Bone Mineral Density In Girls Research Articles

Association of total body fat and fat distribution with bone mineral density among children and adolescents aged 6-17years from Guangzhou, China.

This study aimed to assess the associations of total body fat and fat distribution with bone mineral density (BMD) among children and adolescents in this cross-sectional study. A total of 1032 boys and 897 girls aged 6-17years were enrolled between May 2019 and June 2019 in Guangzhou, China. BMD, total body fat (fat mass index [FMI] and body fat percentage [BF%]), and fat distribution (trunk-to-limb and android-to-gynoid ratios) were measured by dual-energy X-ray absorptiometry. Inverse probability of treatment weighting regression was used to explore the association between fat and BMD. Traditional regression of covariate adjustment was applied as sensitivity analysis. Regression with inverse probability weighting suggested BF% and android-to-gynoid ratio were negatively associated with BMD in boys (β = - 0.12 and - 0.16, respectively; P < 0.05). Android-to-gynoid ratio was also inversely associated with BMD in girls (β = - 0.08, P < 0.05). When stratified by age, the negative associations were retained in boys aged 12-17years (β = - 0.23 and - 0.25, respectively; P < 0.001). But for girls, it showed a positive association of FMI with BMD in the 6-9years group (β = 0.33, P < 0.001) and a negative association between the android-to-gynoid ratio and BMD in the 10-17years group (β = - 0.10, P < 0.05). Traditional regression supported the robustness of the results. Conclusion: Total body fat is positively associated with BMD in younger girls but inversely associated in older boys. As for abdominal adipose, it is associated with lower BMD in both older boys and girls. What is Known: • The lean mass has been consistently positively associated with bone mineral density (BMD) among children and adolescents. However, the impact of fat mass on BMD remained controversial. • Beyond total body fat, site-specific fat mass, especially abdominal adiposity, might impede bone formation. What is New: • The associations of total body fat and fat distribution with BMD in children and adolescents were gender- and age-specific. • More attention should be paid to the abdominal fat accumulation to promote bone health in older children.

The relationship between chemerin, bone metabolism, the RANKL/RANK/OPG system, and bone mineral density in girls with anorexia nervosa

Based on recent studies in humans, chemerin has been classified as an adipokine that might be associated with osteoporosis and BMD. Bone loss is common in adolescents with anorexia nervosa (AN). Moreover, dysfunction in the production of chemerin has also been shown. Therefore, we carried out a comparative analysis between chemerin, bone metabolism, the RANKL/RANK/OPG system, and BMD in girls with AN. Plasma chemerin, OC, CTx, OPG, and sRANKL were determined by ELISA in 75 girls with AN aged 12.6-17.8 years. BMD was assessed by DXA and expressed as Z-score according to the lumbar spine (s) and total body (TB) sites. According to the s-BMD- and TB-BMD Z-score, girls with AN were divided into two subgroups with parallel analyses used: normal (Z-score > -2.0) and low (Z-score ≤ -2.0) s-BMD, and normal (Z-score > -2.0) and low (Z-score ≤ -2.0) TB-BMD. Mean OC and the OPG/sRANKL ratio were markedly lower in the low s-BMD subgroup compared to the normal s-BMD subgroup. The s-Z-score values (both low and normal) correlated significantly and positively with the OPG/sRANKL ratio. Only in the low s-BMD subgroup did chemerin correlate significantly and positively with all nutritional indices and the OPG/sRANKL ratio. In the low TB-BMD subgroup the mean OC and the OPG/sRANKL ratio were lower than in the normal TB-BMD subgroup. The TB-Z-score values (both normal and low) correlated significantly and positively with all nutritional indices and the OPG/sRANKL ratio. The low TB-Z-score values correlated significantly and positively also with chemerin. In the low TB-BMD subgroup chemerin correlated significantly and positively with weight and BMI (expressed as absolute values), Cole index, the duration of the disease, and OPG/sRANKL ratio while its correlation with age was negative. Undernutrition and associated deficit of adipose tissue may result in inadequate chemerin production and skeletal disorders in girls with AN. Chemerin acts as a coordinator of the dynamic balance between bone metabolism and the OPG/RANK/RANKL system and, in turn, may contribute to the loss of bone mass in girls with AN. The cortical bone site seems to be more severely responsive to chemerin actions than the trabecular bone site.

