Are birth characteristics related to bone quality measures in young adults?: The HUNT study, Norway

Abstract

UNLABELLED: This population-based study investigated the association between birth characteristics and DXA-derived bone quality in 2,680 young adults (aged 20-54 years). Higher birth weight and length were positively associated with bone strength measures, while associations with buckling ratio and hip axis length were weaker and less consistent.

PURPOSE: To investigate the association between birth characteristics and bone quality indicators from dual-energy X-ray absorptiometry (DXA) in young adults.

METHODS: This population-based study included 2,680 participants (60% women), aged 20-54 years, from the Trøndelag Health Study (HUNT3 and HUNT4), linked with birth data from the Medical Birth Registry of Norway. Birth characteristics included birth weight, birth length, and birth weight relative to gestational age and sex (categorized as small, appropriate, or large for gestational age). Linear regressions assessed associations with bone quality measures, including cross-sectional area, cross-sectional moment of inertia, buckling ratio, and hip axis length. Analyses were adjusted for sex, birth year, age at DXA scan, gestational length, and adult height (for buckling ratio and hip axis length). Additional analyses included bone mineral density (BMD) to assess direct effects.

RESULTS: Higher birth weight and length were positively associated with cross-sectional area and cross-sectional moment of inertia. For each SD increase in birth weight and length, CSA increased by 4.33 and 4.29 mm2, and CSMI by 0.74 and 0.45 mm4, respectively. After BMD adjustment, these associations were attenuated for both birth weight (CSA: 1.90 mm2; CSMI: 0.55 mm4), and birth length (CSA: 2.13 mm2; CSMI: 0.58 mm4). Buckling ratio and hip axis length showed weaker and less consistent associations with birth characteristics, but the association of birth weight and small for gestational age with buckling ratio was somewhat strengthened after adjustment for BMD.

CONCLUSION: Birth characteristics are associated with both bone strength and geometry in young adulthood. These associations are partly independent of BMD, highlighting the value of DXA-derived bone quality measures in assessing skeletal health.

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