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Body composition and bone mineral density in childhood.

ABSTRACT: BACKGROUND:Body mass compartments may have different directions of influence on bone accrual. Studies of children are limited by relatively small sample sizes and typically make strong assumptions of linear regression. OBJECTIVE:To evaluate associations of overall body mass, components of overall body mass (fat-free and total fat), and components of total fat mass (truncal and non-truncal fat), measured via dual-energy X-ray absorptiometry (DXA) and anthropometry, with total body less head areal bone mineral density (aBMD) Z-score in mid-childhood. METHODS:We performed a cross-sectional study among 876 Boston-area children who had DXA measures. We evaluated linearity of associations using generalized additive models. RESULTS:Children were median 7.7 (range 6-10) years of age, and 61% were white. After adjustment for sociodemographics and other compartments of body mass, overall body mass, particularly the fat-free mass component, appeared to have a positive relationship with aBMD Z-score [e.g., 0.25 (95% CI: 0.23, 0.28) per 1-kg fat-free mass]. The relationship between truncal fat and aBMD Z-score appeared non-linear, with a negative association only in children with levels of fat mass in the upper 15th percentile [-0.17 (95% CI: -0.26, -0.07) aBMD Z-score per 1-kg truncal fat mass], while non-truncal fat mass was not associated with aBMD Z-score. CONCLUSIONS:Our analyses suggest that central adiposity is associated with lower aBMD Z-score only in children with the highest levels of abdominal fat. This finding raises the possibility of a threshold above which central adipose tissue becomes more metabolically active and thereby adversely impacts bone.

SUBMITTER: Rokoff LB

PROVIDER: S-EPMC6391186 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Body composition and bone mineral density in childhood.

Rokoff Lisa B LB Rifas-Shiman Sheryl L SL Switkowski Karen M KM Young Jessica G JG Rosen Clifford J CJ Oken Emily E Fleisch Abby F AF

Bone 20181215

<h4>Background</h4>Body mass compartments may have different directions of influence on bone accrual. Studies of children are limited by relatively small sample sizes and typically make strong assumptions of linear regression.<h4>Objective</h4>To evaluate associations of overall body mass, components of overall body mass (fat-free and total fat), and components of total fat mass (truncal and non-truncal fat), measured via dual-energy X-ray absorptiometry (DXA) and anthropometry, with total body ...[more]

PMID: 30557635

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Project description:BackgroundThe impact of the type and the severity of disability on whole-body and regional body composition (BC), and bone mineral density (BMD) must be considered for dietary advice in athletes with a physical impairment (PI). This study aimed to investigate the impact of the type and the severity of disability on BC, the pattern of distribution of fat mass at the regional level, and BMD in athletes with a PI.MethodsForty-two male athletes with spinal cord injury (SCI, n = 24; age = 40.04 ± 9.95 years, Body Mass Index [BMI] = 23.07 ± 4.01 kg/m2) or unilateral lower limb amputation (AMP, n = 18; age = 34.39 ± 9.19 years, BMI = 22.81 ± 2.63 kg/m2) underwent a Dual-Energy X-Ray Absorptiometry scan. Each athlete with a PI was matched by age with an able-bodied athlete (AB, n = 42; age = 37.81 ± 10.31 years, BMI = 23.94 ± 1.8 kg/m2).ResultsOne-Way Analysis of Variance showed significant differences between the SCI, AMP and AB groups for percentage fat mass (%FM) (P < 0.001, eta squared = 0.440). Post-hoc analysis with Bonferroni's correction showed that athletes with SCI had significantly higher %FM vs. the AMP and AB groups (25.45 ± 5.99%, 21.45 ± 4.21% and 16.69 ± 2.56%, respectively; P = 0.008 vs. AMP and P < 0.001 vs. AB). The %FM was also significantly higher in the AMP vs. the AB group (P < 0.001). Whole-body BMD was negatively affected in SCI athletes, with about half of them showing osteopenia or osteoporosis. In fact, the mean BMD and T-score values in the SCI group (1.07 ± 0.09 g/cm2 and -1.25 ± 0.85, respectively) were significantly lower in comparison with the AB group (P = 0.001 for both) as well as the AMP group (P = 0.008 for both). The type of disability affected BC and BMD in the trunk, android, gynoid and leg regions in SCI athletes and the impaired leg only in AMP athletes.ConclusionsIn conclusion, the type of disability and, partly, the severity of PI impact on BC and BMD in athletes with a PI. Nutritionists, sports medicine doctors, clinicians, coaches and physical conditioners should consider athletes with SCI or AMP separately. Athletes with a PI would benefit from specific nutrition and training programs taking into account the type of their disability.