The relationship of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with bone mineral density in adolescent girls suffering from anorexia nervosa

Introduction: Inflammation is supposed to be one of the factors contributing to decreased bone mineral density (BMD) in anorexia nervosa (AN). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple and cost-effective inflammatory markers, well documented as indicators of postmenopausal osteoporosis. This study aimed to assess the relationships between these ratios and BMD in girls with AN. Material and methods: The electronic records of 73 girls hospitalized for AN were analysed retrospectively. The age range of the study group was 12.56–17.67 years. BMD was assessed by dual-energy X-ray absorptiometry (DXA) and expressed as Z-scores according to lumbar spine (s-BMD) and total body (TB-BMD) sites. NLR and PLR were calculated according to complete blood count results. Patients were divided into 2 subgroups with parallel analyses — according to the TB-BMD criterion and the s-BMD criterion: normal (Z-score &gt; –2.0, n = 63) and low s-BMD subgroup (Z-score ≤ –2.0, n = 10), and normal (Z-score &gt; –2.0, n = 45) and low TB-BMD subgroup (Z-score ≤ –2.0, n = 28). Results: In the low s-BMD subgroup a tendency to an increase of mean NLR, PLR, and WBC values was observed. Respective BMD Z-score values correlated significantly and negatively with PLR in the low s-BMD (R = –0.892, p &lt; 0.001) and normal TB-BMD (R = –0.451, p = 0.002) subgroups, while with NLR only in the normal TB-BMD subgroup (R = –0.685, p &lt; 0.001). In the low s-BMD subgroup the PLR was shown to be a significant and independent predictor of s-BMD (β = –0.881, p &lt; 0.001). The PLR contributed to 77.6% of the s-BMD Z-score variability (R 2 = 0.776, p &lt; 0.001). In the normal TB-BMD subgroup, the PLR and NLR levels were significant and independent predictors of TB-BMD (β = –0.352, p = 0.004; β = –0.450, p = 0.001; β = –0.339, p = 0.005, respectively) and explained 44.4% of TB-BMD Z-score variability (R 2 = 0.444, p &lt; 0.001). Conclusions: These results indicate that there might be a relationship between bone mass loss and inflammation expressed as NLR and PLR in adolescent girls suffering from AN. These connections seem to be dependent on the examined skeletal area. NLR and PLR, which are common indicators of morbidity and mortality in many malignancies and inflammatory chronic diseases, can also be useful in the evaluation of bone condition in adolescent females with AN. However, there is a need for further investigation in this field.

A Comparison of Lumbar Spine and Lateral Distal Femur Bone Density in Girls With Rett Syndrome

Introduction/Background: Patients with Rett syndrome (RS) are at risk for low bone mineral density (BMD) and femoral fractures. In patients with RS, assessment with lateral distal femur (LDF) dual-energy X-ray absorptiometry (DXA) is recommended and clinically relevant. This study is the first to assess LDF BMD in girls with RS, and to compare LDF BMD results with lumbar spine BMD results in RS. Method Eleven girls (mean age 8.4 yr) with molecularly diagnosed RS and clinical DXA scan(s) were identified; medical charts were retrospectively reviewed. Baseline and serial lumbar spine and LDF BMD Z-scores were evaluated based on patients’ ambulation status, presence of epilepsy, and mutation type. Results At the time of first scan, 8 of 11 patients had normal lumbar spine BMD and low LDF BMD Z-scores. Two patients had fracture history. Fully ambulatory (3) patients had higher lumbar spine and LDF BMD than partially (5) and nonambulatory (3) patients. Patients with epilepsy had lower average BMD at all sites. No difference was seen in lumbar spine or LDF BMD in patients with high-risk BMD mutations. Seven patients had serial DXA scans with an average observation of 5.1 yr (range 3.1 yr to 6.2 yr). Lumbar spine BMD over time was variable, while LDF bone mass accrual occurred at a lower rate than typically developing girls. Conclusion Females with RS exhibited lower BMD Z-scores at the LDF than at the lumbar spine. LDF and lumbar spine results were discordant. Ambulatory status and the presence of epilepsy were related to BMD. LDF BMD accrual deviated from normal as patients aged.

