Tracking of Areal Bone Mineral Density From Age Eight to Young Adulthood and Factors Associated With Deviation From Tracking: A 17-Year Prospective Cohort Study

Abstract

We have previously shown that bone mineral density (BMD) tracks strongly from age 8 to 16 years. This study aimed to describe whether this strong tracking continued to age 25 years and describe factors associated with deviation from tracking. Ninety-nine participants were followed from age 8 to 25 years and 197 participants from age 16 to 25 years. Outcomes measured were BMD at the spine, hip, and total body (by dual-energy X-ray absorptiometry [DXA]). Other factors measured were anthropometrics, inhaled corticosteroids (ICS) use, history of being breastfed, sports participation, fitness (by physical work capacity [PWC ]), lean mass (LM), and fat mass (FM) (by DXA). There was moderate to strong tracking of BMD from age 8 to 25 years (correlation coefficients: males, 0.59 to 0.65; females, 0.70 to 0.82) and strong tracking from age 16 to 25 years (males, 0.81 to 0.83; females, 0.84 to 0.88) after adjustment for change in body size. From age 8 to 25 years, 54% to 56% of participants kept their BMD tertile position. PWC at age 8 years, relative and absolute change in LM, and sports participation at age 25 years predicted males would improve their tertile position or remain in the highest tertile of spine or hip BMD. However, relative and absolute change in FM had the opposite association in males while absolute change in FM predicted positive deviation in females. From age 16 to 25 years, LM, PWC , sports participation at age 16 years, and change in LM, PWC , and sports participation at age 25 years predicted positive deviation in males. LM at age 16 years was positively associated and PWC negatively associated with positive deviation in females. BMD tracks from childhood to early adulthood in both males and females. There appears to be greater capacity to alter tracking before age 16 years. Increasing LM in both sexes and improving fitness and sports participation in males during growth might be effective strategies to improve BMD in early adulthood. © 2017 American Society for Bone and Mineral Research.

A Comprehensive Review of Bone Health in a Child: From Birth to Adulthood

“…Breastfeeding at a young age and having lean body mass have been shown to push children into higher BMD quantiles. 4,13 Furthermore, smoking and hormone levels contribute to fracture incidence.…”

“…With early recognition and appropriate intervention, children are not destined to track within a low-BMD quantile for the remainder of their growth. 13…”

Early Life Programming of Skeletal Health

“…There is evidence of moderate to high tracking (maintenance of the relative position of an individual within the population distribution over time) of BMD through childhood, puberty and into young adulthood [ 11 , 12 ]. This might partly reflect a genetic tendency as osteoporosis has high heritability and numerous loci associated with BMD have been identified in genome-wide association studies (GWAS) [ 13 ].…”

The association between weight-adjusted-waist index and total bone mineral density in adolescents: NHANES 2011–2018

“…Childhood and adolescence represent critical phases for bone development, with bone mass typically peaking in late adolescence ( 5 , 6 ). Numerous studies have shown that bone mineral density (BMD) is traceable from childhood to adolescence and into adulthood ( 7 , 8 ). Consequently, bone metabolism during childhood and adolescence plays a vital role in preventing OP in later life ( 9 ).…”