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Ghanbari F, Otomo N, Gamache I, Iwami T, Koike Y, Khanshour AM, Ikegawa S, Wise CA, Terao C, Manousaki D. Interrogating Causal Effects of Body Composition and Puberty-Related Risk Factors on Adolescent Idiopathic Scoliosis: A Two-Sample Mendelian Randomization Study. JBMR Plus 2023; 7:e10830. [PMID: 38130750 PMCID: PMC10731118 DOI: 10.1002/jbm4.10830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 12/23/2023] Open
Abstract
Adolescent idiopathic scoliosis (AIS) is the most common form of pediatric musculoskeletal disorder. Observational studies have pointed to several risk factors for AIS, but almost no evidence exists to support their causal association with AIS. Here, we applied Mendelian randomization (MR), known to limit bias from confounding and reverse causation, to investigate causal associations between body composition and puberty-related exposures and AIS risk in Europeans and Asians. For our two-sample MR studies, we used single nucleotide polymorphisms (SNPs) associated with body mass index (BMI), waist-hip ratio, lean mass, childhood obesity, bone mineral density (BMD), 25-hydroxyvitamin D (25OHD), age at menarche, and pubertal growth in large European genome-wide association studies (GWAS), and with adult osteoporosis risk and age of menarche in Biobank Japan. We extracted estimates of the aforementioned SNPs on AIS risk from the European or Asian subsets of the largest multiancestry AIS GWAS (N = 7956 cases/88,459 controls). The results of our inverse variance-weighted (IVW) MR estimates suggest no causal association between the aforementioned risk factors and risk of AIS. Pleiotropy-sensitive MR methods yielded similar results. However, restricting our analysis to European females with AIS, we observed a causal association between estimated BMD and the risk of AIS (IVW odds ratio for AIS = 0.1, 95% confidence interval 0.01 to 0.7, p = 0.02 per SD increase in estimated BMD), but this association was no longer significant after adjusting for BMI, body fat mass, and 25OHD and remained significant after adjusting for age at menarche in multivariable MR. In conclusion, we demonstrated a protective causal effect of BMD on AIS risk in females of European ancestry, but this effect was modified by BMI, body fat mass, and 25OHD levels. Future MR studies using larger AIS GWAS are needed to investigate small effects of the aforementioned exposures on AIS. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Faegheh Ghanbari
- Research Center of the Sainte‐Justine University HospitalUniversity of MontrealMontrealQuebecCanada
| | - Nao Otomo
- Laboratory for Statistical and Translational GeneticsRIKEN Center for Integrative Medical Sciences, RIKENYokohamaJapan
- Department of Orthopedic SurgeryKeio University School of MedicineTokyoJapan
| | - Isabel Gamache
- Research Center of the Sainte‐Justine University HospitalUniversity of MontrealMontrealQuebecCanada
| | - Takuro Iwami
- Laboratory for Statistical and Translational GeneticsRIKEN Center for Integrative Medical Sciences, RIKENYokohamaJapan
- Department of Orthopedic SurgeryKeio University School of MedicineTokyoJapan
| | - Yoshinao Koike
- Laboratory for Statistical and Translational GeneticsRIKEN Center for Integrative Medical Sciences, RIKENYokohamaJapan
- Department of Orthopedic SurgeryHokkaido University Graduate School of MedicineSapporoJapan
| | - Anas M. Khanshour
- Scottish Rite for Children Center for Pediatric Bone Biology and Translational ResearchDallasTexasUSA
| | - Shiro Ikegawa
- Laboratory for Statistical and Translational GeneticsRIKEN Center for Integrative Medical Sciences, RIKENYokohamaJapan
| | - Carol A. Wise
- Scottish Rite for Children Center for Pediatric Bone Biology and Translational ResearchDallasTexasUSA
- McDermott Center for Human Growth & DevelopmentUniversity of Texas Southwestern Medical CenterDallasTexasUSA
| | - Chikashi Terao
- Laboratory for Statistical and Translational GeneticsRIKEN Center for Integrative Medical Sciences, RIKENYokohamaJapan
| | - Despoina Manousaki
- Research Center of the Sainte‐Justine University HospitalUniversity of MontrealMontrealQuebecCanada
- Department of PediatricsUniversity of MontrealMontrealCanada
- Department of Biochemistry and Molecular MedicineUniversity of MontrealMontrealQuebecCanada
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Abstract