Relationship between serum level of growth differentiation factors 8, 11 and bone mineral density in girls with anorexia nervosa.

Adolescents with anorexia nervosa (AN) have low body mass and low bone mineral density (BMD). Growth differentiation factor 8 (Myostatin, GDF8) and its homologue growth differentiation factor 11 (GDF11), members of the TGF-β super-family, play an important role in muscle regeneration and bone metabolism in healthy individuals. However, their association with BMD in AN is unknown. The present study was undertaken to investigate the relationship between GDF8, GDF11 and BMD in adolescent girls with AN. Serum GDF8, GDF11 and BMD were determined in 25 girls (12-16years old) with AN and 31 healthy girls (12-16years old). Growth differentiation factor 8 levels were lower in AN subjects. On the contrary, GDF11 levels were higher in AN subjects than controls. There was no relationship between GDF8 and BMD. A significant negative correlation between GDF11 and BMD was found. In multiple linear stepwise regression analysis, BMI, 25-hydroxyvitamin D, GDF11, or lean mass, but not fat mass and GDF8, were independent predictors of BMD in the AN and control groups separately. Growth differentiation factor 11 was independent predictor of BMD in girls with AN. It suggested that GDF11 exerts a negative effect on bone mass.

Are consumption of dairy products and physical activity independently related to bone mineral density of 6-year-old children? Longitudinal and cross-sectional analyses in a birth cohort from Brazil.

To evaluate cross-sectional and longitudinal associations of consumption of dairy products and physical activity (PA) with bone mineral density (BMD). Cohort study with children from the 2004 Pelotas (Brazil) Birth Cohort. Pelotas, a medium-sized Brazilian city. The study started in 2004 and mothers/children were interviewed/measured periodically from birth to age 6 years. PA was measured by maternal proxy at 4 and 6 years and by accelerometry at 6 years. Consumption of dairy products was measured using 24 h food recall (at 4 years) and FFQ (at 6 years). Total-body and lumbar-spine BMD (g/cm2) were measured by dual-energy X-ray absorptiometry. At 6 years, BMD was measured in 3444 children and 2636 children provided data on objectively measured PA by accelerometry. Consumption of dairy products at 4 years was associated with higher lumbar-spine BMD at 6 years in boys, while current consumption was positively associated with BMD in both sexes (P < 0·001). PA assessed by maternal report at 4 and 6 years of age was associated with higher BMD at 6 years in boys. PA assessed by accelerometry was positively related to total-body and lumbar-spine BMD in boys and lumbar-spine BMD in girls. We did not find evidence for an interaction between PA and consumption of dairy products on BMD. We observed positive and independent longitudinal and cross-sectional associations between consumption of dairy products and PA with BMD in the total body and at the lumbar spine in young children.

Bone mineral density in girls with Turner's syndrome

Bone mineral density in girls with Turner's syndrome

Serum 25(OH)vitamin D level and Its correlation with bone mineral density in girls with Adolescent Idiopathic Scoliosis (AIS)

Objectives AIS is associated with both low bone mass and elevated serum bone alkaline phosphatase. It was also reported the prevalence of AIS was positively correlated with the latitude of the geographical region. These specific features were compatible with the presence of either Vit-D insufficiency or abnormal physiology with Vit-D. It is important to evaluate these potentially treatable conditions regarding their roles in the etiopathogenesis of AIS. The objectives of this case-control study were to evaluate Vit-D status and its correlation with areal bone mineral density (aBMD) in AIS subjects and normal controls.

Vitamin D status and its correlation with bone mineral density in girls with adolescent idiopathic scoliosis (AIS)

Vitamin D status and its correlation with bone mineral density in girls with adolescent idiopathic scoliosis (AIS)

Influence of physical activity and skeleton geometry on bone mass at the proximal femur in 10- to 12-year-old children--a longitudinal study.