Project description:BackgroundBody composition assessment aids evaluation of energy stores and the impact of diseases and interventions on child growth. Current United States pediatric reference ranges from the National Health and Nutrition Examination Survey (NHANES) include 20% of children with obesity, body mass index of ≥95th percentile.ObjectivesThis study aimed to develop dual energy X-ray absorptiometry (DXA) based reference ranges in a diverse cohort with low-obesity prevalence from the Bone Mineral Density in Childhood Study (BMDCS).MethodsThis is a secondary analysis of a longitudinal, prospective, observational cohort. Healthy children (height and BMI within 3rd to 97th percentiles, ages 5-19 y at enrollment), from 5 United States centers were measured annually for ≤7 visits. Whole body scans were acquired using Hologic scanners. A subsample underwent repeat measurements to determine precision. We generated reference ranges for appendicular and total lean soft tissue mass index (LSTM Index), fat mass index (FMI), and other body composition measures. Resulting curves were compared to NHANES and across subgroups. Sex and age-specific equations were developed to adjust body composition Z-scores for height Z score.ResultsWe obtained 9846 scans of 2011 participants (51% female, 22% Black, 17% Hispanic, 48% White, 7% Asian/Pacific Islander, and 6% with obesity). Precision (percent coefficient of variation) ranged from 0.7% to 1.96%. Median and-2 standard deviation curves for BMDCS and NHANES were similar, but NHANES +2 standard deviation LSTM Index and FMI curves were distinctly greater than the respective BMDCS curves. Subgroup differences were more extreme for appendicular LSTM Index-Z (mean ± SD: Asian -0.52 ± 0.93 compared with Black 0.77 ± 0.87) than for FMI-Z (Hispanic 0.29 ± 0.98 compared with Black -0.14 ± 1.1) and were smaller for Z-scores adjusted for height Z-score.ConclusionsThese reference ranges add to sparse normative data regarding body composition in children and adolescents and are based on a cohort with an obesity prevalence similar to current BMI charts. Awareness of subgroup differences aids in interpreting results.

Project description:BackgroundLow bone mineral density (BMD) and subsequent skeletal fragility have emerged as a long-term complication of phenylketonuria (PKU).ObjectiveTo determine if there are differences in BMD and body composition between male and female participants with PKU.MethodsFrom our randomized, crossover trial [1] of participants with early-treated PKU who consumed a low-phenylalanine (Phe) diet combined with amino acid medical foods (AA-MF) or glycomacropeptide medical foods (GMP-MF), a subset of 15 participants (6 males, 9 females, aged 15-50 y, 8 classical and 7 variant PKU) completed one dual energy X-ray absorptiometry (DXA) scan and 3-day food records after each dietary treatment. Participants reported lifelong compliance with AA-MF. In a crossover design, 8 participants (4 males, 4 females, aged 16-35 y) provided a 24-h urine collection after consuming AA-MF or GMP-MF for 1-3 weeks each.ResultsMale participants had significantly lower mean total body BMD Z-scores (means ± SE, males = - 0.9 ± 0.4; females, 0.2 ± 0.3; p = 0.01) and tended to have lower mean L1-4 spine and total femur BMD Z-scores compared to female participants. Only 50% percent of male participants had total body BMD Z-scores above - 1.0 compared to 100% of females (p = 0.06). Total femur Z-scores were negatively correlated with intake of AA-MF (r = - 0.58; p = 0.048). Males tended to consume more grams of protein equivalents per day from AA-MF (means ± SE, males: 67 ± 6 g, females: 52 ± 4 g; p = 0.057). Males and females demonstrated similar urinary excretion of renal net acid, magnesium and sulfate; males showed a trend for higher urinary calcium excretion compared to females (means ± SE, males: 339 ± 75 mg/d, females: 228 ± 69 mg/d; p = 0.13). Females had a greater percentage of total fat mass compared to males (means ± SE, males: 24.5 ± 4.8%, females: 36.5 ± 2.5%; p = 0.047). Mean appendicular lean mass index was similar between males and females. Male participants had low-normal lean mass based on the appendicular lean mass index.ConclusionsMales with PKU have lower BMD compared with females with PKU that may be related to higher intake of AA-MF and greater calcium excretion. The trial was registered at www.clinicaltrials.gov as NCT01428258.

Project description:BackgroundThe aim of the study were to analyze the lumbar volumetric bone mineral density (BMD), fat distribution and changes of skeletal muscle with quantitative computed tomography (QCT) in postmenopausal women with type 2 diabetes mellitus (T2DM), and to evaluate the relationship between body composition and BMD.MethodsOne hundred seventy-seven postmenopausal women with T2DM and 136 postmenopausal women without diabetes were included in the study and were divided into two groups according to age, 50-65 years age group and over 65 years of age group. The lumbar BMD (L1-L3), visceral fat mass (VFM), visceral fat area (VFA), subcutaneous fat mass (SFM), subcutaneous fat area (SFA), psoas major mass (PMM) and psoas major area (PMA) of each group were compared. Univariable and multivariable linear regression analysis were used to analyze the contribution of each variable to BMD in postmenopausal women with T2DM.ResultsIn women aged 50-65, the patients in the T2DM group had higher body mass index (BMI), VFM, VFA, and SFM (p < 0.05), compared with non-T2DM group. Over 65 years old, the BMI, BMD, VFM, VFA, and SFM was found to be much higher in participants with T2DM than in non-T2DM group (p < 0.05). Compared with women aged in 50-65 years old, those over 65 years old had higher VFA and VFM and lower BMD (p < 0.05), whether in the T2DM group or the non-T2DM group. Age, VFA and VFM were negatively correlated with BMD (r = -0.590, p ≤ 0.001; r = -0.179, p = 0.017; r = -0.155, p = 0.040, respectively). After adjusting for age, VFM and VFA were no longer correlated with BMD. No correlations between fat distribution or psoas major muscle and BMD in postmenopausal women with T2DM were observed.ConclusionsT2DM can affect abdominal fat deposition in postmenopausal women. Postmenopausal elderly women with diabetes have higher BMD than normal elderly women. There was no correlation between fat distribution or psoas major and BMD in postmenopausal women with diabetes mellitus.

