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Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study

Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study
Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study
Although measures to enhance bone mineralization during childhood and adolescence are widely incorporated into preventive programmes against osteoporotic fracture, there are no published data directly linking growth rates in childhood with the risk of later hip fracture. We addressed this issue in a unique Finnish cohort in whom birth and childhood growth data were linked to later hospital discharge records. This permitted follow-up of 3639 men and 3447 women who were born in Helsinki University Central Hospital between 1924 and 1933, who went to school in Helsinki and still lived in Finland in 1971. Body size at birth was recorded and an average of 10 measurements were obtained of height and weight throughout childhood. We identified 112 subjects (55 men and 57 women) who sustained a hip fracture during 165 404 person-years of follow-up. After adjustment for age and sex in a proportional hazards model, we identified two major determinants of hip fracture risk: tall maternal height (p<0.001) and a low rate of childhood growth (height, p = 0.006; weight, p = 0.01). The hazard ratio for hip fracture was 2.1 (95% CI 1.2-3.5) among men and women born to mothers taller than 1.61 m, when compared with those whose mothers were shorter than 1.54 m. The ratio was 1.9 (95% CI 1.1-3.2) among those whose rate of childhood height gain was below the lowest quartile for the cohort, compared with those whose growth rate was above the highest quartile. The effects of maternal height and childhood growth rate were statistically independent of each other, and remained after adjusting for socioeconomic status. The patterns of childhood growth that predicted future hip fracture differed between boys and girls. In boys, there was a constant deficit in height and weight between ages 7 and 15 years among those later sustaining fractures; in girls, there was a progressively increasing deficit in weight but a delayed height gain among those later sustaining fractures. This epidemiologic study provides the first direct evidence that a low rate of childhood growth is a risk factor for later hip fracture. Whether reduced growth rate is a consequence of childhood lifestyle, genetic background or intrauterine hormonal programming, the data support measures to optimize childhood growth as part of preventive strategies against osteoporotic fracture in future generations.
childhood growth, epidemiology, fetal origins, osteoporosis, programming
0937-941X
623-629
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Eriksson, J.G.
eda300d2-b247-479f-95b9-f12d2c72e92b
Forsén, T.
636ecafb-05fa-46a7-a2d5-f5561e29dc6c
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Tuomilehto, J.
acb95a9e-fc01-4443-ad0f-93eaf107aac2
Barker, D.J.P.
64c6005a-eea7-4c26-8f07-50d875998512
Cooper, C.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Eriksson, J.G.
eda300d2-b247-479f-95b9-f12d2c72e92b
Forsén, T.
636ecafb-05fa-46a7-a2d5-f5561e29dc6c
Osmond, C.
2677bf85-494f-4a78-adf8-580e1b8acb81
Tuomilehto, J.
acb95a9e-fc01-4443-ad0f-93eaf107aac2
Barker, D.J.P.
64c6005a-eea7-4c26-8f07-50d875998512

Cooper, C., Eriksson, J.G., Forsén, T., Osmond, C., Tuomilehto, J. and Barker, D.J.P. (2001) Maternal height, childhood growth and risk of hip fracture in later life: a longitudinal study. Osteoporosis International, 12 (8), 623-629. (doi:10.1007/s001980170061).

Record type: Article

Abstract

Although measures to enhance bone mineralization during childhood and adolescence are widely incorporated into preventive programmes against osteoporotic fracture, there are no published data directly linking growth rates in childhood with the risk of later hip fracture. We addressed this issue in a unique Finnish cohort in whom birth and childhood growth data were linked to later hospital discharge records. This permitted follow-up of 3639 men and 3447 women who were born in Helsinki University Central Hospital between 1924 and 1933, who went to school in Helsinki and still lived in Finland in 1971. Body size at birth was recorded and an average of 10 measurements were obtained of height and weight throughout childhood. We identified 112 subjects (55 men and 57 women) who sustained a hip fracture during 165 404 person-years of follow-up. After adjustment for age and sex in a proportional hazards model, we identified two major determinants of hip fracture risk: tall maternal height (p<0.001) and a low rate of childhood growth (height, p = 0.006; weight, p = 0.01). The hazard ratio for hip fracture was 2.1 (95% CI 1.2-3.5) among men and women born to mothers taller than 1.61 m, when compared with those whose mothers were shorter than 1.54 m. The ratio was 1.9 (95% CI 1.1-3.2) among those whose rate of childhood height gain was below the lowest quartile for the cohort, compared with those whose growth rate was above the highest quartile. The effects of maternal height and childhood growth rate were statistically independent of each other, and remained after adjusting for socioeconomic status. The patterns of childhood growth that predicted future hip fracture differed between boys and girls. In boys, there was a constant deficit in height and weight between ages 7 and 15 years among those later sustaining fractures; in girls, there was a progressively increasing deficit in weight but a delayed height gain among those later sustaining fractures. This epidemiologic study provides the first direct evidence that a low rate of childhood growth is a risk factor for later hip fracture. Whether reduced growth rate is a consequence of childhood lifestyle, genetic background or intrauterine hormonal programming, the data support measures to optimize childhood growth as part of preventive strategies against osteoporotic fracture in future generations.

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Published date: 2001
Keywords: childhood growth, epidemiology, fetal origins, osteoporosis, programming

Identifiers

Local EPrints ID: 25376
URI: http://eprints.soton.ac.uk/id/eprint/25376
ISSN: 0937-941X
PURE UUID: 659c60b4-0730-4469-bf5f-5bade98f7406
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for C. Osmond: ORCID iD orcid.org/0000-0002-9054-4655

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Date deposited: 10 Apr 2006
Last modified: 18 Mar 2024 02:44

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Contributors

Author: C. Cooper ORCID iD
Author: J.G. Eriksson
Author: T. Forsén
Author: C. Osmond ORCID iD
Author: J. Tuomilehto
Author: D.J.P. Barker

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