strength is controlled by both genetic and developmental factors. Malnutrition and low levels of physical activity are commonly considered to result in reduced bone size during growth. Several studies have also demonstrated the general relationship between BMD and physical activity in the appendicular skeleton. PURPOSE In this study, we wanted to clarify the role of physical activity on vertebral bodies. Vertebral dimensions appear to generally be less pliant than long bones when lifetime changes occur. We wanted to explore the association between physical activity during late adolescence and vertebral strength parameters such as cross-sectional size and BMD. STUDY DESIGN The association between physical activity and vertebral strength was explored by measuring vertebral strength parameters and defining the level of physical activity during adolescence. PATIENT SAMPLE The study population consisted of 6,928 males and females who, at 15 to 16 and 19 years of age, responded to a mailed questionnaire inquiring about their physical activity. A total of 558 individuals at the mean age of 21 years underwent magnetic resonance imaging (MRI) scans. METHODS We measured the dimensions of the fourth lumbar vertebra from the MRI scans of the Northern Finland Birth Cohort 1986 and performed T2* relaxation time mapping, reflective of BMD. Vertebral strength was based on these two parameters. We analyzed the association of physical activity on vertebral strength using the analysis of variance. RESULTS AND CONCLUSIONS We observed no association between the level of physical activity during late adolescence and vertebral strength at 21 years.
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