Subtotal Bone Mineral Density Research Articles

Association between dietary copper intake and bone mineral density in children and adolescents aged 8-19 years: A cross-sectional study.

Some studies showed the possible role of copper intake on bone mineral density (BMD) in adults or the elderly, but the association remained uncertain in children and adolescents. Our research explored the association between copper intake and BMD in individuals aged 8-19 years from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. In the present study, 6,965 individuals aged 8-19 (mean age 13.18 ± 3.38 years) were enrolled from the NHANES 2011-2016. Copper intake was evaluated by averaging two 24-hour copper dietary intake recalls. Multivariate linear regression analyses were used to explore the association between copper intake and total BMD, subtotal BMD, and total spine BMD in children and adolescents. Stratified analyses and interaction tests were performed by age, gender, and race. Participants of the higher quartile of copper intake were more likely to be older, men, Non-Hispanic White, and Other Hispanic. They have higher values of poverty income ratio (PIR), serum phosphorus, blood urea nitrogen, serum vitamin D, and BMD and lower values of body mass index (BMI), cholesterol, total protein, and serum cotinine. In the fully adjusted model, we found positive associations between copper intake and total BMD (β = 0.013, 95CI: 0.006, 0.019)), subtotal BMD (β = 0.020, 95CI: 0.015, 0.024), and total spine BMD (β = 0.014, 95CI: 0.009, 0.019). Stratified analyses showed that the association was stronger in men, individuals aged 14-19, Non-Hispanic White, and Other Hispanic. Our study suggests that copper intake is positively associated with BMD in U.S. children and adolescents. The study emphasizes the role of copper intake on bone health in the early stages of life. However, more investigations are needed to verify our findings and their underlying mechanisms.

The Association between Serum Copper and Bone Mineral Density among Adolescents Aged 12 to 19 in the United States.

Bone mineral density (BMD) is a key parameter widely used in the assessment of bone health. Although many investigations have explored the relationship between trace elements and BMD, there are fewer studies focused on serum copper and BMD, especially for adolescents. Using data extracted from the National Health and Nutrition Examination Survey, we applied a multiple-linear regression and smooth curve fitting to assess the relationship between serum copper and BMD. A total of 910 participants were finally included in this study. After adjusting for relevant covariates, serum copper was negatively associated with lumbar spine BMD (β = -0.057, 95% CI: -0.109 to -0.005), trunk bone BMD (β = -0.068, 95% CI: -0.110 to -0.026), pelvis BMD (β = -0.085, 95% CI: -0.145 to -0.024), subtotal BMD (β = -0.072, 95% CI: -0.111 to -0.033), and total BMD (β = -0.051, 95% CI: -0.087 to -0.016) (p < 0.05). In quartile analysis, the highest level of serum copper was associated with decreased BMD when compared with those at the lowest quartile (p < 0.05). The stratified analysis revealed a significant interaction between age and the effects of serum copper on trunk bone BMD (p = 0.022) and pelvis BMD (p = 0.018). Meanwhile, the higher level of serum copper was negatively associated with BMD in males, and gender modified the relationship (p < 0.001). Future longitudinal studies will be necessary for a more definitive interpretation of our results.

Do Serum 25-Hydroxyvitamin D Concentrations Affect Body Composition, Physical Fitness, Bone Strength and Bone Biomarkers in Female Children and Adolescent Football Players? A One-Season Study.

The aim was to compare changes in body composition, physical fitness, and bone biomarkers in female children and adolescent football players with different Vitamin D levels. Twenty-two players were classified into two groups according to 25(OH)D concentrations: 11 with deficient/insufficient 25(OH)D levels (IVD; <30 ng/mL) and 11 with sufficient 25(OH)D levels (SVD; ≥30 ng/mL). Body composition parameters were measured using dual-energy X-ray absorptiometry and a peripheral quantitative computed tomography scanner. The following physical fitness tests were applied: maximal isometric knee extension (MIF), long jump, 30-m sprint, and 20-m shuttle run test (VO2max). Electrochemiluminescence immunoassays were used to analyze bone biomarkers and 25(OH)D. All variables were registered at the beginning and the end of the football season. The increase in subtotal bone mineral density (BMD) was higher in players with SVD than those with IVD (p = 0.030). Only players with SVD improved their MIF of the left leg (p = 0.005); whereas, only players with IVD decreased their 30-m sprint performance (p = 0.007) and VO2max (p = 0.046). No significant between- and within-group differences were found for bone biomarkers. SVD might cause an extra improvement of subtotal BMD in female children and adolescent football players. Moreover, it seems that the 25(OH)D concentration could be an important parameter for physical fitness improvement in this population.

Association between bone mineral density and content and physical growth parameters among children and adolescents diagnosed with HIV: a cross-sectional study.

