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Ethnic differences in peripheral skeletal development among urban South African adolescents: a ten-year longitudinal pQCT study

Ethnic differences in peripheral skeletal development among urban South African adolescents: a ten-year longitudinal pQCT study
Ethnic differences in peripheral skeletal development among urban South African adolescents: a ten-year longitudinal pQCT study
There are no longitudinal pQCT data of bone growth and development from sub-Saharan Africa, where rapid environmental, societal and economic transitions are occurring, and where fracture rates are predicted to rise. The aim of this study was to compare skeletal development in black and white South African adolescents using longitudinal data from the Birth to Twenty study.

The Birth to Twenty Bone Health sub-cohort consisted of 543 adolescents (261[178 black] girls, 282[201 black] boys). Annual pQCT measurements of the radial and tibial metaphysis and diaphysis were obtained between ages 12 and 22 years (distal metaphysis: cross-sectional area [CSA] and trabecular bone mineral density [BMD]; diaphysis: total and cortical CSA, cortical BMD and polar stress-strain index [SSIp]). Age at peak height velocity (APHV) was calculated to account for differences in maturational timing between ethnic groups and sexes. Mixed-effects models were used to describe trajectories for each pQCT outcome. Likelihood-ratio tests were used to summarize the overall difference in trajectories between black and white participants within each sex.

APHV (mean[SD] years) was similar in black (11.8[0.8]) and white (12.2[1.0]) girls, but delayed in black (14.2[1.0]) relative to white boys (13.3[0.8]). By four years post APHV, white adolescents had significantly greater cortical CSA and SSIp than black adolescents at the radius. There were no significant differences at the radial metaphysis but there was some divergence, such that black adolescents had greater radial trabecular BMD by the end of follow-up. At the tibia, white adolescents had lower diaphyseal CSA and SSIp, and greater metaphyseal CSA. There was no ethnic difference in tibial trabecular BMD.

There are ethnic differences in bone growth and development, independent of maturation, in South African adolescents. This work gives new insights into the possible etiology of childhood fractures, which occur most commonly as peripheral sites.
0884-0431
2355-2366
Schoenbuchner, Simon M.
e20c0f65-3133-4598-9e3b-fc0f95551f11
Pettifor, John M.
61e300fe-7ae4-4117-b247-5f918313a608
Norris, Shane
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Micklesfield, Lisa K.
4c625289-a9ed-47e1-8dec-a1d445481206
Prentice, Ann
b103f864-7606-4860-8bf2-125b4be3c0f3
Ward, Kate A.
39bd4db1-c948-4e32-930e-7bec8deb54c7
Schoenbuchner, Simon M.
e20c0f65-3133-4598-9e3b-fc0f95551f11
Pettifor, John M.
61e300fe-7ae4-4117-b247-5f918313a608
Norris, Shane
1d346f1b-6d5f-4bca-ac87-7589851b75a4
Micklesfield, Lisa K.
4c625289-a9ed-47e1-8dec-a1d445481206
Prentice, Ann
b103f864-7606-4860-8bf2-125b4be3c0f3
Ward, Kate A.
39bd4db1-c948-4e32-930e-7bec8deb54c7

Schoenbuchner, Simon M., Pettifor, John M., Norris, Shane, Micklesfield, Lisa K., Prentice, Ann and Ward, Kate A. (2017) Ethnic differences in peripheral skeletal development among urban South African adolescents: a ten-year longitudinal pQCT study. Journal of Bone and Mineral Research, 32 (12), 2355-2366. (doi:10.1002/jbmr.3279).

Record type: Article

Abstract

There are no longitudinal pQCT data of bone growth and development from sub-Saharan Africa, where rapid environmental, societal and economic transitions are occurring, and where fracture rates are predicted to rise. The aim of this study was to compare skeletal development in black and white South African adolescents using longitudinal data from the Birth to Twenty study.

The Birth to Twenty Bone Health sub-cohort consisted of 543 adolescents (261[178 black] girls, 282[201 black] boys). Annual pQCT measurements of the radial and tibial metaphysis and diaphysis were obtained between ages 12 and 22 years (distal metaphysis: cross-sectional area [CSA] and trabecular bone mineral density [BMD]; diaphysis: total and cortical CSA, cortical BMD and polar stress-strain index [SSIp]). Age at peak height velocity (APHV) was calculated to account for differences in maturational timing between ethnic groups and sexes. Mixed-effects models were used to describe trajectories for each pQCT outcome. Likelihood-ratio tests were used to summarize the overall difference in trajectories between black and white participants within each sex.

APHV (mean[SD] years) was similar in black (11.8[0.8]) and white (12.2[1.0]) girls, but delayed in black (14.2[1.0]) relative to white boys (13.3[0.8]). By four years post APHV, white adolescents had significantly greater cortical CSA and SSIp than black adolescents at the radius. There were no significant differences at the radial metaphysis but there was some divergence, such that black adolescents had greater radial trabecular BMD by the end of follow-up. At the tibia, white adolescents had lower diaphyseal CSA and SSIp, and greater metaphyseal CSA. There was no ethnic difference in tibial trabecular BMD.

There are ethnic differences in bone growth and development, independent of maturation, in South African adolescents. This work gives new insights into the possible etiology of childhood fractures, which occur most commonly as peripheral sites.

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Accepted/In Press date: 22 August 2017
e-pub ahead of print date: 9 October 2017
Published date: December 2017

Identifiers

Local EPrints ID: 416449
URI: http://eprints.soton.ac.uk/id/eprint/416449
ISSN: 0884-0431
PURE UUID: 19882703-a01f-408a-9f1b-82395f88b9ea
ORCID for Kate A. Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 18 Dec 2017 17:30
Last modified: 07 Oct 2020 06:08

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Contributors

Author: Simon M. Schoenbuchner
Author: John M. Pettifor
Author: Shane Norris
Author: Lisa K. Micklesfield
Author: Ann Prentice
Author: Kate A. Ward ORCID iD

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