Oliver Helen, Jameson Karen A, Sayer Avan Aihie, Cooper Cyrus, Dennison Elaine M
MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK.
Bone. 2007 Sep;41(3):400-5. doi: 10.1016/j.bone.2007.05.007. Epub 2007 May 31.
Infant growth is a determinant of adult bone mass, and poor childhood growth is a risk factor for adult hip fracture. Peripheral quantitative computed tomography (pQCT) allows non-invasive assessment of bone strength. We utilised this technology to examine relationships between growth in early life and bone strength. We studied 313 men and 318 women born in Hertfordshire between 1931 and 1939 who were still resident there in adult life, for whom detailed early life records were available. Lifestyle factors were evaluated by questionnaire, anthropometric measurements made, and peripheral QCT examination of the radius and tibia performed (Stratec 4500). Birthweight and conditional weight at 1 year were strongly related to radial and tibial length in both sexes (p<0.001) and to measures of bone strength [fracture load X, fracture load Y, polar strength strain index (SSI)] at both the radius and tibia. These relationships were robust to adjustment for age, body mass index (BMI), social class, cigarette and alcohol consumption, physical activity, dietary calcium intake, HRT use, and menopausal status in women. Among men, BMI was strongly positively associated with radial (r=0.46, p=0.001) and tibial (r=0.24, p=0.006) trabecular bone mineral density (BMD). Current smoking was associated with lower cortical (radius: p=0.0002; tibia: p=0.08) and trabecular BMD (radius: p=0.08; tibia: p=0.04) in males. Similar trends of BMD with these anthropometric and lifestyle variables were seen in women but they were non-significant. Current HRT use was associated with greater female cortical (radius: p=0.0002; tibia: p=0.001) and trabecular (radius: p=0.008; tibia: p=0.04) BMD. Current HRT use was also associated with greater radial strength (polar SSI: p=0.006; fracture load X: p=0.005; fracture load Y: p=0.02) in women. Women who had sustained any fracture since the age of 45 years had lower radial total (p=0.0001), cortical (p<0.005) and trabecular (p=0.0002) BMD, poorer forearm bone strength [polar SSI (p=0.006), fracture load X and Y (p=0.02)], and lower tibial total (p<0.001), cortical (p=0.008), and trabecular (p=0.0001) BMD. We have shown that growth in early life is associated with bone size and strength in a UK population aged 65-73 years. Lifestyle factors were associated with volumetric bone density in this population.
婴儿期生长是成人骨量的一个决定因素，儿童期生长不良是成人髋部骨折的一个危险因素。外周定量计算机断层扫描（pQCT）可对骨强度进行无创评估。我们利用这项技术来研究生命早期生长与骨强度之间的关系。我们研究了1931年至1939年在赫特福德郡出生、成年后仍居住在那里且有详细早期生活记录的313名男性和318名女性。通过问卷调查评估生活方式因素，进行人体测量，并对桡骨和胫骨进行外周QCT检查（Stratec 4500）。出生体重和1岁时的条件体重与男女的桡骨和胫骨长度均密切相关（p<0.001），也与桡骨和胫骨的骨强度指标[骨折负荷X、骨折负荷Y、极强度应变指数（SSI）]密切相关。这些关系在对年龄、体重指数（BMI）、社会阶层、吸烟和饮酒、身体活动、饮食钙摄入量、激素替代疗法（HRT）使用情况以及女性绝经状态进行调整后依然稳固。在男性中，BMI与桡骨（r = 0.46，p = 0.001）和胫骨（r = 0.24，p = 0.006）的小梁骨矿物质密度（BMD）呈强正相关。当前吸烟与男性较低的皮质骨（桡骨：p = 0.0002；胫骨：p = 0.08）和小梁骨BMD（桡骨：p = 0.08；胫骨：p = 0.04）相关。在女性中也观察到了BMD与这些人体测量和生活方式变量的类似趋势，但不显著。当前使用HRT与女性较高的皮质骨（桡骨：p = 0.0002；胫骨：p = 0.001）和小梁骨（桡骨：p = 0.008；胫骨：p = 0.04）BMD相关。当前使用HRT还与女性较高的桡骨强度（极SSI：p = 0.006；骨折负荷X：p = 0.005；骨折负荷Y：p = 0.02）相关。45岁以后发生过任何骨折的女性，其桡骨总BMD（p = 0.0001）、皮质骨（p < 0.005）和小梁骨（p = 0.0002）较低，前臂骨强度[极SSI（p = 0.006）、骨折负荷X和Y（p = 0.02）]较差，胫骨总BMD（p < 0.001）、皮质骨（p = 0.008）和小梁骨（p = 0.0001）也较低。我们已经表明，生命早期生长与英国65 - 73岁人群的骨大小和强度相关。生活方式因素与该人群的体积骨密度相关。
