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Total body bone mineral content and tibial cortical bone measures in preschool children
B L Specker1, N Johannsen, T Binkley
1E.A. Martin Program in Human Nutrition, South Dakota State University, Brookings 57007, USA.
Insights
Childhood obesity may negatively impact bone development, leading to lower bone mineral content. Premature birth is also associated with reduced bone mass, warranting further investigation in diverse populations.
Area of Science:
- Pediatric Bone Health
- Childhood Obesity Research
- Growth and Development Studies
Background:
- Bone development in early childhood is crucial for lifelong skeletal health.
- Factors influencing bone mass accretion in preschool-aged children require further elucidation.
- Understanding the impact of prematurity on bone metrics is essential for early intervention.
Purpose of the Study:
- To identify key factors affecting total body bone area (TBBA), total body bone mineral content (TBBMC), and tibial cortical bone measures in 3-5-year-old children.
- To investigate the relationship between body composition, diet, physical activity, and bone parameters.
- To examine the influence of preterm birth on bone development.
Main Methods:
- Cross-sectional study involving 239 children aged 3-5 years.
- Collection of demographic, anthropometric, dietary, physical activity, and strength data.
- Multiple regression analysis to determine correlations between variables and bone measures (TBBA, TBBMC, tibial cortical bone).
Main Results:
- TBBA positively correlated with height, weight, and calcium intake, but inversely with percent body fat.
- TBBMC correlated with TBBA and weight, but inversely with height and percent body fat.
- Children born preterm exhibited lower TBBMC, greater endosteal circumference, and lower cortical bone area compared to term-born children.
Conclusions:
- High body fat in preschool children is linked to higher TBBA but lower TBBMC, suggesting potential undermineralization and negative effects of obesity on bone mass.
- Lower tibial periosteal circumference in heavier, higher-body-fat children indicates a potential biomechanical disadvantage.
- Preterm birth is associated with reduced TBBMC and cortical bone area, necessitating confirmation in other populations and further research into potential causes like activity differences.
Abstract:
This study was undertaken to identify factors that influence total body bone area (TBBA), total body bone mineral content (TBBMC), and tibial cortical bone measures in 239 children aged 3-5 years. We obtained information on demographic and anthropometric characteristics and measurements of diet, physical activity, and strength. In multiple regression analysis, TBBA correlated with height (p < 0.001), weight (p < 0.001), percent body fat (p < 0.001), and calcium intake (p = 0.02). TBBMC correlated with TBBA (p < 0.001), age (p = 0.001), and weight (p = 0.02) and inversely correlated with height (p < 0.001) and percent body fat (p < 0.001). Children born preterm had lower TBBMC compared with children born at term (p = 0.02). Both periosteal and endosteal circumferences were correlated with weight (both,p < 0.001) and inversely correlated with age (p = 0.006 and p = 0.003, respectively) and percent body fat (p = 0.002 and p = 0.005 respectively). Endosteal circumference was greater and cortical bone area was lower in children born preterm compared with those born at term (both, p = 0.04). Findings of higher TBBA and lower TBBMC in children with high percent body fat indicate undermineralization of bone and suggest that obesity in preschool children may have detrimental effects on total body bone mass accretion. A smaller tibial periosteal circumference and thus cross-sectional area in children with the same weight but higher percent body fat also would lead to a biomechanical disadvantage in these children. Findings of low TBBMC and cortical bone area among children born preterm need to be confirmed in other populations. We speculate that differences in these measurements between children born preterm and at term may be caused by differences in activity.