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Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromso Study, Fit Futures

Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromso Study, Fit Futures
Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromso Study, Fit Futures
BackgroundPositive association between body weight and bone mass is well established, and the concept of body mass index (BMI) is associated with higher areal bone mineral density (aBMD) and reduced fracture risk. BMI, that comprises both fat mass (FM) and lean mass (LM) may contribute to peak bone mass achievement in different ways. This study explored the influence of body composition in terms of total body LM and FM on hip aBMD-values in adolescence.MethodsIn 2010/2011, 93% of the region’s first-year upper-secondary school students (15–17 years old) in Tromsø, Norway attended the Tromsø Study, Fit Futures. Areal BMD at femoral neck (aBMDFN) and total hip (aBMDTH) (g/cm2), total body LM and FM (g) were measured by dual energy X-ray absorptiometry (DXA). Height and weight were measured, and BMI calculated. Lifestyle variables were collected by self-administered questionnaires and interviews, including questions on time spent on leisure time physical activity. Stratified analyses of covariance and regression models included 395 girls and 363 boys. Crude results were adjusted for age, height, sexual maturation, physical activity levels, vitamin D levels, calcium intake, alcohol consumption and smoking habits.ResultsUnadjusted distribution indicated higher aBMD-levels at higher LM-levels in both genders (p < 0.001), but higher aBMD at higher FM-levels were found only in girls (p < 0.018). After multiple adjustments, aBMDFN-levels in girls were associated by 0.053 g/cm2 and 0.032 g/cm2 per standard deviation (SD) change in LM and FM (p < 0.001). Corresponding values in boys were 0.072 and 0.025 (p < 0.001). The high LM groups accounted for the highest aBMD-levels, while aBMD-levels at the LM/FM-combinations indicated different patterns in girls compared to boys. The adjusted odds ratio (95% CI) for low levels of aBMDFN was 6.6 (3.4,13.0) in boys, compared to 2.8 (1.6,4.9) in girls per SD lower LM.ConclusionsLM and FM should be regarded as strong predictors for bone mass and hence bone strength in adolescents. A gender specific difference indicated that high lean mass is of crucial importance prominently in boys. In adolescents with low lean mass, especially in girls, high fat mass may partially ameliorate the effect of deficient lean mass levels.
1-11
Winther, Anne
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Jorgensen, Lone
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Ahmed, L.A.
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Christoffersen, T.
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Furberg, Anne-Sofie
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Grimnes, Guri
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Jorde, Rolfe
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Nilsen, O.A.
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Dennison, Elaine
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Emaus, Nina
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Winther, Anne
149948cc-08b2-426c-9fa2-6dd9a8d03204
Jorgensen, Lone
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Ahmed, L.A.
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Christoffersen, T.
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Furberg, Anne-Sofie
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Grimnes, Guri
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Jorde, Rolfe
121e5bee-5139-4637-82d9-a370179f3394
Nilsen, O.A.
50795bda-b064-4ae2-8747-9aefa61ddf6b
Dennison, Elaine
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Emaus, Nina
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Winther, Anne, Jorgensen, Lone, Ahmed, L.A., Christoffersen, T., Furberg, Anne-Sofie, Grimnes, Guri, Jorde, Rolfe, Nilsen, O.A., Dennison, Elaine and Emaus, Nina (2018) Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromso Study, Fit Futures. BMC Musculoskeletal Disorders, 19 (21), 1-11. (doi:10.1186/s12891-018-1933-x).

Record type: Article

Abstract

BackgroundPositive association between body weight and bone mass is well established, and the concept of body mass index (BMI) is associated with higher areal bone mineral density (aBMD) and reduced fracture risk. BMI, that comprises both fat mass (FM) and lean mass (LM) may contribute to peak bone mass achievement in different ways. This study explored the influence of body composition in terms of total body LM and FM on hip aBMD-values in adolescence.MethodsIn 2010/2011, 93% of the region’s first-year upper-secondary school students (15–17 years old) in Tromsø, Norway attended the Tromsø Study, Fit Futures. Areal BMD at femoral neck (aBMDFN) and total hip (aBMDTH) (g/cm2), total body LM and FM (g) were measured by dual energy X-ray absorptiometry (DXA). Height and weight were measured, and BMI calculated. Lifestyle variables were collected by self-administered questionnaires and interviews, including questions on time spent on leisure time physical activity. Stratified analyses of covariance and regression models included 395 girls and 363 boys. Crude results were adjusted for age, height, sexual maturation, physical activity levels, vitamin D levels, calcium intake, alcohol consumption and smoking habits.ResultsUnadjusted distribution indicated higher aBMD-levels at higher LM-levels in both genders (p < 0.001), but higher aBMD at higher FM-levels were found only in girls (p < 0.018). After multiple adjustments, aBMDFN-levels in girls were associated by 0.053 g/cm2 and 0.032 g/cm2 per standard deviation (SD) change in LM and FM (p < 0.001). Corresponding values in boys were 0.072 and 0.025 (p < 0.001). The high LM groups accounted for the highest aBMD-levels, while aBMD-levels at the LM/FM-combinations indicated different patterns in girls compared to boys. The adjusted odds ratio (95% CI) for low levels of aBMDFN was 6.6 (3.4,13.0) in boys, compared to 2.8 (1.6,4.9) in girls per SD lower LM.ConclusionsLM and FM should be regarded as strong predictors for bone mass and hence bone strength in adolescents. A gender specific difference indicated that high lean mass is of crucial importance prominently in boys. In adolescents with low lean mass, especially in girls, high fat mass may partially ameliorate the effect of deficient lean mass levels.

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Accepted/In Press date: 10 January 2018
e-pub ahead of print date: 19 January 2018
Published date: 2018

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Local EPrints ID: 422750
URI: https://eprints.soton.ac.uk/id/eprint/422750
PURE UUID: 09a0ebd3-0b23-4681-8418-82f58b6028eb
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 03 Aug 2018 16:30
Last modified: 03 Dec 2019 02:00

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Contributors

Author: Anne Winther
Author: Lone Jorgensen
Author: L.A. Ahmed
Author: T. Christoffersen
Author: Anne-Sofie Furberg
Author: Guri Grimnes
Author: Rolfe Jorde
Author: O.A. Nilsen
Author: Elaine Dennison ORCID iD
Author: Nina Emaus

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