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The association between childhood fractures and adolescence bone outcomes: a population study, The Tromso Study, Fit Futures

The association between childhood fractures and adolescence bone outcomes: a population study, The Tromso Study, Fit Futures
The association between childhood fractures and adolescence bone outcomes: a population study, The Tromso Study, Fit Futures
Summary

Childhood fracture may predict persistent skeletal fragility, but it may also reflect high physical activity which is beneficial to bone development. We observe a difference in the relationship between previous fracture and bone outcome across physical activity level and sex. Further elaboration on this variation is needed.

Purpose

Childhood fracture may be an early marker of skeletal fragility, or increased levels of physical activity (PA), which are beneficial for bone mineral accrual. This study investigated the association between a previous history of childhood fracture and adolescent bone mineral outcomes by various PA levels.

Methods

We recruited 469 girls and 492 boys aged 15–18 years to this study. We assessed PA levels by questionnaire and measured areal bone mineral density (aBMD) and bone mineral content (BMC) using dual-energy X-ray absorptiometry (DXA) at arm, femoral neck (FN), total hip (TH), and total body (TB) and calculated bone mineral apparent density (BMAD, g/cm3). Fractures from birth to time of DXA measurements were retrospectively recorded. We analyzed differences among participants with and without fractures using independent sample t test. Multiple linear regression was used to examine the association between fractures and aBMD and BMC measurements according to adolescent PA.

Results

Girls with and without a previous history of fracture had similar BMC, aBMD, and BMAD at all sites. In multiple regression analyses stratified by physical activity intensity (PAi), there was a significant negative association between fracture and aBMD-TH and BMC-FN yet only in girls reporting low PAi. There was a significant negative association between forearm fractures, BMAD-FN, and BMAD-arm among vigorously active boys.

Conclusion

Our findings indicate a negative association between childhood fractures and aBMD/BMC in adolescent girls reporting low PAi. In boys, such an association appears only in vigorously active participants with a history of forearm fractures.
0937-941X
441–450
Christoffersen, T.
6cf0d24c-a945-41c8-85d5-19b998671153
Emaus, Nina
fa8b8643-dc1b-462c-9e69-e8923b2115fd
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Furberg, Anne-Sofie
1a5a184e-be6d-4559-a706-9e4703bba170
Gracia-Marco, Luis
bd431c1b-0f0d-4b64-a19d-8ac2e3ac7748
Grimnes, Guri
a51f752e-ee2a-4033-9691-66b6f35a544d
Nilsen, O.A.
eece711a-2825-47d5-b653-da412f4320c3
Vlachopoulos, Dimitris
b167136d-52d6-4815-a1f7-feb532264a94
Winther, Anne
149948cc-08b2-426c-9fa2-6dd9a8d03204
Ahmed, L.A.
f6f3d295-4fb0-4349-aca3-a08a6ef0e819
Christoffersen, T.
6cf0d24c-a945-41c8-85d5-19b998671153
Emaus, Nina
fa8b8643-dc1b-462c-9e69-e8923b2115fd
Dennison, Elaine
ee647287-edb4-4392-8361-e59fd505b1d1
Furberg, Anne-Sofie
1a5a184e-be6d-4559-a706-9e4703bba170
Gracia-Marco, Luis
bd431c1b-0f0d-4b64-a19d-8ac2e3ac7748
Grimnes, Guri
a51f752e-ee2a-4033-9691-66b6f35a544d
Nilsen, O.A.
eece711a-2825-47d5-b653-da412f4320c3
Vlachopoulos, Dimitris
b167136d-52d6-4815-a1f7-feb532264a94
Winther, Anne
149948cc-08b2-426c-9fa2-6dd9a8d03204
Ahmed, L.A.
f6f3d295-4fb0-4349-aca3-a08a6ef0e819

Christoffersen, T., Emaus, Nina, Dennison, Elaine, Furberg, Anne-Sofie, Gracia-Marco, Luis, Grimnes, Guri, Nilsen, O.A., Vlachopoulos, Dimitris, Winther, Anne and Ahmed, L.A. (2018) The association between childhood fractures and adolescence bone outcomes: a population study, The Tromso Study, Fit Futures. Osteoporosis International, 29 (2), 441–450. (doi:10.1007/s00198-017-4300-0).

Record type: Article

Abstract

Summary

Childhood fracture may predict persistent skeletal fragility, but it may also reflect high physical activity which is beneficial to bone development. We observe a difference in the relationship between previous fracture and bone outcome across physical activity level and sex. Further elaboration on this variation is needed.

Purpose

Childhood fracture may be an early marker of skeletal fragility, or increased levels of physical activity (PA), which are beneficial for bone mineral accrual. This study investigated the association between a previous history of childhood fracture and adolescent bone mineral outcomes by various PA levels.

Methods

We recruited 469 girls and 492 boys aged 15–18 years to this study. We assessed PA levels by questionnaire and measured areal bone mineral density (aBMD) and bone mineral content (BMC) using dual-energy X-ray absorptiometry (DXA) at arm, femoral neck (FN), total hip (TH), and total body (TB) and calculated bone mineral apparent density (BMAD, g/cm3). Fractures from birth to time of DXA measurements were retrospectively recorded. We analyzed differences among participants with and without fractures using independent sample t test. Multiple linear regression was used to examine the association between fractures and aBMD and BMC measurements according to adolescent PA.

Results

Girls with and without a previous history of fracture had similar BMC, aBMD, and BMAD at all sites. In multiple regression analyses stratified by physical activity intensity (PAi), there was a significant negative association between fracture and aBMD-TH and BMC-FN yet only in girls reporting low PAi. There was a significant negative association between forearm fractures, BMAD-FN, and BMAD-arm among vigorously active boys.

Conclusion

Our findings indicate a negative association between childhood fractures and aBMD/BMC in adolescent girls reporting low PAi. In boys, such an association appears only in vigorously active participants with a history of forearm fractures.

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Manuscript accepted_TCH_OI 2018 - Accepted Manuscript
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More information

Accepted/In Press date: 2 November 2017
e-pub ahead of print date: 16 November 2017
Published date: February 2018

Identifiers

Local EPrints ID: 422751
URI: https://eprints.soton.ac.uk/id/eprint/422751
ISSN: 0937-941X
PURE UUID: a323795f-99f5-4437-a02c-1d8593485c1b
ORCID for Elaine Dennison: ORCID iD orcid.org/0000-0002-3048-4961

Catalogue record

Date deposited: 03 Aug 2018 16:30
Last modified: 10 Dec 2019 05:16

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