BACKGROUND Age at menarche (AAM) directly affects female estrogen levels, which play a vital role in bone metabolism. The exact relationship between bone mineral density (BMD) and AAM remains controversial. Thus, this study aimed to determine the association between AAM and lumbar spine (LS) BMD in postmenopausal women. METHODS Our data were based on the National Health and Nutrition Examination Survey (NHANES) 2011-2018. AAM was divided into three categories including ≤ 12, 13-15, and ≥ 16 years, and the ≤ 12 years old category was used as the reference group. To examine the association between AAM and LS BMD, we used three weighted linear regression models, Model 1 (without adjustment), Model 2 (with adjustment for age, race, and body mass index [BMI]), and Model 3 (with adjustment for all covariates). RESULTS This study included 1195 postmenopausal women aged 40-59 years. In the unadjusted model, a menarche age of ≥ 16 years compared with a menarche age of ≤ 12 years was associated with lower LS BMD (β = - 0.083, 95% CI - 0.117, - 0.048, P < 0.001). After adjusting for potential confounding factors, there was still a negative correlation in model 2 (β = - 0.078, 95% CI - 0.113, - 0.042, P < 0.001) and model 3 (β = - 0.065, 95% CI - 0.096, - 0.033, P < 0.001). Moreover, this significant relationship persisted after excluding participants who used female hormones (β = - 0.053, 95% CI - 0.089, - 0.016, P = 0.006). CONCLUSION Our study found that postmenopausal women with a menarche age of ≥ 16 years had significantly lower LS BMD than that had by those with a menarche age of ≤ 12 years. As a result of this study, postmenopausal women with a late menarche age may have a higher risk of lumbar osteoporotic fractures and need better bone health care.
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Affiliation(s)
- Yimei Yang
- grid.440642.00000 0004 0644 5481Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong, 226001 China
| | - Shanshan Wang
- grid.440642.00000 0004 0644 5481Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong, 226001 China
| | - Hui Cong
- grid.440642.00000 0004 0644 5481Department of Blood Transfusion, Affiliated Hospital of Nantong University, #20 Xisi Road, Nantong, 226001 China ,grid.440642.00000 0004 0644 5481Department of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong, 226001 China
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He Y, Huang J, Jiang G, Wang H, Zhao J, Chen Z, Zhang C, Chen S, Li W, Li D, Xie X. Menarche age exceed 17 years and menopausal age smaller than 48 years may affect prevalence of osteoporosis for Chinese women. Arch Osteoporos 2021; 16:123. [PMID: 34427772 DOI: 10.1007/s11657-021-00959-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/20/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED In this work, we used a cross-sectional study to evaluate influence of menarche age, menstrual cycle, menstrual period, menopausal age, and menopause years for osteoporosis in women from China. We found that different menarche age, menstrual cycle, menopausal years, and menopausal age are related with the prevalence of osteoporosis. However, menarche age exceeds 17 years and menopausal age smaller than 48 years are risk factors for osteoporosis in women. STUDY DESIGN A cross-sectional, population-based study. PURPOSE The purpose of this study was to explore relationship between prevalence of osteoporosis and menarche age, menstrual cycle, menstrual period, menopausal age, and menopause years for women. METHODS From March to October 2016, the cluster sampling method was used to conduct an osteoporosis-related questionnaire survey on women aged 40-80 in two communities in Lanzhou City, Gansu, China, and bone mineral density(BMD)was carried out using the DTX-200 dual-energy X-ray absorptiometer produced by the US OSTEOMETER company. The relationship between prevalence of osteoporosis and menarche age, menstrual cycle, menstrual period, menopausal age, and menopause years were analyzed using logistic regression analysis. RESULTS There were 2224 female participates enrolled in this study and average age was 61.60 ± 8.05 years and total rate of prevalence was 32.73%; among them, different menarche age, menstrual cycle, menopausal years, and menopausal age have statistical differences with the prevalence of osteoporosis, but there is no statistical difference between different menstruation and the prevalence of osteoporosis. Single logistic regression analysis found that older menarche age, earlier menopausal age, and longer menopausal years were related factors for the prevalence of osteoporosis, while menarche age exceed 17 years and menopausal age smaller than 48 years are risk factors for osteoporosis for women in multivariate regression analysis. CONCLUSIONS In China, ages at menarche and menopause are associated with prevalence of osteoporosis. Later, menarche and earlier menopause are associated with higher osteoporosis risk. Menarche and menopause history may help identify women with increased risk of developing osteoporosis.