Physical activity (PA) have long been identified as a determining factor of the mineralization of the skeleton, particularly in children. Our research supports the hypothesis that the geometry of the pelvis and proximal femur (PF) might moderate the effect of PA in the relative mineralization of the PF subregions. Using a longitudinal observational study with two evaluations and a 1-year follow-up interval, we investigated the influence of PA and skeletal geometry in bone mineral density (BMD) and bone mass distribution at the PF in 96 girls and 81 boys (10-12 years). It is plausible that the geometry of the pelvis-PF structure moderates mechanical forces exerted at the hip and therefore creates different degrees of mineralization among PF subregions. Whole body and left hip dual X-ray absorptiometry scans were used to derive geometric measures of the pelvis-inter-acetabular distance (IAD) and PFabductor lever arm (ALA). BMD was measured at the integral, superolateral (SL), and inferomedial (IM) femoral neck (FN), and at the trochanter (TR). These subregions were used to represent bone mass distribution via three BMD ratios: FN/PF, IM/SL, and TR/PF. PA was measured using accelerometry and a bone-specific PA questionnaire (BPAQ). A longitudinal data approach revealed BPAQ as a positive predictor for all BMD variables (p < 0.05) except TR BMD in girls and FN BMD in boys. Comparing the most active with the less-active participants, the greatest benefits of PA were observed at the FN of the girls with the lowest IAD (p < 0.001), at the FN of the boys with the highest IAD (p < 0.001) and at the TR of the boys with the lowest ALA (p < 0.01). Geometric measures of IAD and ALA seem to moderate the effect of PA role in the relative mineralization of the PF regions. On the other hand, absolute BMD levels appear to be determined by mechanical loading.

Bone mineral density in girls with functional hypothalamic amenorrhea subjected to estroprogestagen treatment: a 4-year prospective study

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Transcription Factor Runx2 in the Low Bone Mineral Density of Girls with Adolescent Idiopathic Scoliosis

The molecular mechanism of low bone mass in girls with adolescent idiopathic scoliosis (AIS) has not been ascertained. Runx2 is a critical transcription factor regulating osteoblast differentiation and maturation. The present study aimed to explore the possible relationship between Runx2 expression in osteoblasts and bone mineral density (BMD) in subjects with AIS. Twenty-two girls with AIS scheduled to corrective surgery with iliac crest as donor site of autograft for spinal fusion were recruited. The BMD of lumbar spine and femoral neck were assessed by dual-energy X-ray absorptiometry, then patients were divided into two groups with either normal or reduced BMD. Cancellous bone was harvested from their iliac crests for primary culture of osteoblasts. mRNA and protein expression of Runx2 were assayed by reverse transcription-polymerase chain reaction and western blotting, respectively. Results were compared between the two groups and correlated with BMD. AIS patients with normal BMD showed comparable maturity and body mass index but significant lower Cobb angle of main curve than those of patients with reduced BMD. The mean BMD of lumbar spine and femoral neck were 0.993 g/m(2) and 0.911 g/m(2) in patients with normal BMD, and were 0.757 g/m(2) and 0.733 g/m(2) in those with reduced BMD, respectively. The differences were significant between two groups (P < 0.05). The relative mean mRNA and protein expression of Runx2 were 0.49 ± 0.12 and 0.062 ± 0.020 in AIS with normal BMD, 0.35 ± 0.12 and 0.042 ± 0.006 in AIS with reduced BMD, respectively. Significantly lower Runx2 mRNA and protein expression were found in patients with AIS patients with reduced BMD than in those with normal BMD (P < 0.05). After controlling for age, weight and body mass index, positive correlations were found between Runx2 expression of both mRNA and protein and BMD of lumbar spine and femoral neck. The abnormal expression of Runx2 in patients with AIS and reduced BMD indicates abnormal regulation of differentiation of their osteoblasts. Runx2 may play an important role in the pathogenesis of reduced BMD in patients with AIS.

