Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.
Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, VIC, Australia.
J Bone Miner Res. 2020 Sep;35(9):1652-1659. doi: 10.1002/jbmr.4044. Epub 2020 Jul 8.
We have found that early-life exposures are associated with areal bone mineral density (aBMD) at ages 8 and 16 years. This study aimed to assess whether these associations persist into young adulthood when peak bone mass (PBM) is achieved and extend this analysis to microarchitecture. Participants were followed from perinatal period to 25 years old (n = 201). Outcomes were total body, spine, and hip aBMD (by dual-energy X-ray absorptiometry [DXA]), and cortical and trabecular bone measures at the distal radius and tibia (by high-resolution peripheral quantitative computed tomography [HRpQCT]). Early-life exposures including breastfeeding, maternal smoking during pregnancy, and birth weight. Sex, weight, height, vegetables, fruit and calcium intake at age 25 years were regarded as potential confounders in the analysis. There were significant interactions between period of gestation and early-life exposures for bone measures, so all analyses were stratified by period of gestation. Breastfeeding was beneficially associated with hip and total body aBMD, total, cortical and trabecular volumetric BMD (vBMD), cortical thickness, porosity, trabecular number (Tb.N), separation (Tb.Sp), and bone volume fraction (Tb.BV/TV) at radius and/or tibia at age 25 years in participants born prematurely (β ranged from -0.92 to 0.94), but there were no associations in those born at term. Maternal smoking had no association with any DXA/HRpQCT measures in those born prematurely but was detrimentally associated with inner transitional zone porosity and Tb.N (β = 0.40 and β = -0.37, respectively) in those full-term participants. Associations of birth weight with bone measures did not persist after adjustment for weight gain since birth. Breastfeeding was associated with a lower risk of lower limb fractures and maternal smoking had a deleterious association with upper limb fractures. In conclusion, breastfeeding and maternal smoking may have effects on peak bone microarchitecture whereas the association with birth weight is countered by subsequent growth. © 2020 American Society for Bone and Mineral Research.
我们发现，生命早期暴露与 8 岁和 16 岁时的骨矿物质密度（aBMD）有关。本研究旨在评估这些关联是否在达到峰值骨量（PBM）的成年早期持续存在，并将这一分析扩展到微观结构。参与者从围产期一直随访到 25 岁（n=201）。结果是全身、脊柱和髋部 aBMD（通过双能 X 射线吸收测定法[DXA]），以及桡骨和胫骨远端的皮质和小梁骨测量（通过高分辨率外周定量计算机断层扫描[HRpQCT]）。生命早期的暴露包括母乳喂养、孕妇怀孕期间吸烟和出生体重。25 岁时的性别、体重、身高、蔬菜、水果和钙摄入量被认为是分析中的潜在混杂因素。骨量的孕期和生命早期暴露之间存在显著的相互作用，因此所有分析都按孕期进行分层。在早产儿（β范围为-0.92 至 0.94）中，母乳喂养与髋部和全身 aBMD、总、皮质和小梁体积 BMD（vBMD）、皮质厚度、孔隙率、小梁数量（Tb.N）、分离（Tb.Sp）和骨体积分数（Tb.BV/TV）呈正相关，而在足月出生的参与者中则没有相关性。母亲吸烟与早产儿出生时的任何 DXA/HRpQCT 测量均无关联，但与足月出生的参与者的内过渡区孔隙率和 Tb.N 呈负相关（β=0.40 和β=-0.37）。出生体重与骨量的关联在出生后体重增加调整后不再持续。母乳喂养与下肢骨折风险降低相关，而母亲吸烟与上肢骨折有不利关联。总之，母乳喂养和母亲吸烟可能对峰值骨微观结构有影响，而与出生体重的关联则被随后的生长所抵消。2020 年美国骨与矿物研究协会。