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Affiliation(s)
- Yong He
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China.
| | - Jin Huang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Guopeng Jiang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Huaming Wang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Jun Zhao
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Zhilong Chen
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Chen Zhang
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Shihai Chen
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Weiping Li
- Department of Orthopedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou, Gansu, China
| | - Dingpeng Li
- Second Provincial People's Hospital of Gan Su, Lanzhou, Gansu, China
| | - Xingwen Xie
- Second Provincial People's Hospital of Gan Su, Lanzhou, Gansu, China
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Ning H, Du Y, Zhao LJ, Tian Q, Feng H, Deng HW. The mediating effect of skeletal muscle index on the relationship between menarcheal age and bone mineral density in premenopausal women by race/ethnicity. Menopause 2021; 28:1143-1149. [PMID: 34313616 PMCID: PMC8514157 DOI: 10.1097/gme.0000000000001814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the contribution of skeletal mass index (SMI) as a mediator in the relationship between menarcheal age and hip/spine bone mineral density (BMD) in premenopausal women by race/ethnicity. METHODS The data of 4,329 participants (age ≥ 18; mean age=35.7 ± 9.5) of Whites (n = 2,543), African Americans (n = 1,236), and Asians (n = 550) enrolled from October 2011 to January 2019 from the Louisiana Osteoporosis Study were analyzed. After adjustment for physiological and behavioral factors, multivariable linear regression analyses were conducted to evaluate each component of the proposed mediation models, and mediation was verified by the bootstrapping resampling approach. RESULTS Premenopausal women with early menarcheal age tended to have higher SMI and BMD than women with normal menarcheal age among all races/ethnicities included. Women with late menarcheal age were, however, more likely to have a lower SMI than their counterparts with normal menarcheal age (r = -0.212, 95% CI = [-0.321 to -0.103] for White women; r = -0.181, 95% CI = [-0.410 to -0.008] for African-American women; r = -0.174, 95% CI = [-0.343 to -0.006] for Asian women). Similar results were found for both spine and hip BMD. SMI fully mediated the difference in BMD due to different menarcheal ages among Whites, African Americans, and Asian women with early menarcheal age; however, no mediating effects were observed for Asian women with late menarcheal age. CONCLUSIONS SMI, as a full mediator, affected the relationship between menarcheal age and BMD among premenopausal women, and the mediating effects varied by race/ethnicity. To prevent or slow down the loss of hip/spine BMD and the development of osteoporosis, measures aiming at minimizing the risk for muscle mass loss should be recommended, especially for White and African-American women with late menarcheal age.