Inhibition of Pref‐1 (preadipocyte factor 1) by oestradiol in adolescent girls with anorexia nervosa is associated with improvement in lumbar bone mineral density

Adolescents with anorexia nervosa (AN) are amenorrheic and have decreased bone mass accrual and low bone mineral density (BMD). The regulation of mesenchymal stem cell differentiation is an important factor governing bone formation. Preadipocyte factor 1 (Pref-1), an inhibitor of adipocyte and osteoblast differentiation, is elevated in states of oestrogen deficiency. In this study, we aim to (i) investigate effects of transdermal oestradiol on Pref-1 in adolescent girls with AN, and (ii) examine associations of changes in Pref-1 with changes in lumbar BMD and bone turnover markers. Adolescent girls with AN and normal-weight controls were studied cross-sectionally. Girls with AN were examined longitudinally in a double-blind study and received transdermal oestradiol (plus cyclic medroxyprogesterone) or placebo for 12 months. Sixty-nine girls (44 with AN, 25 normal-weight controls) 13-18 years were studied at baseline; 22 AN girls were followed prospectively. Pref-1 levels, bone formation and resorption markers, and BMD. Pref-1 levels decreased in girls with AN after treatment with transdermal oestradiol compared with placebo (-0·015 ± 0·016 vs 0·060±0·026 ng/ml, P = 0·01), although at baseline, levels did not differ in AN vs controls (0·246 ± 0·015 vs 0·267 ± 0·022 ng/ml). Changes in Pref-1 over 12 months correlated inversely with changes in lumbar BMD (r = -0·48, P = 0·02) and positively with changes in CTX (r = 0·73, P = 0·006). For the first time, we show that Pref-1 is negatively regulated by oestradiol in adolescent girls with AN. Inhibition of Pref-1 may mediate the beneficial effects of transdermal oestradiol replacement on BMD in girls with AN.

Long-term prospective evaluation of the effects of estroprogestagen therapy on the bone mineral density of girls with Turner syndrome carrying variousPvuIIANDXbaIpolymorphisms of ER-α

Long-term prospective evaluation of the effects of estroprogestagen therapy on the bone mineral density of girls with Turner syndrome carrying various<i>PvuII</i>AND<i>XbaI</i>polymorphisms of ER-α

Prospective study of bone mineral density in girls treated with estroprogestagens for functional hypothalamic amenorrhea during late puberty in relation to the polymorphism of VDR (BsmI), ER (PvuII; Xba I), and COLIA1 genes

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Sex Specific Association of Physical Activity on Proximal Femur BMD in 9 to 10 Year-Old Children

The results of physical activity (PA) intervention studies suggest that adaptation to mechanical loading at the femoral neck (FN) is weaker in girls than in boys. Less is known about gender differences associated with non-targeted PA levels at the FN or other clinically relevant regions of the proximal femur. Understanding sex-specific relationships between proximal femur sensitivity and mechanical loading during non-targeted PA is critical to planning appropriate public health interventions. We examined sex-specific associations between non-target PA and bone mineral density (BMD) of three sub-regions of the proximal femur in pre- and early-pubertal boys and girls. BMD at the FN, trochanter (TR) and intertrochanter (IT) regions, and lean mass of the whole body were assessed using dual-energy x-ray absorptiometry in 161 girls (age: 9.7±0.3 yrs) and 164 boys (age: 9.7±0.3 yrs). PA was measured using accelerometry. Multiple linear regression analyses (adjusted for body height, total lean mass and pubertal status) revealed that vigorous PA explained 3–5% of the variability in BMD at all three sub-regions in boys. In girls, vigorous PA explained 4% of the variability in IT BMD and 6% in TR BMD. PA did not contribute to the variance in FN BMD in girls. An additional 10 minutes per day of vigorous PA would be expected to result in a ∼1% higher FN, TR, and IT BMD in boys (p<0.05) and a ∼2% higher IT and TR BMD in girls. In conclusion, vigorous PA can be expected to contribute positively to bone health outcomes for boys and girls. However, the association of vigorous PA to sub-regions of the proximal femur varies by sex, such that girlś associations are heterogeneous and the lowest at the FN, but stronger at the TR and the IT, when compared to boys.

Relationship between serum omentin-1 level and bone mineral density in girls with anorexia nervosa.

