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Published on: January 29, 2018
Infant programming of bone size and bone mass in 10-year-old black and white South African children
Linda Vidulich1, Shane A Norris, Noël Cameron
1MRC Mineral Metabolism Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa. vanderlingen.linda@kendle.com
Insights
Early life factors like low birth weight and infancy size impact bone mass in children. This study in South Africa suggests these early indicators predict bone mineral content, potentially influencing later osteoporosis risk.
Area of Science:
- Pediatric bone health and osteoporosis risk assessment.
- Longitudinal growth and development studies.
Background:
- Low birth weight and infant size are known risk factors for low bone mass and osteoporosis in developed countries.
- The association between early life factors and bone health in developing countries and in black populations remains unclear.
Purpose of the Study:
- To investigate the relationship between birth weight (BW), weight and length at 1 year (WT1, LT1), and bone size and bone mineral content (BMC) at age 10 years in a South African cohort.
- To determine if early life growth indicators predict bone mass independently of skeletal growth tracking.
Main Methods:
- A longitudinal cohort study of 476 children (black and white, boys and girls) born in Johannesburg in 1990.
- Bone area (BA) and BMC measurements of the whole body, femoral neck, and lumbar spine were performed using dual-energy X-ray absorptiometry (DXA) at age 10.
- Statistical analysis adjusted for multiple covariates including race, gender, age, socioeconomic status, bone age, height, and weight at 10 years.
Main Results:
- Adjusted WT1, LT1, and BW were significant predictors of whole body bone area and bone mineral content.
- WT1, LT1, and BW were also significant predictors of femoral neck BMC.
- Even after adjusting BMC for BA, BW, WT1, and LT1 remained predictive of femoral neck BMC, suggesting an independent association not solely explained by skeletal growth tracking.
Conclusions:
- Compromised intrauterine and first-year growth, reflected by low birth weight and small size at 1 year, are associated with smaller bones and lower bone mineral content at the femoral neck in children.
- These findings support the hypothesis that early life growth influences long-term bone health and may be linked to osteoporosis risk later in life.
- Bone mineral content at 10 years is independently associated with weight and length at 1 year, indicating lasting effects beyond typical growth patterns.
Abstract:
In developed countries, the earliest of factors shown to identify those at a high risk of having low bone mass and so be prone to osteoporosis in later life is that of quality of early life reflected by low birthweight (BW) and size in infancy. It is unclear whether such relationships exist in developing countries and in black populations. Associations were studied between BW, weight (WT1) and length (LT1) at 1 year and bone size and bone mass in 476 children (boys: 182 black, 72 white; girls: 158 black, 64 white) aged 10 years, who formed part of a longitudinal cohort of children born in Johannesburg, South Africa, during 1990. Bone area (BA) and bone mineral content (BMC) measurements were made of the whole body, femoral neck and lumbar spine (L1-L4) by dual-energy X-ray absorptiometry (DXA). After adjusting BA and BMC for race, gender, age, socio-economic status, bone age, height and weight at 10 years, on which BA and BMC in children are so dependent, WT1, LT1 and BW were significant predictors of whole body BA (WT1, P < 0.0001; LT1, P < 0.01; BW, P < 0.05) and BMC (WT1, P < 0.01; LT1, P < 0.05; BW, P < 0.05) and of BMC of the femoral neck (WT1, P < 0.01; LT1, P < 0.05). When BMC was in addition corrected for BA, then BW, WT1 and LT1 were predictive of femoral neck BMC (BW, P < 0.05; WT1, P < 0.05; LT1, P < 0.01) but not whole body BMC. Thus, BMC at 10 years appears to be independently associated with weight and length at 1 year, which is not completely mediated by the tracking of skeletal growth. Low BW and small size at 1 year resulted in smaller bones and/or bones of lower BMC at the femoral neck. The findings support the hypothesis that growth and development, both intrauterine and in the first year, which are measures of genetic, intrauterine and postnatal environmental factors, may have long-term consequences when compromised, and may be associated with the risk of osteoporosis in later life.
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