ABSTRACTBACKGROUND:During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD).OBJECTIVE:To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV).DESIGN AND SETTING:Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV.METHOD:BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05.RESULTS:Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates.CONCLUSION:Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

The Association between Lead Exposure and Bone Mineral Density in Childhood and Adolescence: Results from NHANES 1999-2006 and 2011-2018.

There are few studies on lead’s effect on bone mineral density (BMD) in childhood. In this study, we examined the association between lead exposure and BMD among 13,951 children and adolescents aged 8–19 years from NHANES 1999–2006 and 2011–2018. The whole blood lead levels (BLLs) were used as lead exposure biomarkers, and total BMD, subtotal BMD, lumbar spine BMD and limb BMD were used as outcome variables. The survey weighted multivariable generalized additive models (GAMs) with smoothing terms were used to explore the association between blood lead levels and BMDs, adjusted for age, sex, race/ethnicity, height, weight, family-income-to-poverty ratio and blood cadmium. Subgroup analyses stratified by sex and bony sites were further performed. We found an N-shaped curve association between BLLs and total BMD, subtotal BMD and limb BMD for males and females, whereas the association between BLLs and lumbar spine BMD was only significantly negative for females. The findings suggested that lead exposure had different effects on BMD of different bony sites (highly cortical or trabecular regions) in childhood and adolescence and had different effects on the same bone among different ages population and/or at different levels.

Association between handgrip strength and bone mass parameters in HIV-infected children and adolescents. A cross-sectional study.

Low bone mineral content (BMC) and bone mineral density (BMD) have been identified in human immunodeficiency virus (HIV)-infected children and adolescents. The direct adverse effects of HIV infection and combined antiretroviral therapy (ART) negatively contribute to bone metabolism. A direct relationship between muscle strength levels and BMD in HIV-infected adults and older adults has been described. However, it is unknown whether handgrip strength (HGS) is associated with bone mass in pediatric populations diagnosed with HIV. To ascertain whether HGS levels are associated with BMC and BMD in HIV-infected children and adolescents. Cross-sectional study conducted in Florianãpolis, Brazil, in 2016. The subjects were 65 children and adolescents (8-15 years) diagnosed with vertically-transmitted HIV. Subtotal and lumbar-spine BMC and BMD were obtained via dual-emission X-ray absorptiometry (DXA). HGS was measured using manual dynamometers. The covariates of sex, ART, CD4+ T lymphocytes and viral load were obtained through questionnaires and medical records. Sexual maturation was self-reported and physical activity was measured using accelerometers. Simple and multiple linear regression were used, with P < 0.05. HGS was directly associated with subtotal BMD (β = 0.002; R² = 0.670; P < 0.001), subtotal BMC (β = 0.090; R² = 0.734; P = 0.005) and lumbar-spine BMC (β = 1.004; R² = 0.656; P = 0.010) in the adjusted analyses. However, no significant association was found between HGS and lumbar-spine BMD (β = 0.001; R² = 0.464; P = 0.299). HGS was directly associated with BMD and BMC in HIV-infected children and adolescents.

Exploring the Relationships Among the Inflammatory Potential of the Diet, Bone Mineral Density, and Injury Incidence in Collegiate Athletes (P23-006-19)

ObjectivesThe relationship between the inflammatory potential of the diet, estimated by the Dietary Inflammatory Index (DII) score, and bone health has been studied in older populations and suggests that the diet can influence bone mineral density (BMD) and fracture risk. These relationships have yet to be explored in other potentially vulnerable populations, such as athletes, where risk of injuries may be more common due to high physical stresses and over-use. The aims of this study were 1) to examine the correlation between DII scores, and BMD in collegiate athletes, and 2) to assess the relationship between DII score and self-reported prior injury incidence. MethodsHealthy collegiate athletes (n = 43) were recruited for this study: football, n = 12; men’s soccer, n = 2; women’s soccer, n = 13; women’s swimming, n = 12; and women’s basketball, n = 4. For each athlete, three 24-hour dietary intakes were collected using a standardized multiple-pass interview methodology (Nutrition Data System for Research) and this data was used to calculate individual DII scores. Body composition, including whole-body sub-total BMD, was measured using dual-energy X-ray absorptiometry. A modified overuse injury questionnaire (Oslo Sports Trauma Research Centre) was used to assess incidence of injuries in the prior 12 months. ResultsThe participants (n = 14 male, n = 29 female) had a mean age of 19.4 ± 1.1 yrs and BMI of 25.8 ± 4.1 kg/m2. Mean DII score was −0.43 ± 0.17 points (range: −3.94 to 4.34). Mean BMD was 1.251 ± 0.169 g/cm2. Overall, DII score and BMD was not correlated (P = 0.47). Furthermore, DII scores of athletes that reported no prior injury did not differ from those who reported 1 or more injuries. ConclusionsUnlike research in postmenopausal women, it appears that bone health of young healthy athletes is less vulnerable to the influence of diets with higher inflammatory potential. Moreover, the lack of difference in DII score among athletes reporting various levels of prior injury suggests that the inflammatory potential of the diet is a poor predictor of injury risk in collegiate athletes. Funding SourcesN/A.

