Longitudinal changes in calcaneal quantitative ultrasound measures during childhood

Associations of Sex Steroids With Changes in Calcaneal Quantitative Ultrasound Measurements: A Longitudinal Study in Chinese Male Adolescents

This 2-year longitudinal study aimed to detect the associations of sex steroids, sex hormone-binding globulin with bone parameters and the changes thereof in Chinese male adolescents. A total of 642 male students aged 12-16 years from a secondary school in Jiangmen, China, were included. Total testosterone (T), total oestradiol (E2), and sex hormone-binding globulin were measured by chemiluminescence immunoassay. The bioavailable T (BioT) and E2 (BioE2) were calculated. The speed of sound, broadband ultrasound attenuation, and stiffness index of the right heel were measured by Sahara Clinical Bone Sonometer at both baseline and 2-year follow-up. The confounding effects of age, height, weight, pubertal stage, physical activity, energy-adjusted dietary calcium intake, and dietary vitamin D intake were adjusted. The baseline value of each bone parameter was also adjusted in the longitudinal analysis. Results showed that total T and BioT were positively associated with bone parameters and changes in them (β = 0.076-0.115, p < 0.05). A threshold effect of BioT on broadband ultrasound attenuation, stiffness index and their changes were also observed. Positive associations between BioT and bone mass gain were observed only in individuals with BioT levels <240.0 ng/dl (β = 0.088-0.131, p < 0.05). Moreover, total E2 or BioE2 were found to be inversely associated with speed of sound and its change (β = -0.109 to -0.077, p < 0.05). This study supported that in Chinese male adolescents, serum T was a positive predictor for bone formation with a threshold effect, and E2 could have influence on the changes in bone architecture during puberty. These findings may improve the understanding of the effects of sex steroids on the acceleration of bone formation in male adolescents and provide useful information for the prediction model establishment of peak bone mass.

Adiposity is not beneficial to bone mineral density in 0-5 year old Chinese children: The Jiangsu bone health study

OBJECTIVE

Data on obesity in relation to bone mineral density(BMD) in infants and preschool children were sparse in China. The objective of this study was to examine the associations between body mass index (BMI) and BMD.

SUBJECTS AND METHODS

This was a large population-based multicenter study in which the representative children aged 0-5 years were recruited from 13 Children's Health Care Centers by a stratified cluster random-sampling method in Jiangsu Province, China. BMD was measured by using quantitative ultrasound. The association of BMD with BMI and obesity were evaluated using multiple linear regression and logistic regression analysis taking into account the effects of confounders. The relations between age, weight, height, BMI and BMD were analyzed by using Pearson's correlation and further tested using partial correlation in the additive model.

RESULTS

A total of 5,289 children (2786 boys and 2503 girls) were recruited. The BMD was positively linear relation with age, length/height, and was inversely linear relation with BMI (r=0.711, P<0.001; r=0.727, P<0.001; r=-0.318, P<0.001, respectively). The BMD gradually increased when the weight was in the range within 21.2kg, but started to gain slowlyand even decreased when the weight was over 21.2kg. After adjusting for confounders, compared with control group, children with obesityhad higher odds of low BMD (OR 95%CI: 2.73 (1.57, 4.76), P<0.001), the speed of sound (SOS)value in children with obesity was lower 47.45 (β=-47.45, 95%CI=-85.07, -9.83, P=0.013).

CONCLUSIONS

Adiposity was not advantageous for bone mineral density in 0-5-year-old Chinese children.

Relationship between physical activity, dietary intake and bone parameters in 10-12 years old Hungarian boys and girls

OBJECTIVES

Physical activity (PA) and adequate macro- and micronutrient intake have favourable influence on the bone status. The aim of this study was to analyse the relationships among PA, anthropometric data, dietary intake and ultrasound bone characteristics in children.

METHODS

10-12 years old Hungarian children (N = 123, 59 girls, 64 boys) provided physical activity, diet, anthropometric and bone data. PA was measured with accelerometer (Actigraph GT3X+). Diet was evaluated with three-day, 24-hour food recall. Calcaneal quantitative ultrasound (QUS) bone parameters were registered with Sonost3000 bone densitometer.

