Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland.
Psychology/Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland.
Paediatr Perinat Epidemiol. 2022 Sep;36(5):665-672. doi: 10.1111/ppe.12876. Epub 2022 Mar 25.
Children and adults born very low birthweight (VLBW, <1500 g) at preterm gestations have lower bone mineral density (BMD) and/or bone mineral content (BMC) than those born at term, but causality remains unknown.
Our aim was to assess BMD and BMC in adults born at VLBW in a sibling comparison setting to account for shared genetic and environmental confounders.
We conducted a cohort study of 77 adults born VLBW and 70 same-sex term-born siblings at mean age of 29 years. The primary outcome variables were BMD Z-scores, and BMC, of the femoral neck, lumbar spine, and whole body, measured using dual-energy X-ray absorptiometry. We analysed data by linear mixed models.
The VLBW adults had a 0.25 (95% CI 0.02, 0.47) Z-score unit lower femoral neck BMD, and 0.35 (95% CI 0.16, 0.54) grams lower femoral neck BMC than their term-born siblings, after adjustment for sex, age, and maternal smoking. Additional adjustment for adult body size attenuated the results. Lumbar spine, and whole body BMC were also lower in the VLBW group.
Individuals born at VLBW had lower BMC values at all three measurement sites, as well as lower femoral neck BMD Z-scores, compared to term-born siblings, partly explained by their smaller adult body size, but the differences were smaller than those reported previously with unrelated controls. This suggests that genetic or environmental confounders explain partly, but not exclusively, the association between preterm VLBW birth and adult bone mineralisation.
与足月出生的儿童和成人相比，极低出生体重（VLBW，<1500g）早产儿的骨矿物质密度（BMD）和/或骨矿物质含量（BMC）较低，但因果关系尚不清楚。
本研究旨在通过同胞比较设计评估极低出生体重成年患者的 BMD 和 BMC，以排除遗传和环境混杂因素的影响。
本队列研究纳入了 77 名极低出生体重的成年患者和 70 名同性别足月出生的同胞，平均年龄为 29 岁。主要结局变量为使用双能 X 线吸收法测量的股骨颈、腰椎和全身的 BMD Z 评分和 BMC。我们通过线性混合模型对数据进行分析。
校正性别、年龄和母亲吸烟状况后，极低出生体重组的成年患者的股骨颈 BMD 比同胞低 0.25（95%CI 0.02，0.47）Z 评分单位，股骨颈 BMC 低 0.35（95%CI 0.16，0.54）克。进一步校正成年人体型后，结果减弱。极低出生体重组的腰椎和全身 BMC 也较低。
与足月出生的同胞相比，极低出生体重组的成年患者在三个测量部位的 BMC 值均较低，股骨颈 BMD Z 评分也较低，部分原因是其成人体型较小，但与以前使用无关联对照的研究相比，差异较小。这表明遗传或环境混杂因素部分解释了早产儿极低出生体重与成年骨矿化之间的关联，但并非完全解释。
