Abstract
Background: To explore associations between pubertal growth and later bone health in a cohort with infrequent measurements, using another cohort with more frequent measurements to support the modelling, data from the Medical Research Council (MRC) National Survey of Health and Development (2–26 years, 4901/30 004 subjects/measurements) and the Avon Longitudinal Study of Parents And Children (ALSPAC) (5–20 years) (10 896/74 120) were related to National Survey of Health and Development (NSHD) bone health outcomes at 60–64 years. Methods: NSHD data were analysed using Super-Imposition by Translation And Rotation (SITAR) growth curve analysis, either alone or jointly with ALSPAC data. Improved estimation of pubertal growth parameters of size, tempo and velocity was assessed by changes in model fit and correlations with contemporary measures of pubertal timing. Bone outcomes of radius [trabecular volumetric bone mineral density (vBMD) and diaphysis cross-sectional area (CSA)] were regressed on the SITAR parameters, adjusted for current body size. Results: The NSHD SITAR parameters were better estimated in conjunction with ALSPAC, i.e. more strongly correlated with pubertal timing. Trabecular vBMD was associated with early height tempo, whereas diaphysis CSA was related to weight size, early tempo and slow velocity, the bone outcomes being around 15% higher for the better vs worse growth pattern. Conclusions: By pooling NSHD and ALSPAC data, SITAR more accurately summarized pubertal growth and weight gain in NSHD, and in turn demonstrated notable associations between pubertal timing and later bone outcomes. These associations give insight into the importance of the pubertal period for future skeletal health and osteoporosis risk.
Highlights
Puberty is a time of dramatic change in body size and composition, driven by a complex hormonal cascade that results in rapid weight gain and height gain, the timing of which varies widely between individuals.[1]
We found that greater height and weight growth during ‘pre-puberty’ and ‘postpuberty’ were positively associated with bone size, a predictor of fracture risk, at 60–64 years
The weight curves differ materially after age 10 years, with the sole curves steeper before age 15 years and shallower after. This implies a real difference in the growth pattern between the two cohorts during and after puberty, even after the Super-Imposition by Translation And Rotation (SITAR) adjustment, with greater weight gain in Avon Longitudinal Study of Parents And Children (ALSPAC)
Summary
Puberty is a time of dramatic change in body size and composition, driven by a complex hormonal cascade that results in rapid weight gain and height gain, the timing of which varies widely between individuals.[1] Studies using questionnaire-derived data on recalled age at menarche, a discrete event during late puberty in girls, indicate that the timing of puberty is influenced by both genetic[2] and nongenetic factors, and that it has important relevance to later health outcomes.[3] the regulation of pubertal changes in weight and height, and in particular the relevance of these growth traits to later outcomes, is difficult to study, for two reasons: the need for serial growth measurements over much of the second decade of life, and the need for a suitable methodology to model and summarize the pattern of pubertal growth to relate it to later outcome An example of this arises in our recent report on the associations between childhood growth and bone outcomes at 60–64 years[4] in the Medical Research Council (MRC) National Survey of Health and Development (NSHD), a birth cohort born in one week in March 1946 and followed up over the subsequent 70 years.[5,6] We found that greater height and weight growth during ‘pre-puberty’ and ‘postpuberty’ were positively associated with bone size, a predictor of fracture risk, at 60–64 years. Trabecular vBMD was associated with early height tempo, whereas diaphysis CSA was related to weight size, early
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