RESULTS

Nutrition and anthropometry did not differ by gender. The values of broadband ultrasound attenuation (BUA) were significantly higher in boys. Girls spent significantly more time being sedentary, boys had greater light, moderate, vigorous, and moderate to vigorous physical activity (MVPA) levels. The children accumulated more than twice the suggested amount of public health guidelines for MVPA. QUS parameters correlated significantly with vigorous physical activity in boys, and with age, height, weight, fat percentage, and body mass index (BMI) for both genders. There was no significant relationship between nutrition and QUS; however, inadequate vitamin K intake correlated with less favourable bone parameters. Multiple linear regression analysis confirmed the importance of vigorous PA - speed of sound (SOS): β = 0.358, p = 0.006; BUA: β = 0.340, p = 0.007; bone quality index (BQI): β = 0.377, p = 0.002; vitamin K intake - SOS: β = 0.256, p = 0.025; BUA: β = 0.235, p = 0.033; BQI: β = 0.295, p = 0.007; BMI - SOS: β = 0.207, p = 0.064; BUA: β = 0.455, p < 0.001; BQI: β = 0.284, p = 0.008; and age - SOS: β = 0.450, p < 0.001; BUA: β = 0.318, p = 0.004; BQI: β = 0.444, p < 0.001).

CONCLUSIONS

Changes in the characteristics of ultrasound bone parameters among 10-12 years old children mainly depended on the amount of intense PA, adequate vitamin K intake and anthropometric variables related to age.

Reference data for ultrasound bone characteristics in Hungarian children aged 7-19 years

Backround: Osteoporosis is a common disease and physical activity (PA) has a favourable influence on bone status.

AIM

To establish normative data for calcaneal quantitative ultrasound (QUS) bone characteristics in children and to analyse the relationships between PA, anthropometric and bone parameters.

SUBJECTS AND METHODS

Hungarian children aged 7-19 (n = 2674; 1325 girls, 1349 boys) provided PA, anthropometric and bone data. QUS parameters were registered with Sonost3000 densitometer (speed of sound: SOS, m/s; broadband ultrasound attenuation: BUA, dB/MHz; bone quantity index (BQI = αSOS + βBUA). Reference centiles of QUS parameters were constructed by LMS method. Multivariate linear regression models were used to analyse the relationships.

RESULTS

QUS bone parameters increased with age. There were no gender differences, except in 11- and 19-year-old children, where boys showed higher values. SOS (1497.15 ± 15.72 vs 1494.05 ± 14.81 m/s) and BQI (65.31 ± 16.71 vs 62.26 ± 15.78) were higher in athletic children. The regression model revealed significant relations between SOS and age, relative muscle mass and PA; BUA correlated with gender, morphological age, BMI, relative muscle mass and PA.

CONCLUSIONS

Changes in the bone parameters among 7-19-year-old Hungarian children depended on age, anthropometric dimensions and the level of PA. The normative data could be used for monitoring QUS bone parameters in children, leading to more effective interventions for healthy bones.

Body composition and bone mineral status in patients with Turner syndrome

Turner syndrome (TS) is associated with decreased bone mineral density and increased fracture rate. However, the developmental trajectory of bone density or body composition in patients with TS is still unclear. The present study tested the hypothesis that different karyotypes and/or age contributes to abnormal body composition and decreased bone mineral status parameters in patients with TS. This study included 24 girls with TS, in which 13 girls exhibited X0 karyotype and 11 had mosaicism. Quantitative ultrasound (QUS) assessed the bone mineral status of the calcaneus, including bone mineral density (BMD), amplitude-dependent speed of sound (AD-SOS), broadband ultrasound attenuation (BUA) and InBody 770 assessed body composition. Pearson's test was performed to correlate measured parameters with patient age. The body composition and bone mineral status parameters were not significantly influenced by patient karyotype. There was a correlation between patient age and AD-SOS (r = -0.61, P = 0.002) and BUA (r = 0.50, P = 0.013) but not BMD (r = -0.19, P = 0.379). In conclusion, there was no effect of karyotype on body composition or body mineral status. Bone mineral status, as evidenced by changes in AD-SOS and BUA, alters with age regardless of karyotype. The developmental trajectory demonstrated in the current study warrants further validation in a longitudinal study.

Growth in bone and body size among Asian and white girls in the Female Adolescent Maturation (FAM) study

RATIONALE

This study intends to identify differences in growth of Asian and White girls.

MAIN RESULT

Asian girls gained bone at similar rates to White girls. Physical activity was important to bone growth. Ethnic differences remained after adjusting for physical activity, demographics, and diet.

SIGNIFICANCE

Physical activity can improve bone gain.