Adolescents with anorexia nervosa (AN) have low bone mineral density (BMD). Omentin- 1, the main circulating adipocytokine, plays an important role in bone metabolism in healthy individuals. However, their association with bone metabolism in AN is unknown. Serum omentin-1, bone turnover biochemical markers, and BMD were determined in 26 girls with AN and 24 healthy girls (15-18 years old). Omentin-1 levels increased in AN subjects, and the differences became greater after controlling for fat mass. Omentin-1 was negatively correlated with BMD. In the multiple linear stepwise regression analysis, omentin-1, body mass index and lean mass, but not fat mass, were independent predictors of BMD for the combined group. Significant negative correlations were found between omentin-1 and bone-specific alkaline phosphatase, bone cross-linked N-telopeptides of type I collagen. Omentin-1 was also independently associated with BMD and bone turnover markers in the AN and control groups considered separately. Omentin-1 was an independent predictor of BMD in adolescents with AN, and negatively correlated with bone turnover markers. This suggested that omentin-1 may exert a negative effect on bone mass by inhibiting bone formation in girls with AN.

Bone mineral density and body composition in girls with idiopathic central precocious puberty before and after treatment with a gonadotropin-releasing hormone agonist

OBJECTIVES:Idiopathic central precocious puberty and its postponement with a (gonadotropin-releasing hormone) GnRH agonist are complex conditions, the final effects of which on bone mass are difficult to define. We evaluated bone mass, body composition, and bone remodeling in two groups of girls with idiopathic central precocious puberty, namely one group that was assessed at diagnosis and a second group that was assessed three years after GnRH agonist treatment.METHODS:The precocious puberty diagnosis and precocious puberty treatment groups consisted of 12 girls matched for age and weight to corresponding control groups of 12 (CD) and 14 (CT) girls, respectively. Bone mineral density and body composition were assessed by dual X-ray absorptiometry. Lumbar spine bone mineral density was estimated after correction for bone age and the mathematical calculation of volumetric bone mineral density. CONEP: CAAE-0311.0.004.000-06.RESULTS:Lumbar spine bone mineral density was slightly increased in individuals diagnosed with precocious puberty compared with controls; however, after correction for bone age, this tendency disappeared (CD = -0.74±0.9 vs. precocious puberty diagnosis = -1.73±1.2). The bone mineral density values of girls in the precocious puberty treatment group did not differ from those observed in the CT group.CONCLUSION:There is an increase in bone mineral density in girls diagnosed with idiopathic central precocious puberty. Our data indicate that the increase in bone mineral density in girls with idiopathic central precocious puberty is insufficient to compensate for the marked advancement in bone age observed at diagnosis. GnRH agonist treatment seems to have no detrimental effect on bone mineral density.

Lumbar spine and proximal femur BMD values in Turkish girls and the effect of precocious puberty on BMD.

Previous studies have shown no impairment in bone mineral density in girls with precocious and early puberty. The aim of this study was to evaluate the effect of precocious puberty on BMD and to measure average bone mineral density in Turkish girls. Fourteen girls between the ages of 5-10 (7.57 ± 1.83 year) who had new diagnosed precocious and early puberty were included in this study. BMD was measured in the posterior-anterior projection at the lumbar spine and at the right hip using DEXA. Correlation analysis was performed among BMD in all sub-regions. According to age, new average BMD values of sub-regionals in lumbar spine and proximal femur were calculated by linear regression formula leading to an average value of the lumbar spine total BMD in normal population. According to new average ± SD BMD of all sub-regions, simulated new Z-scores of each girl in proximal femur and lumbar spine were calculated and statistically compared. We found significant Z-score correlation between proximal femur and lumbar spine (r=0.70 – 0.99). According to age, new average values of sub-regional BMD in lumbar vertebrae and proximal femoral sub-regions in Turkish girls were presented. Average spinal BMD values in Turkish girls were similar with western countries. We though that DEXA scan at lumbar spine, with the exception of some patients, may be enough for an accurate measurement in children.

P2-199 Association between adherence to the mediterranean diet and bone quality in a sample of Portuguese adolescents

IntroductionDietary patterns provide insights into how diet, rather than specific nutrients, affects bone health. We aimed to evaluate whether Mediterranean diet associates with bone mineral density at 13 years-old.MethodsWe used...