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Affiliation(s)
- Hongting Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yan Du
- School of Nursing, University of Texas Health Science Center at San Antonio, San Antonio, TX
| | - Lan-Juan Zhao
- Center for Bioinformatics and Genomics, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Qing Tian
- Center for Bioinformatics and Genomics, Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Hui Feng
- Xiangya School of Nursing, Xiangya-Oceanwide Health Management Research Institute, Central South University, Changsha, Hunan, China
| | - Hong-Wen Deng
- School of Medicine, Tulane University, New Orleans, LA
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Tsukahara Y, Namba A, Kamada H, Torii S, Tabata S, Yamasawa F, Sato K. Factors that affect menarche in Japanese national-level track-and-field athletes. Am J Hum Biol 2021; 34:e23622. [PMID: 34048626 DOI: 10.1002/ajhb.23622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 05/08/2021] [Accepted: 05/18/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The minimum body mass index (BMI) required to menarche and the relationship between the training onset age of sports and menarche is not fully understood. The aim of this study is to elucidate the minimum BMI required to attain menarche in female adolescent athletes competing at a national level, and to determine how the occurrence of menarche is associated with training onset age in track-and-field athletes. METHODS Overall, 134 sprinters and 44 long-distance (LD) runners of ninth-grade females at a national level were enrolled and an anonymous questionnaire was administered. RESULTS As BMI increased, the proportion of athletes who had attained menarche increased. The BMI cutoff values for menarche were 17.3 and 17.1 kg/m2 for sprinters and LD runners, respectively. Menarche had not occurred in almost 50% of the LD runners who began training at elementary school, and among LD runners, those who began training at elementary school had 18.4 higher odds of not attaining menarche until the age of 15 years as opposed to those who started training after elementary school. CONCLUSIONS The BMI cutoff values could be an indicator for menarche in sprinters and LD runners. For LD runners, starting to compete at elementary school could be a risk factor for delayed menarche.
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Affiliation(s)
- Yuka Tsukahara
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan.,Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan.,Waseda Institute for Sport Sciences, Waseda University, Saitama, Japan
| | - Akira Namba
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan.,Department of Clinical Genomics, Saitama Medical University, Saitama, Japan
| | - Hiroshi Kamada
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan.,Department of Orthopaedic Surgery, University of Tsukuba, Ibaraki, Japan
| | - Suguru Torii
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan.,Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Shogo Tabata
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan
| | - Fumihiro Yamasawa
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan
| | - Kazuki Sato
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
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Li F, Du Y. Bone mineral density of proximal femur in adult Chinese females. J Orthop 2020; 22:53-58. [PMID: 32280169 PMCID: PMC7138931 DOI: 10.1016/j.jor.2020.03.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/25/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study was designed to establish bone mineral density (BMD) reference data of proximal femur, research the effect of age, height and weight on BMD of proximal femur, and estimate the prevalence of osteoporosis in a Chinese female population. In addition we compared the results with Lebanese and USA white women reference data. METHODS Our study was conducted at one center, including 1578 Chinese women, aged 20-79years. We measured the BMD for proximal femur using dual-energy X-ray absorptiometry, and then established a reference database of proximal femur and set up regression equations of age, height and weight for BMD at proximal femur to research the effects of age, height and weight on BMD. After that, we calculated the standardized BMD and compared them with Lebanese and USA white women reference data. RESULTS The peak BMD occurred in the age range 30-39 years for femoral neck and Ward's triangle, and 40-49 years for trochanter in Chinese women, which were later than in Lebanese and USA white women. The BMD of proximal femur in Chinese women were lower than Lebanese and USA white women in most age ranges. Weight profoundly influenced BMD in all age groups, and age and height mainly effected BMD in older age groups. The standardized prevalence of osteoporosis among Chinese women of 50-79 years old was 9.6% in femoral neck, which was higher than Lebanese but lower than USA white women. CONCLUSION The BMD database of proximal femur in Chinese women we established is normative and different from Lebanese and USA white women reference data, which provides more reliable information on the prevalence of osteoporosis in China.
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Affiliation(s)
| | - Yibin Du
- Department of Orthopaedics, Third Affliated Hospital, Anhui Medical University, Hefei, Anhui, 230022, PR China
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Lee I, Kim J, Kang H. Cardiorespiratory Fitness is Inversely Associated with Risk of Low Bone Mineral Density in Older Korean Men. Int J Environ Res Public Health 2020; 17:ijerph17217907. [PMID: 33126597 PMCID: PMC7663600 DOI: 10.3390/ijerph17217907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/15/2020] [Accepted: 10/26/2020] [Indexed: 12/11/2022]
Abstract
Little is known regarding the association between physical fitness and bone health in older Korean men. This study investigated the relationship between estimated cardiorespiratory fitness (eCRF) and bone mineral density (BMD). This cross-sectional study included 2715 Korean men aged 50 years and older selected from those who participated in the 2008–2011 Korea National Health and Nutritional Examination and Survey. eCRF was obtained using a sex-specific algorithm developed on the basis of age, body mass index, resting heart rate, and physical activity and classified into low, middle, and high categories. Femoral neck BMD was assessed by dual X-ray absorptiometry. Odds ratios (OR) and 95% confidence intervals (CI) for osteopenia, osteoporosis, and low BMD were calculated for eCRF categories in models fully adjusted for age, waist circumference, education, income, smoking, heavy alcohol intake, serum vitamin D, serum parathyroid hormone, and dietary intake of energy, protein, calcium, and vitamins A and C. Overall, eCRF levels were positively associated with BMD and negatively with prevalence of osteopenia, osteoporosis, and low BMD. Logistic regression showed inverse trends in the risks of osteopenia (high vs. low: OR = 0.692; 95% CI, 0.328–0.517; p = 0.049) and low BMD (high vs. low: OR = 0.669; 95% CI, 0.497–0.966; p = 0.029) by eCRF category in models fully adjusted for all the measured covariates. The current findings suggest that maintaining high eCRF via regular physical activity may contribute to attenuation of age-related loss of BMD and decreased risk for low BMD in older Korean men.