Analysis of bone mineral density and content in children with molar incisor hypomineralization using dual-energy X-ray absorptiometry scan: A pilot study.

The objective was to evaluate the bone mineral density (BMD) and bone mineral content (BMC) in children affected with molar incisor hypomineralization (MIH) using dual-energy X-ray absorptiometry (DEXA) scan. The study comprised a total of 30 children aged 6-10 years. Fifteen children were affected with MIH (moderate and severe variety) diagnosed using the European Academy of Paediatric Dentistry 2003 criteria, and remaining 15 children not affected with MIH serve as a control group. DEXA scan was done in all the selected children under standard conditions. A positive association was seen between childhood illness and MIH. The mean subtotal BMC (grams) in MIH and control group was 633 ± 80.05 and 670.33 ± 166.41, respectively, whereas mean subtotal BMD (g/m2) was 1.00 and 0.87 ± 0.35, respectively, with no statistically significant difference between two groups. BMD and BMC at the lumbar spine and thoracic spine locations were also did not vary significantly between MIH-affected children and controls. Childhood illnesses were more common in MIH-affected children compared to controls. Bone maturation parameters (BMD, BMC) do not differ between MIH affected and control children.

Bone Density in Children With Chronic Liver Disease Correlates With Growth and Cholestasis.

Osteopenia and bone fractures are significant causes of morbidity in children with cholestatic liver disease. Dual-energy X-ray absorptiometry (DXA) analysis was performed in children with intrahepatic cholestatic diseases who were enrolled in the Longitudinal Study of Genetic Causes of Intrahepatic Cholestasis in the Childhood Liver Disease Research Network. DXA was performed on participants aged >5 years (with native liver) diagnosed with bile acid synthetic disorder (BASD), alpha-1 antitrypsin deficiency (A1AT), chronic intrahepatic cholestasis (CIC), and Alagille syndrome (ALGS). Weight, height, and body mass index Z scores were lowest in CIC and ALGS. Total bilirubin (TB) and serum bile acids (SBA) were highest in ALGS. Bone mineral density (BMD) and bone mineral content (BMC) Z scores were significantly lower in CIC and ALGS than in BASD and A1AT (P < 0.001). After anthropometric adjustment, bone deficits persisted in CIC but were no longer noted in ALGS. In ALGS, height-adjusted and weight-adjusted subtotal BMD and BMC Z scores were negatively correlated with TB (P < 0.001) and SBA (P = 0.02). Mean height-adjusted and weight-adjusted subtotal BMC Z scores were lower in ALGS participants with a history of bone fractures. DXA measures did not correlate significantly with biliary diversion status. Conclusion: CIC patients had significant bone deficits that persisted after adjustment for height and weight and generally did not correlate with degree of cholestasis. In ALGS, low BMD and BMC reference Z scores were explained by poor growth. Anthropometrically adjusted DXA measures in ALGS correlate with markers of cholestasis and bone fracture history. Reduced bone density in this population is multifactorial and related to growth, degree of cholestasis, fracture vulnerability, and contribution of underlying genetic etiology.

The Association Between Body Composition, 25(OH)D, and PTH and Bone Mineral Density in Black African and Asian Indian Population Groups

There are few data on the contribution of body composition to bone mineral density (BMD) in non-Caucasian populations. We therefore studied the contribution of body composition, and possible confounding of 25-hydroxyvitamin D and PTH, to BMD at various skeletal sites in black African (BA) and Asian Indian (AI) subjects. This was a cross-sectional study in Johannesburg, South Africa. BMD, body fat, and lean mass were measured using dual x-ray absorptiometry and abdominal fat distribution by ultrasound in 714 healthy subjects, aged 18-65 years. Whole-body (subtotal), hip, femoral neck, and lumbar spine (lumbar) BMD were significantly higher in BA than AI subjects (P < .001 for all). Whole-body lean mass positively associated with BMD at all sites in both ethnic groups (P < .001 for all) and partially explained the higher BMD in BA females compared with AI females. Whole-body fat mass correlated positively with lumbar BMD in BA (P = .001) and inversely with subtotal BMD in AI subjects (P < .0001). Visceral adiposity correlated inversely with subtotal BMD in the BA (P = .037) and with lumbar BMD in the AI group (P = .005). No association was found between serum 25-hydroxyvitamin D and BMD. PTH was inversely associated with hip BMD in the BA group (P = .01) and with subtotal (P = .002), hip (P = .001), and femoral BMD (P < .0001) in the AI group. Significant differences in whole-body and site-specific BMD between the BA and AI groups were observed, with lean mass the major contributor to BMD at all sites in both groups. The contribution of other components of body composition differed by site and ethnic group.

