Bone strength and its determinants in pre- and early pubertal boys and girls

Macdonald, Heather M.; Kontulainen, Saija; Petit, Moira A.; Janssen, Patricia A.; McKay, Heather

doi:10.1016/j.bone.2006.02.057

Cited by 152 publications

(147 citation statements)

References 50 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…This unbalanced inclusion of males may have reduced the magnitude and significance of all of Ward's comparisons, as many of their analyses indicated smaller magnitudes for activity effects among males. Furthermore, other studies have reported sexual dimorphism in bone strength and other bone indices among pre-pubertal children (26,27). Nevertheless, considering methodological differences, our results appear to complement and corroborate the pQCT findings of Ward et al…”

Section: Discussionsupporting

confidence: 89%

Bone Geometry, Density, and Strength Indices of the Distal Radius Reflect Loading via Childhood Gymnastic Activity

Dowthwaite

Flowers

Spadaro

et al. 2007

Journal of Clinical Densitometry

View full text Add to dashboard Cite

The distal radius bears unique forces during gymnastic activity. Its relatively simple anatomy, minimal soft tissue envelope and varied composition make the distal radius ideal for evaluating the effects of loading on bone properties. For 56 premenarcheal gymnasts and non-gymnasts, ultradistal and 1/3 distal radius DXA scans measured bone mineral content (BMC), areal bone mineral density and projected area. Simplified geometric models were used to generate bone mineral apparent density (BMAD), geometric indices, strength indices and fall strength ratios. Ratios of regional BMC vs. total body fat free mass (FFM) were calculated. Separate Tanner I and II analyses of covariance adjusted bone parameters for age and height. Ratios were compared using maturity-matched analyses of variance. At the 1/3 region, periosteal width, BMC, cortical cross-sectional area, and section modulus were greater in gymnasts than non-gymnasts (p<0.05); 1/3 BMAD means were equivalent. Ultradistal BMAD, BMC and index for structural strength in axial compression were higher in gymnasts than non-gymnasts; ultradistal periosteal width was only larger in Tanner I gymnasts. Fall strength ratios and BMC/FFM ratios were greater in gymnasts (p<0.05). Geometric and volumetric responses to mechanical loading are site-specific during late childhood and early adolescence.The distal radius bears unique forces during gymnastic activity, and fan beam magnification error is negligible at this site, making it ideal for DXA evaluation of associated bone properties. For 56 premenarcheal gymnasts and non-gymnasts, ultradistal and 1/3 distal radius DXA scans measured bone mineral content, areal bone mineral density and projected area. Simplified geometric models were used to generate bone mineral apparent density, geometric indices, strength indices and fall strength ratios. Ratios of regional bone mineral content vs. total body fat free mass were calculated. Separate Tanner I and II analyses of covariance adjusted bone parameters for age and height. Ratios were compared using maturity-matched analyses of variance. At the 1/3 region, periosteal width, bone mineral content, cortical cross-sectional area, and section modulus were greater in gymnasts than non-gymnasts (p<0.05); 1/3 bone mineral apparent densities were equivalent. Gymnasts' ultradistal bone mineral apparent density, bone mineral content and index for structural strength in axial compression were higher; ultradistal periosteal width was only larger in Tanner I gymnasts. Fall strength ratios and bone mineral content vs. fat-free mass were greater in gymnasts (p<0.05). Gymnasts' geometric and volumetric responses to mechanical loading are site-specific during late childhood and early adolescence.

show abstract

Section: Discussionsupporting

confidence: 89%

Bone Geometry, Density, and Strength Indices of the Distal Radius Reflect Loading via Childhood Gymnastic Activity

Dowthwaite

Flowers

Spadaro

et al. 2007

Journal of Clinical Densitometry

View full text Add to dashboard Cite

show abstract

“…Multivariable linear regression was used to compare measures of bone quality between overweight and healthy-weight females and males. Similar to previous studies [31,37], we built our regression models in three steps. In Model 1, we compared bone quality of overweight and healthy-weight participants after adjusting for age, ethnicity (Asian or white), and limb length (tibia or ulna).…”

Section: Methodsmentioning

confidence: 99%

“…We included ethnicity in our models due to known differences in bone measures, particularly lower BMC in Asian children than in white children [6,36]. As in previous studies [31,32], we included limb length as an estimate of moment arm. In Model 2, we added LM as a surrogate of muscle force to the covariates in Model 1.…”

Section: Methodsmentioning

confidence: 99%

How Does Bone Quality Differ Between Healthy-weight and Overweight Adolescents and Young Adults?

