Abstract
ABSTRACTThe onset of walking in early childhood results in exposure of the lower limb to substantial forces from weight bearing activity that ultimately contribute to adult bone strength. Relationships between gross motor score (GMS), at 18 months and bone outcomes measured at age 17 years were examined in 2327 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Higher GMS indicated greater motor competence in weight‐bearing activities. Total hip bone mineral density (BMD) and hip cross‐sectional moment of inertia (CSMI) were assessed from dual‐energy X‐ray absorptiometry (DXA). Bone measures including cortical bone mineral content (BMC), periosteal circumference (PC), cortical thickness (CT), cortical bone area (CBA), cortical BMD (BMDC) and cross‐sectional moment of inertia (CSMI) were assessed by peripheral quantitative computed tomography (pQCT) at 50% distal‐proximal length. Before adjustment, GMS was associated with hip BMD, CSMI, and tibia BMC, PC, CT, CBA and CSMI (all p < 0.001) but not BMDC (p > 0.25). Strongest associations (standardized regression coefficients with 95% CI) were between GMS and hip BMD (0.086; 95% CI, 0.067 to 0.105) and tibia BMC (0.105; 95% CI, 0.089 to 0.121). With the exception of hip BMD, larger regression coefficients were observed in males (gender interactions all p < 0.05). Adjustment for lean mass resulted in substantial attenuation of regression coefficients, suggesting associations between impaired motor competence and subsequent bone development are partly mediated by alterations in body composition. In conclusion, impaired motor competence in childhood is associated with lower adolescent bone strength, and may represent a risk factor for subsequent osteoporosis. © 2015 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).
Highlights
Bone is strongly influenced by the habitual strains to which it is exposed
The present analysis is based on 2327 Avon Longitudinal Study of Parents and Children (ALSPAC) offspring with complete measures, including perinatal data, a gross motor score (GMS) score at 18 months, ALSPAC Coordination Test (ACT) results at age 7 years, and peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) measures at age 17.8 years (Fig. 1)
Total body lean mass (LM) and muscle CSA were lower in at risk and impaired groups compared to controls, whereas no differences were seen for total body fat mass (FM) (Table 2)
Summary
Bone is strongly influenced by the habitual strains to which it is exposed. Due to the short levers muscles work with, muscular forces are the greatest stressors of bone.[1]. Greater bone mass and 100% greater torsional bone stiffness at 15 months than children who had yet to walk, despite no association between walking onset age and bone strength at birth. It is plausible, that early-life mobility and resultant bone loading may contribute directly to bone strength in childhood and adolescence, thereby representing a risk factor for subsequent osteoporosis. Growth velocity in early childhood is greater than at any other time of life,(3) including the pubertal growth spurt This period may represent an important time for bone mass accrual. Muscle and bone size are closely related to, even independent of, allometric scaling,(13) associations between motor competence and muscle size/lean mass (LM) remain unexplored
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