Centre for Child and Adolescent Health and Academic Rheumatology, Southmead Hospital, University of Bristol, United Kingdom.
Am J Clin Nutr. 2011 Dec;94(6 Suppl):1861S-1864S. doi: 10.3945/ajcn.110.001495. Epub 2011 Apr 27.
We examined associations between proxy measures of in utero nutrition and total body bone mineral content (BMC), bone area (BA), and bone mineral density (BMD) assessed at age 9.9 y in the Avon Longitudinal Study of Parents and Children (ALSPAC). There were positive relations between birth weight and BMC, BA, and BMD. These associations were explained by the co-association of birth weight with body size in later childhood. In height- and weight-adjusted analyses, an inverse association was observed between birth weight and BMD at age 9.9 y, which suggests that birth weight had a negative influence on bone mass after relations with bone and body size were taken into account. In analyses of associations between bone mass at age 9 y and background ultraviolet B exposure during the third trimester of pregnancy (a proxy measure for maternal vitamin D status), maternal ultraviolet B exposure was positively related to BMC, BA, and BMD. After adjustment for height, these associations were only partially attenuated, which suggests that maternal ultraviolet B exposure affected skeletal size and mass independently of longitudinal growth, possibly by the increase of periosteal expansion. There was a positive relation between maternal folate intake and BMD of the spine subregion independent of body size. Although a co-association with folate intake in childhood could explain this relation, the maternal methylenetetrahydrofolate reductase (MTHFR) genotype affected spine BMD independently of the child MTHFR genotype, which suggests that maternal folate status has an independent effect on bone development of offspring. Together, these results confirm that there is a relation between bone development in childhood and several proxy measures for nutritional status in utero.
我们研究了孕期替代指标与 9.9 岁时总身体骨矿物质含量（BMC）、骨面积（BA）和骨密度（BMD）之间的关联，这些指标在阿冯纵向父母和子女研究（ALSPAC）中进行了评估。出生体重与 BMC、BA 和 BMD 呈正相关。这些关联可以通过出生体重与儿童后期身体大小的共同关联来解释。在身高和体重调整分析中，观察到出生体重与 9.9 岁时的 BMD 呈负相关，这表明出生体重在考虑到骨骼和身体大小的关系后对骨量有负面影响。在分析 9 岁时的骨量与妊娠第三个月背景紫外线 B 暴露（母体维生素 D 状况的替代指标）之间的关联时，母体紫外线 B 暴露与 BMC、BA 和 BMD 呈正相关。在调整身高后，这些关联仅部分减弱，这表明母体紫外线 B 暴露独立于纵向生长影响骨骼大小和质量，可能通过增加骨膜扩张来实现。母体叶酸摄入量与脊柱子区域的 BMD 呈正相关，独立于身体大小。虽然与儿童时期叶酸摄入量的共同关联可以解释这种关系，但母体亚甲基四氢叶酸还原酶（MTHFR）基因型独立于儿童 MTHFR 基因型影响脊柱 BMD，这表明母体叶酸状况对后代骨骼发育有独立影响。总之，这些结果证实了儿童期骨骼发育与几种孕期营养状况的替代指标之间存在关联。