Hoy¹,

Macdonald²,

McKay³

2013

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Overweight youth have greater bone mass than their healthy-weight peers but sustain more fractures. However, it is unclear whether and how excess body fat influences bone quality in youth. Questions/purposes We determined whether overweight status correlated with three-dimensional aspects of bone quality influencing bone strength in adolescent and young adult females and males. Methods We categorized males (n = 103; mean age, 17 years) and females (n = 85; mean age, 18 years) into healthy-weight and overweight groups. We measured lean mass (LM) and fat mass (FM) with dual-energy x-ray absorptiometry (DXA). We used high-resolution peripheral quantitative CT to assess the distal radius (7% site) and distal tibia (8% site). Bone quality measures included total bone mineral density (Tt.BMD), total area (Tt.Ar), trabecular bone volume fraction (BV/TV), trabecular number (Tb.N), separation (Tb.Sp), and thickness (Tb.Th). We used multiple regression to compare bone quality between healthy-weight and overweight adolescents adjusting for age, ethnicity, limb length, LM, and FM. Results Overweight males had higher (10%-21%) Tt.BMD, BV/TV, and Tb.N and lower Tb.Sp at the tibia and lower Tt.Ar at the radius than healthy-weight males. No differences were observed between overweight and healthy-weight females. LM attenuated the differences in bone quality between groups in males while FM negatively predicted Tt.BMD, BV/TV, Tb.N, and Tb.Th. Conclusions Our data suggest overweight males have enhanced bone quality compared with healthy-weight males; however, when group differences are interpreted in the context of the mechanostat theory, it appears bone quality of overweight adolescents adapts to LM and not to greater FM.

show abstract

“…28,29 The cBSI has been used in other studies to estimate the strength of the distal end of long bones. 29,30 Indeed, a human cadaver study showed that at the 4% tibial site, the cBSI is an excellent determinant of failure load, accounting for 85% of variance. 31 For the radius diaphysis (33% site), the variables of interest were ToA (square millimetres), cortical bone area (CoA; square millimetres), cortical bone mineral content (BMC; milligrams per centimetre), cortical vBMD (milligrams per cubic centimetre), and cortical thickness (millimetres).…”

Section: Peripheral Quantitative Computed Tomographymentioning

confidence: 99%

“…In addition, the polar stress-strain index (p-SSI; cubic millimetres) was also generated by the pQCT. The p-SSI is used to indicate bone strength against torsional loads in long bone shafts, 17,29,30,32 and the system computed it by using the following formula: 33…”

Section: Peripheral Quantitative Computed Tomographymentioning

confidence: 99%

Changes in Bone Density and Geometry of the Upper Extremities after Stroke: A Case Report

Pang

Yang

Lau

et al. 2012

Physiotherapy Canada

View full text Add to dashboard Cite

Purpose: The purpose of this study was to examine changes in bone density and geometry of the forearm region and motor function of the paretic upper extremity in a person with subacute stroke. Client Description: The participant was a 48-year-old man with right hemiparesis. Intervention: Not applicable. Measures and Outcomes: The assessment of upper-extremity (UE) function and bone imaging took place at 3 months and 12 months after stroke. The participant had moderate motor impairment and severe disuse of the paretic UE 3 months after stroke. During the follow-up period, no substantial change in paretic UE function was observed. At the 12 month follow-up, the areal bone mineral density (aBMD) of the ultradistal and mid-regions of the paretic forearm, as measured by dual-energy X-ray absorptiometry, sustained a significant reduction of 7.9% and 5.9%, respectively. The non-paretic side, in contrast, had a significant 4.0% increase in aBMD of the mid-forearm and a 2.8% increase in aBMD of the total forearm. Significant findings from peripheral quantitative computed tomography were a reduction in total volumetric bone mineral density (À12.1%) and bone strength index (À20.6%) in the radius distal epiphysis on the paretic side and an increase in cortical bone mineral content (2.0%) and bone strength index (7.6%) in the radius diaphysis on the non-paretic side. Implications: After a stroke that resulted in moderate to severe UE impairment, a significant decline in bone mineral density was identified in various skeletal sites in the forearm region as the participant entered the subacute and chronic stages of recovery. The results point to the potential importance of early rehabilitative intervention in preventing unfavourable bone changes in the paretic upper limb among individuals with stroke.Key Words: bone and bones; osteoporosis; muscles; rehabilitation; stroke. RÉ SUMÉObjectif : Examiner les changements dans la densité et la gé omé trie osseuses de la ré gion de l'avant-bras et la fonction motrice d'un membre supé rieur paré tique chez une personne ayant subi un AVC subaigu (participant A). Description du client : Le participant A est â gé de 48 ans avec hé miparé sie du cô té droit. Intervention : Ne s'applique pas. Mesures et ré sultats : L'é valuation de la fonction des membres supé rieurs et une imagerie osseuse ont é té ré alisé es 3 mois, puis 12 mois suivant l'AVC. Le participant A avait une incapacité motrice modé ré e et une dysfonction grave du membre supé rieur paré tique 3 mois aprè s l'AVC. Au cours de la pé riode de suivi, aucun changement particulier de la fonction du membre paré tique supé rieur n'a é té observé . Aprè s un suivi de 12 mois, la densité miné rale osseuse surfacique (aBMD) de la ré gion mé diane et ultradistale de l'avant-bras paré tique, telle que mesuré e par absorptiomé trie aux rayons X à double intensité (DXA) affichait une ré duction considé rable de 7,9 % et de 5,9 %, respectivement. Le cô té non paré tique, au contraire, affichait une augmentation de densité miné rale ...

show abstract

Bone strength and its determinants in pre- and early pubertal boys and girls

Cited by 152 publications

References 50 publications

Bone Geometry, Density, and Strength Indices of the Distal Radius Reflect Loading via Childhood Gymnastic Activity

Bone Geometry, Density, and Strength Indices of the Distal Radius Reflect Loading via Childhood Gymnastic Activity

How Does Bone Quality Differ Between Healthy-weight and Overweight Adolescents and Young Adults?

Changes in Bone Density and Geometry of the Upper Extremities after Stroke: A Case Report

Contact Info

Product

Resources

About