Project description:Objective: The objective of this study was to evaluate whether evolution of bone mineral density (BMD) is associated with the thyroid hormone profile in a cohort of euthyroid women with no other known diseases within 1 year. Methods: This was a prospective cohort study conducted at the University of Campinas, Brazil. We used a database with 52 women aged 20-39 who were followed for 1 year in a family planning outpatient clinic. The inclusion criteria were body mass index (BMI) <30 kg/m2, no known diseases/medication use, fasting glucose <100 mg/dl, and 2 h glucose after a 75 g oral glucose load <140 mg/dl. The women were divided into groups of normal weight (n = 30) and overweight (n = 22). The main outcomes were BMD measured by dual-energy x-ray absorptiometry (DXA) and thyroid hormone profile (thyrotropin TSH, free triiodothyronine FT3, free thyroxine FT4, and T3/T4 ratio); other variables were body composition (DXA), calcium metabolism markers, and life habits. We used a repeated measures analysis of variance (ANOVA) and multiple regression analyses to evaluate associations. Results: At the baseline data collection, overweight women showed a higher T3/T4 ratio, leptin, calcium, BMD in the lumbar spine and total femur, total mass, mass, and percentage of fat mass than normal weight women. At 12 months, both groups had increased FT4, calcium, ALP, femoral neck BMD, and total mass by time effect. The normal weight group presented a decrease of vitamin D when compared to the baseline. Increased BMD of the femoral neck was associated with moderate coffee intake, and as such, there were no associations found between this increase and the thyroid hormone profile. Leptin and ALP were associated with total mass variation, while leptin and PTH were associated with fat mass variation. The normal BMI was inversely associated with the variation of total mass, mass, and percentage of fat mass, and engaging in regular physical activity was inversely associated with fat mass variation. Conclusions: In this sample of euthyroid healthy women who were both normal weight and overweight, the thyroid hormone profile was not associated with variations in bone mineral density and body composition after a 1 year follow-up.

Project description:Ethnic differences in bone mineral density (BMD) and fracture risk are well-described; the aim of this study was to investigate whether central adiposity or inflammatory status contribute to these ethnic differences in BMD in later life. The Southall and Brent Revisited study (SABRE) is a UK-based tri-ethnic cohort of men and women of European, South Asian or African Caribbean origin. At the most recent SABRE follow-up (2014-2018), in addition to measures of cardiometabolic phenotype, participants had dual-energy X-ray absorptiometry (DXA) bone and body composition scans. Multiple linear regression was used to determine whether markers of body composition, central adiposity or inflammatory status contributed to ethnic differences in BMD. In men and women, age- and height-adjusted BMD at all sites was higher in African Caribbeans compared to Europeans (femoral neck: standardised β (95% confidence interval): men: 1.00SD (0.75, 1.25); women: 0.77SD (0.56, 0.99)). South Asian men had higher BMD than European men at the hip (femoral neck: 0.34SD (95%CI: 0.15, 0.54)). Although adjustment for body mass index (BMI) or lean mass index (LMI) at the lumbar spine reduced the size of the difference in BMD between African Caribbean and European men (age and height adjusted difference: 0.35SD (0.08, 0.62); age and BMI adjusted difference: 0.25SD (-0.02, 0.51)), in both men and women ethnic differences remained after adjustment for measures of central adiposity (estimated visceral adipose tissue mass (VAT mass) and android to gynoid ratio) and inflammation (interleukin-6 (logIL-6) and C-reactive protein (logCRP)). Furthermore, in women, we observed ethnic differences in the relationship between BMI (overall interaction: p = 0.04), LMI (p = 0.04) or VAT mass (p = 0.009) and standardised lumbar spine BMD. In this tri-ethnic cohort, ethnic differences in BMD at the femoral neck, total hip or lumbar spine were not explained by BMI, central adiposity or inflammatory status. Given ethnic differences in fracture incidence, it is important to further investigate why ethnic differences in BMD exist.

Dataset Information

Body composition and bone mineral density in childhood.

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Body composition and bone mineral density in childhood.

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