PURPOSE

The purpose of this study is to examine differences in body size and bone growth of Asian, White, and Asian-White Mixed girls.

METHODS

Three prospective examinations of 99 Asian, 73 White, and 63 Mixed Asian and White girls, with a mean age of 11.0 years at enrollment were performed. Calcaneal bone mass, skeletal breadths, and body fat were measured. Physical activity, diet, and birth size were reported. The analyses examined the extent that body dimensions and bone size changed over time by demographic, diet, physical activity, body, and bone size parameters.

RESULTS

White children were the most physically active yet had lower calcaneal ultrasound values for speed of sound (SOS). Based on regression models, bone mass, and subscapular skinfold thickness were greater in Asian girls compared to White and Asian-White Mixed girls at age 10 years. Asian-White Mixed girls had greater BMI compared to Asian or White girls. Asian girls gained body size more slowly than White girls, but changes in bone parameters did not differ significantly; Asian-White Mixed girls gained abdomen, hip, and weight more slowly than White girls. Among all girls, SOS and broadband ultrasound attenuation (BUA) increased significantly by level of physical activity before 12 years, but not after.

CONCLUSIONS

Asian girls had more upper body (subscapular) fat at age 10 years and gained height and hip and abdomen circumferences more slowly than Asian-White and White girls. Asian girls had greater bone SOS and BUA at age 10 years but gained bone at similar rates to White girls. Physical activity was especially important to bone growth before age 12 years. However, ethnic differences remained after adjusting for physical activity, demographic, and dietary factors.

Influence of birth weight on calcaneal bone stiffness in Belgian preadolescent children

The aim of this study was to investigate the relation between birth weight and calcaneal bone stiffness in a large sample of Belgian, healthy, preadolescent children. Participants were 827 children (3.6-11.2 years, 51.6 % boys) from the Belgian cohort of the IDEFICS study. Birth weight was obtained using a parental questionnaire, and quantitative ultrasound (QUS) measurements were performed to determine calcaneal broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) using the Lunar Achilles device. Average birth weights were 3435.7 ± 512.0 g for boys and 3256.9 ± 471.1 g for girls. Average calcaneal QUS measurements were 89.6 ± 24.0 (23.3-153.9) dB/MHz for BUA, 1621.4 ± 49.6 (1516.3-1776.5) m/s for SOS, and 92.8 ± 15.6 (49.0-163.0) for SI. Birth weight was positively associated with BUA (r = 0.13, p = 0.002) and SOS (r = -0.16, p < 0.001). The associations remained after correcting for age and sex in multiple regression analyses but disappeared after correcting for anthropometric covariates. Our findings suggest that birth weight, as a rough proxy indicator for genetic and environmental influences during intrauterine life, is associated with BUA and SOS in preadolescent children and may therefore influence the risk of osteoporosis later in life. Further studies using QUS are needed to investigate the consistency of the results of this study.

Relationship between markers of body fat and calcaneal bone stiffness differs between preschool and primary school children: results from the IDEFICS baseline survey

The aim of this study was to investigate the relationship between markers of body fat and bone status assessed as calcaneal bone stiffness in a large sample of European healthy pre- and primary school children. Participants were 7,447 children from the IDEFICS study (spread over eight different European countries), age 6.1 ± 1.8 years (range 2.1-9.9), 50.5 % boys. Anthropometric measurements (weight, height, bioelectrical impedance, waist and hip circumference, and tricipital and subscapular skinfold thickness) as well as quantitative ultrasonographic measurements to determine calcaneal stiffness index (SI) were performed. Partial correlation analysis, linear regression analysis, and ANCOVA were stratified by sex and age group: preschool boys (n = 1,699) and girls (n = 1,599) and primary school boys (n = 2,062) and girls (n = 2,087). In the overall study population, the average calcaneal SI was equal to 80.2 ± 14.0, ranging 42.4-153. The results showed that preschool children with higher body fat had lower calcaneal SI (significant correlation coefficients between -0.05 and -0.20), while primary school children with higher body fat had higher calcaneal SI (significant correlation coefficients between 0.05 and 0.13). After adjusting for fat-free mass, both preschool and primary school children showed an inverse relationship between body fat and calcaneal stiffness. To conclude, body fat is negatively associated with calcaneal bone stiffness in children after adjustment for fat-free mass. Fat-free mass may confound the association in primary school children but not in preschool children. Muscle mass may therefore be an important determinant of bone stiffness.