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Segheto KJ, Juvanhol LL, Carvalho CJD, Silva DCGD, Kakehasi AM, Longo GZ. Factors associated with bone mineral density in adults: a cross-sectional population-based study. Rev Esc Enferm USP 2020; 54:e03572. [PMID: 32813800 DOI: 10.1590/s1980-220x2018039903572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 08/22/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aimed to analyze the association between lumbar spine, femoral neck, total hip bone mineral density (biophysical bone health assessment parameter), and sociodemographic, anthropometric, behavioral, and health condition factors in Brazilian adults. METHOD This is a cross-sectional, population-based study performed with individuals of both genders, aged between 20 and 59 (n=701). The dependent variables were evaluated by Dual Energy X-ray Absorptiometry. The independent variables were evaluated through a questionnaire, anthropometric evaluation and blood collection. The association between bone mineral density and the independent variables was evaluated by linear regression analysis. All analyses were stratified by gender. RESULTS Men presented higher bone mineral density than women. Bone mineral density was inversely associated with age range and directly associated with nutritional status in both genders and in the three bone sites analyzed. In addition, 25 Hydroxyvitamin D deficient status among men and contraceptive use among women were associated with lower bone mineral density, and a significant association was only found with lumbar spine bone mineral density in women. CONCLUSION The factors associated with bone health among men were age, skin color, nutritional status, and vitamin D status. For women, the associated factors with bone health were age, skin color, nutritional status and contraceptive use.
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Vandenput L, Kindblom JM, Bygdell M, Nethander M, Ohlsson C. Pubertal timing and adult fracture risk in men: A population-based cohort study. PLoS Med 2019; 16:e1002986. [PMID: 31790400 DOI: 10.1371/journal.pmed.1002986] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 11/04/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Puberty is a critical period for bone mass accrual, and late puberty in boys is associated with reduced bone mass in adult men. The role of variations in pubertal timing within the normal range for adult fracture risk in men is, however, unknown. We, therefore, assessed the association between age at peak height velocity (PHV), an objective measure of pubertal timing, and fracture risk in adult men. METHODS AND FINDINGS In the BMI Epidemiology Study Gothenburg, 31,971 Swedish men born between January 1, 1945, and December 31, 1961, with detailed growth data (height and weight) available from centrally archived school healthcare records and the conscription register were followed until December 31, 2016. Age at PHV was calculated according to a modified infancy-childhood-puberty model, and fracture information was retrieved from the Swedish National Patient Register. The mean ± SD age at PHV was 14.1 ± 1.1 years. In total, 5,872 men (18.4%) sustained at least 1 fracture after 20 years of age and 5,731 men (17.9%) sustained a non-vertebral fracture after 20 years of age during a mean ± SD follow-up of 37.3 ± 11.7 years. Cox proportional hazards models adjusted for birth year and country of origin revealed that age at PHV was associated with the risk of any fracture and non-vertebral fracture. Participants with age at PHV in the highest tertile (after 14.5 years of age) were at greater risk of any fracture (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08-1.22, P < 0.001) and non-vertebral fracture (HR 1.16, 95% CI 1.09-1.24, P < 0.001) compared with those with age at PHV in the lowest tertile (at 13.6 years of age or younger). Additional adjustments for birthweight, childhood BMI, adult educational level, and young adult height did not attenuate the associations between age at PHV and adult fracture risk. Limitations of this study include the inability to adjust for important risk factors for fracture, inadequate power to assess the relation between pubertal timing and specific fracture types, and the limited generalizability to other populations. CONCLUSIONS In this study, we observed that late pubertal timing was associated with increased adult fracture risk in men. These findings suggest that information on pubertal timing might aid in the identification of those men at greatest risk of fracture.
