Areal bone mineral density (aBMD) predicts future fracture risk. This study explores the development of aBMD and associated factors in Norwegian adolescents. Our results indicate a high degree of tracking of aBMD levels in adolescence. Anthropometric measures and lifestyle factors were associated with deviation from tracking.
Norway has one of the highest reported incidences of hip fractures. Maximization of peak bone mass may reduce future fracture risk. The main aims of this study were to describe changes in bone mineral levels over 2 years in Norwegian adolescents aged 15–17 years at baseline, to examine the degree of tracking of aBMD during this period, and to identify baseline predictors associated with positive deviation from tracking.
In 2010–2011, all first year upper secondary school students in Tromsø were invited to the Fit Futures study and 1038 adolescents (93%) attended. We measured femoral neck (FN), total hip (TH), and total body (TB) aBMD as g/cm2 by DXA. Two years later, in 2012–2013, we invited all participants to a follow-up survey, providing 688 repeated measures of aBMD.
aBMD increased significantly (p < 0.05) at all skeletal sites in both sexes. Mean annual percentage increase for FN, TH, and TB was 0.3, 0.5, and 0.8 in girls and 1.5, 1.0, and 2.0 in boys, respectively (p < 0.05). There was a high degree of tracking of aBMD levels over 2 years. In girls, several lifestyle factors predicted a positive deviation from tracking, whereas anthropometric measures appeared influential in boys. Baseline z-score was associated with lower odds of upwards drift in both sexes.
Our results support previous findings on aBMD development in adolescence and indicate strong tracking over 2 years of follow-up. Baseline anthropometry and lifestyle factors appeared to alter tracking, but not consistently across sex and skeletal sites.
Weaver C, Gordon C, Janz K, Kalkwarf H, Lappe J, Lewis R, O’Karma M, Wallace T, Zemel B (2016) The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int 27(4):1281–1386 CrossRefPubMedPubMedCentral
Seeman E, Karlsson MK, Duan Y (2000) On exposure to anorexia nervosa, the temporal variation in axial and appendicular skeletal development predisposes to site-specific deficits in bone size and density: a cross-sectional study. J Bone Miner Res Off J Am Soc Bone Miner Res 15(11):2259–2265. doi: 10.1359/jbmr.2000.15.11.2259 CrossRef
Fujita Y, Iki M, Ikeda Y, Morita A, Matsukura T, Nishino H, Yamagami T, Kagamimori S, Kagawa Y, Yoneshima H (2011) Tracking of appendicular bone mineral density for 6 years including the pubertal growth spurt: Japanese population-based osteoporosis kids cohort study. J Bone Miner Metab 29(2):208–216. doi: 10.1007/s00774-010-0213-0 CrossRefPubMed
Wren TA, Kalkwarf HJ, Zemel BS, Lappe JM, Oberfield S, Shepherd JA, Winer KK, Gilsanz V, Bone Mineral Density in Childhood Study G (2014) Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents: persistence of low bone mass to maturity. J Pediatr 164(6):1280–1285 . doi: 10.1016/j.jpeds.2013.12.040e1282 CrossRefPubMedPubMedCentral
Healthcare G (2010) Lunar enCORE Referansesupplement. vol Revisjon 1
Emaus A, Degerstrom J, Wilsgaard T, Hansen BH, Dieli-Conwright CM, Furberg AS, Pettersen SA, Andersen LB, Eggen AE, Bernstein L, Thune I (2010) Does a variation in self-reported physical activity reflect variation in objectively measured physical activity, resting heart rate, and physical fitness? Results from the Tromso Study. Scand J Public Health 38(5 Suppl):105–118. doi: 10.1177/1403494810378919 CrossRefPubMed
Hosmer DW, Lemeshow S, Sturdivant RX (2013) Applied logistic regression, Wiley series in probability and statistics, 3rd edn. Wiley, Hoboken CrossRef
Berger C, Goltzman D, Langsetmo L, Joseph L, Jackson S, Kreiger N, Tenenhouse A, Davison KS, Josse RG, Prior JC, Hanley DA, CaMos Research G (2010) Peak bone mass from longitudinal data: implications for the prevalence, pathophysiology, and diagnosis of osteoporosis. J Bone Miner Res Off J Am Soc Bone Miner Res 25(9):1948–1957. doi: 10.1002/jbmr.95 CrossRef
Sundberg M, Gardsell P, Johnell O, Ornstein E, Karlsson MK, Sernbo I (2003) Pubertal bone growth in the femoral neck is predominantly characterized by increased bone size and not by increased bone density—a 4-year longitudinal study. Osteoporos Int 14(7):548–558. doi: 10.1007/s00198-003-1406-3 CrossRefPubMed
Theintz G, Buchs B, Rizzoli R, Slosman D, Clavien H, Sizonenko PC, Bonjour JP (1992) Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab 75(4):1060–1065. doi: 10.1210/jcem.75.4.1400871 PubMed
Bouillon R, Rosen V, Rosen CJ, Compston JE (2013) Primer on the metabolic bone diseases and disorders of mineral metabolism, 8th edn. Wiley-Blackwell, Ames
Jackowski SA, Baxter-Jones AD, McLardy AJ, Pierson RA, Rodgers CD (2015) The associations of exposure to combined hormonal contraceptive use on bone mineral content and areal bone mineral density accrual from adolescence to young adulthood: a longitudinal study. Bone Reports
Cummings SR, Palermo L, Browner W, Marcus R, Wallace R, Pearson J, Blackwell T, Eckert S, Black D (2000) Monitoring osteoporosis therapy with bone densitometry: misleading changes and regression to the mean. Fracture intervention trial research group. JAMA 283(10):1318–1321. doi: 10.1001/jama.283.10.1318 CrossRefPubMed
Crabtree NJ, Arabi A, Bachrach LK, Fewtrell M, El-Hajj Fuleihan G, Kecskemethy HH, Jaworski M, Gordon CM, International Society for Clinical D (2014) Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD pediatric official positions. J Clin Densitom 17(2):225–242. doi: 10.1016/j.jocd.2014.01.003 CrossRefPubMed
- Changes and tracking of bone mineral density in late adolescence: the Tromsø Study, Fit Futures
Ole Andreas Nilsen
Luai Awad Ahmed
- Springer London
Neu im Fachgebiet Orthopädie und Unfallchirurgie
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