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Is the skull responsive to bone mineralisation stimuli in children?

Is the skull responsive to bone mineralisation stimuli in children?
Is the skull responsive to bone mineralisation stimuli in children?
Background: whole-body-less-head (WBLH) is the recommended skeletal region of interest (ROI) for dual-energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD) in children. Historically it has been suggested that the skull is less responsive than the rest of the skeleton to stimuli that affect BMD but there are few published data to support this notion. We compared the associations of BMD with anthropometric, body composition, diet, and activity variables across various ROI.

Methods: children from the Southampton Women's Survey (SWS) mother-offspring cohort participated at age 6–7 years, including measurement of height, weight, and whole-body and lumbar spine (LS) BMD by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart) and diet by interviewer-led questionnaire. BMD was measured in the following skeletal ROI: whole-body, skull, WBLH and lower limbs (all derived from the whole-body scan) and LS.

Results: 1218 children participated. Height z-score, weight z-score, lean mass and milk intake were associated with skull BMD, but associations were weaker than observed for other ROI; for example, the association between lean mass and skull BMD was β (95% CI) 0.11 (0.08, 0.14) SD/kg, compared with 0.32 (0.30, 0.34), 0.38 (0.37, 0.40) and 0.23 (0.21, 0.25) SD/kg for whole body, WBLH and lumbar spine, respectively. Relationships with whole-body BMD were attenuated compared with WBLH.

Conclusion: associations between skull BMD and anthropometry, body composition and dietary variables were weaker than for other DXA sites. These findings support, and importantly provide a quantitative basis for, the recommendation that the skull should be excluded from whole-body DXA analyses in children.
Bone mineral density (BMD), Children, Dual-energy X-ray absorptiometry (DXA), Skull, Whole-body-less-head
8756-3282
Moon, Rebecca
954fb3ed-9934-4649-886d-f65944985a6b
D'angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Crozier, Sarah
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Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Davies, Justin
9f18fcad-f488-4c72-ac23-c154995443a9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145
Moon, Rebecca
954fb3ed-9934-4649-886d-f65944985a6b
D'angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Crozier, Sarah
9c3595ce-45b0-44fa-8c4c-4c555e628a03
Godfrey, Keith
0931701e-fe2c-44b5-8f0d-ec5c7477a6fd
Davies, Justin
9f18fcad-f488-4c72-ac23-c154995443a9
Cooper, Cyrus
e05f5612-b493-4273-9b71-9e0ce32bdad6
Harvey, Nicholas
ce487fb4-d360-4aac-9d17-9466d6cba145

Moon, Rebecca, D'angelo, Stefania, Crozier, Sarah, Godfrey, Keith, Davies, Justin, Cooper, Cyrus and Harvey, Nicholas (2022) Is the skull responsive to bone mineralisation stimuli in children? Bone, 160, [116415]. (doi:10.1016/j.bone.2022.116415).

Record type: Article

Abstract

Background: whole-body-less-head (WBLH) is the recommended skeletal region of interest (ROI) for dual-energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD) in children. Historically it has been suggested that the skull is less responsive than the rest of the skeleton to stimuli that affect BMD but there are few published data to support this notion. We compared the associations of BMD with anthropometric, body composition, diet, and activity variables across various ROI.

Methods: children from the Southampton Women's Survey (SWS) mother-offspring cohort participated at age 6–7 years, including measurement of height, weight, and whole-body and lumbar spine (LS) BMD by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart) and diet by interviewer-led questionnaire. BMD was measured in the following skeletal ROI: whole-body, skull, WBLH and lower limbs (all derived from the whole-body scan) and LS.

Results: 1218 children participated. Height z-score, weight z-score, lean mass and milk intake were associated with skull BMD, but associations were weaker than observed for other ROI; for example, the association between lean mass and skull BMD was β (95% CI) 0.11 (0.08, 0.14) SD/kg, compared with 0.32 (0.30, 0.34), 0.38 (0.37, 0.40) and 0.23 (0.21, 0.25) SD/kg for whole body, WBLH and lumbar spine, respectively. Relationships with whole-body BMD were attenuated compared with WBLH.

Conclusion: associations between skull BMD and anthropometry, body composition and dietary variables were weaker than for other DXA sites. These findings support, and importantly provide a quantitative basis for, the recommendation that the skull should be excluded from whole-body DXA analyses in children.

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Accepted/In Press date: 2 April 2022
e-pub ahead of print date: 8 April 2022
Published date: July 2022
Additional Information: Funding Information: This work was supported by grants from Medical Research Council (MRC) [ MC_PC_21003 ; MC_PC_21001 ], Bupa Foundation , British Heart Foundation , National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust , NIHR Oxford Biomedical Research Centre , University of Oxford and the UK Royal Osteoporosis Society Osteoporosis and Bone Research Academy. The work leading to these results was supported by the European Union 's Seventh Framework Programme (FP7/2007–2013), projects EarlyNutrition, ODIN and LifeCycle under grant agreements numbers 289346 , 613977 and 733206 , and by the BBSRC (HDHL-Biomarkers, BB/P028179/1 ), as part of the ALPHABET project, supported by an award made through the ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL), Horizon 2020 grant agreement number 696295 . KMG is supported by the UK Medical Research Council ( MC_UU_12011/4 ), the National Institute for Health Research (NIHR Senior Investigator ( NF-SI-0515-10042 ) and NIHR Southampton Biomedical Research Centre ( IS-BRC-1215-20004 )), the European Union ( Erasmus+ Programme ImpENSA 598488-EPP-1-2018-1-DE-EPPKA2-CBHE-JP ), British Heart Foundation ( RG/15/17/3174, SP/F/21/150013 ) and the US National Institute On Aging of the National Institutes of Health (Award No. U24AG047867 ). RJM is funded by Health Education England (HEE)/ National Institute for Health Research (NIHR) for this research project. For the purpose of Open Access, the author has applied a Creative Commons Attribution (CC BY) licence to any Author Accepted Manuscript version arising from this submission. Publisher Copyright: © 2022 The Authors
Keywords: Bone mineral density (BMD), Children, Dual-energy X-ray absorptiometry (DXA), Skull, Whole-body-less-head

Identifiers

Local EPrints ID: 456606
URI: http://eprints.soton.ac.uk/id/eprint/456606
ISSN: 8756-3282
PURE UUID: a67a19a8-768f-4844-81f5-c9eafa92eab7
ORCID for Stefania D'angelo: ORCID iD orcid.org/0000-0002-7267-1837
ORCID for Sarah Crozier: ORCID iD orcid.org/0000-0002-9524-1127
ORCID for Keith Godfrey: ORCID iD orcid.org/0000-0002-4643-0618
ORCID for Cyrus Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for Nicholas Harvey: ORCID iD orcid.org/0000-0002-8194-2512

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Date deposited: 05 May 2022 16:51
Last modified: 18 Mar 2024 03:23

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Contributors

Author: Rebecca Moon
Author: Stefania D'angelo ORCID iD
Author: Sarah Crozier ORCID iD
Author: Keith Godfrey ORCID iD
Author: Justin Davies
Author: Cyrus Cooper ORCID iD
Author: Nicholas Harvey ORCID iD

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