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Bethard JD, Berger JM, Maiers J, Ross AH. Bone Mineral Density Adult Age Estimation in Forensic Anthropology: A Test of the DXAGE Application. J Forensic Sci 2018; 64:1125-1128. [PMID: 30550631 DOI: 10.1111/1556-4029.13987] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 11/30/2022]
Abstract
Estimating age-at-death of individuals represented only by skeletonized human remains is a fundamental aspect of forensic anthropological casework. Recently, several researchers have proposed that bone mineral density (BMD) is a useful predictor of age-at-death in forensic contexts. Navega et al. (JFS 63(2):497-503) developed an online application called DXAGE for calculating age-at-death from BMD parameters. This study tests the utility of DXAGE by utilizing data from the National Health and Nutrition Examination Survey (NHANES). BMD data from a female subsample (n = 470) of the NHANES 2007-2008 dataset were analyzed, and the relationship between predicted age and real age was examined. Inaccuracy was 14.25 years, and bias was -7.20 years. Results show that there is a weak correlation between predicted and actual age (r = 0.47) using the DXAGE application. While BMD data are potentially useful for predicting age age-at-death, the DXAGE application should be used cautiously in forensic anthropological contexts.
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Affiliation(s)
- Jonathan D Bethard
- Department of Anthropology, University of South Florida, 4202 East Fowler Avenue, SOC107, Tampa, FL, 33620
| | - Jacqueline M Berger
- Department of Anthropology, University of South Florida, 4202 East Fowler Avenue, SOC107, Tampa, FL, 33620
| | - Justin Maiers
- Department of Anthropology, University of South Florida, 4202 East Fowler Avenue, SOC107, Tampa, FL, 33620
| | - Ann H Ross
- Department of Biological Sciences, North Carolina State University, 100 Eugene Brooks Avenue, Raleigh, NC, 27695
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Abstract
PURPOSE Traditional epidemiological studies suggest that there is an association between age at menarche (years) (AAM) and bone mineral density (BMD) at the sites of the femoral neck and lumbar spine (FNK and LS BMD), indicating a potentially important relationship between AAM and the development of osteoporosis (OP). However, these findings may be influenced by unmeasured confounding factors that can obscure the true relationship between the phenotypic traits. Therefore, we performed Mendelian randomization (MR) analyses to determine whether there is a causal relationship between AAM and BMD (FNK and LS BMD), where late AAM may increase the risk of developing OP. METHODS Adopting a two-sample MR approach we incorporated genome-wide association (GWAS) summary statistics from the Reproductive Genetics (ReproGen) Consortium (n = 182,416) (females only) and the GEnetic Factors for OSteoporosis (GEFOS) Consortium (n = 53,236) (both males and females). RESULTS Using this MR approach we discovered that each additional year in AAM is associated with a modest reduction in FNK BMD (β = -0.072 se = 0.022, 95% CI (-0.115, -0.030), p = 0.001) and LS BMD ((β = -0.072, se = 0.025, 95% CI (-0.121, -0.023), p = 0.004), and therefore influences OP susceptibility. CONCLUSIONS This study demonstrates that AAM in females may play a causal role in OP etiology and provides novel insights into the pathophysiology of bone related diseases like osteoporosis, osteopenia and fracture. SUMMARY Our study demonstrates that AAM in females may play a causal role in OP etiology and provides novel insights into the pathophysiology of bone related diseases like osteoporosis, osteopenia and fracture. By adopting Mendelian Randomization approaches, our study was not susceptible to bias from unmeasured confounders or reverse causation.
