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Body composition in childhood influenced bone strength, potentially fractures
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The relationship between bone strength and fat mass may differ at weight-bearing compared with nonweight-bearing sites in children and adolescents, according to research published in The Journal of Clinical Endocrinology & Metabolism.
During growth, distal radius strength does not increase equitably with excessive weight gain, which could cause a mismatch between bone strength and load during a fall and would explain why forearm fractures are over-represented in children with obesity, according to researchers.
“Our findings highlight the importance of lean mass for optimizing bone strength during growth, and suggest that the highly integrated nature of the musculoskeletal system is established early in life,” the researchers wrote.
Joshua N. Farr, PhD, of the Mayo Clinic College of Medicine, Rochester, Minn., and colleagues examined appendicular lean mass (ALM) and total body fat mass (TBFM) in relation to bone strength (failure load) at the distal radius and tibia in a cross-sectional study of 198 healthy children (109 boys, 89 girls) aged 8 to younger than 15 years.
The researchers assessed bone strength through micro-finite element analysis of high-resolution peripheral quantitative computed tomography. They used multiple linear regression analyses in boys and girls, separately, with adjustments for bone age, height, fracture history, ALM and TBFM.
Strong positive associations were observed between ALM and failure loads at the distal radius (boys: beta=0.92, P<.001; girls: beta=0.66, P=.001) and tibia (boys: beta=0.96, P<.001; girls: beta=0.66, P<.001).
Conversely, the relationship between TBFM and failure load at the distal radius was nearly nonexistent (boys: beta=–0.07; P=.284; girls: beta=–0.03; P=.729) in both boys and girls.
At the distal tibia, positive but weak associations were seen between TBFM and failure load in boys (beta=0.09, P=.075) and girls (beta=0.17, P=.033).
Disclosure: One researcher reports serving on a scientific advisory board for Merck and another for Amgen and Bone Therapeutics. This work was supported by NIH grants.
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