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Affiliation(s)
- Qiang Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, NO.100 Kexue Road, High-Tech Development Zone Of States, PR China
| | - Jonathan Greenbaum
- Center for Bioinformatics and Genomics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Wei-Dong Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, NO.100 Kexue Road, High-Tech Development Zone Of States, PR China
| | - Chang-Qing Sun
- College of Public Health, Zhengzhou University, Zhengzhou, NO.100 Kexue Road, High-Tech Development Zone Of States, PR China
| | - Hong-Wen Deng
- Center for Bioinformatics and Genomics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
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Méndez-Gallegos E, Caire-Juvera G, Astiazarán-García H, Méndez-Estrada RO. Comparison of Measurements of Bone Mineral Density in Young and Middle-Aged Adult Women in Relation to Dietary, Anthropometric and Reproductive Variables. Nutrients 2018; 10:nu10111669. [PMID: 30400559 PMCID: PMC6265878 DOI: 10.3390/nu10111669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 10/24/2018] [Accepted: 10/25/2018] [Indexed: 12/03/2022] Open
Abstract
The objective of this study was to compare current measurements of bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN), and total femur (TF) regions with initial values recorded 12 years ago in women from Northwest Mexico, and evaluate their correlation with dietary, anthropometric, and reproductive variables. BMD was assessed by Dual-energy X-ray absorptiometry. Participants were grouped as follows: Nulliparous (G1); women who were mothers 12 years ago (G2); and women who were nulliparous 12 years ago, but are now mothers (G3). In all three groups, current LS BMD was higher than initial (p ≤ 0.05) and current TF BMD in G2 was higher than initial values (p ≤ 0.05). When comparing current FN and TF BMD among the three groups, G2 had higher values than G3 (p ≤ 0.05). G2 also showed higher LS BMD than G1 and G3 (p = 0.006). Age at menarche was inversely-correlated with FN and TF BMD in G1 (p < 0.01), while the body mass index (BMI) correlated positively with all three bone regions in G2 (p < 0.05). This study shows that in women without and with children, age at menarche, BMI, and age were factors associated to BMD in healthy subjects in reproductive age.
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Affiliation(s)
- Eloy Méndez-Gallegos
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
| | - Graciela Caire-Juvera
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
| | - Humberto Astiazarán-García
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
| | - Rosa O Méndez-Estrada
- Centro de Investigación en Alimentación y Desarrollo (CIAD), Km 0.6 a La Victoria, Hermosillo, Sonora 83304, Mexico.
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Ng SY, Bettany-Saltikov J, Cheung IYK, Chan KKY. The Role of Vitamin D in the Pathogenesis of Adolescent Idiopathic Scoliosis. Asian Spine J 2018; 12:1127-1145. [PMID: 30322242 PMCID: PMC6284127 DOI: 10.31616/asj.2018.12.6.1127] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/22/2018] [Indexed: 12/20/2022] Open
Abstract
Several theories have been proposed to explain the etiology of adolescent idiopathic scoliosis (AIS) until present. However, limited data are available regarding the impact of vitamin D insufficiency or deficiency on scoliosis. Previous studies have shown that vitamin D deficiency and insufficiency are prevalent in adolescents, including AIS patients. A series of studies conducted in Hong Kong have shown that as many as 30% of these patients have osteopenia. The 25-hydroxyvitamin D3 level has been found to positively correlate with bone mineral density (BMD) in healthy adolescents and negatively with Cobb angle in AIS patients; therefore, vitamin D deficiency is believed to play a role in AIS pathogenesis. This study attempts to review the relevant literature on AIS etiology to examine the association of vitamin D and various current theories. Our review suggested that vitamin D deficiency is associated with several current etiological theories of AIS. We postulate that vitamin D deficiency and/or insufficiency affects AIS development by its effect on the regulation of fibrosis, postural control, and BMD. Subclinical deficiency of vitamin K2, a fat-soluble vitamin, is also prevalent in adolescents; therefore, it is possible that the high prevalence of vitamin D deficiency is related to decreased fat intake. Further studies are required to elucidate the possible role of vitamin D in the pathogenesis and clinical management of AIS.
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