Low-calcium dialysate as a risk factor for decline in bone mineral density in peritoneal dialysis patients

Few studies have linked changes in bone mineral density (BMD) in peritoneal dialysis (PD) patients to the calcium concentration in peritoneal dialysate. In total, 236 incident patients who underwent an annual BMD determination for 2 years were enrolled. The patients were divided into two groups: the standard calcium dialysate (SCD) group (n = 190; 1.75 mmol/l) and the low-calcium dialysate (LCD) group (n = 46; 1.25 mmol/l). There were no significant differences between the baseline demographics of the two groups, such as age, diabetes, calcium, phosphorus, alkaline phosphatase (ALP), intact parathyroid hormone (i-PTH) levels or variables related to BMD. Univariate and multivariate analyses [adjusted for age, gender and time-averaged 25(OH)-vitamin D] determined that the LCD group had higher time-averaged i-PTH and ALP and a greater decrease in bone mineral content, lumbar spine BMD, subtotal BMD and total BMD compared to the SCD group. LCD is associated with a more rapid decline in BMD, higher i-PTH and higher ALP in PD patients. It is suggested that LCD be avoided for PD patients at risk of osteoporosis and hyperparathyroidism.

Association between bone mineral density and C‐reactive protein in a large population‐based sample

Several studies suggest that bone mineral density (BMD) is reduced in chronic inflammatory diseases. Higher serum levels of C-reactive protein (CRP) have been associated with lower BMD in women and older adults. However, it is not clear whether this association holds in a representative sample of the general population. The purpose of this study was to examine the relationship between BMD and CRP level in a large representative US population-based sample from the National Health and Nutrition Examination Survey (NHANES). We included participants age ≥20 years with BMD (total and subregions) measured by dual x-ray absorptiometry scans and complete information on covariates from NHANES. The association between CRP level and BMD was evaluated using multivariate linear regression models, adjusting for potential confounders and further adjusting for comorbid diseases, medications, and serum vitamin D levels. The study sample included 10,475 participants (53% Caucasian, 22% Mexican American, 18% African American, and 7% other races). Men had higher BMD and lower CRP concentrations than women. BMD (total body BMD as well as subtotal BMD and BMD of the extremities, ribs, and trunk subregions) was inversely associated with quintiles of CRP concentration both in men and in women in a dose-dependent manner (for total BMD, P for trend < 0.0001 for men, P for trend = 0.0005 for women). The associations were independent of medications, comorbidities, and other potential confounders. The results remained largely unchanged with further adjustment for serum vitamin D levels. Among men and women in a large representative population-based sample, the CRP level was inversely and independently associated with total BMD in a dose-dependent manner.

Prognosis of osteopenia in chronic alcoholics

Osteoporosis is frequent among alcoholics all by a direct effect of ethanol, malnutrition, and liver failure. Therefore, it may be related to survival. The aim of this study was to assess bone mineral density (BMD), bone mineral content, hormonal status, and to determine prognostic value of these parameters in a total of 124 alcoholics followed up for a median period of 57 months. Several bone homeostasis-related hormones were measured in patients and age- and sex-matched controls. Whole-body densitometry was performed by a Hologic QDR-2000 (Waltham, MA) densitometer; nutritional status and liver function were assessed. Sixty patients underwent a second evaluation 6 months later. Patients showed lower serum insulin-like growth factor-1 (median = 58, interquartile range [IQR] = 33–135 vs. 135 ng/mL, IQR = 116–243 ng/mL, P < .001), vitamin D (25.5, IQR = 18.3–36.8 vs. 79.9 pg/mL, IQR = 59.2–107.8 pg/mL, P < .001), and osteocalcin (2.1, IQR = 1.1–4.5 vs. 6.5 ng/mL, IQR = 4.7–8.7 ng/mL, P < .001) than controls, and lower BMD values, and lower Z- and T-scores at right and left legs and arms, thoracic and lumbar spine, pelvis, and right and left ribs. By multiple regression analysis, BMD mainly depends on nutritional parameters and liver function. Kaplan–Meier curves show that subtotal BMD and BMD at both arms and pelvis were significantly related with survival. Patients who had lost total hip BMD after 6 months showed a shorter survival than those who had not, but using Cox’s regression, encephalopathy, ascites, and nutritional parameters displaced BMD as prognostic factor. Therefore, osteopenia ensues in chronic alcoholic patients. It mainly depends on poor nutrition and is related to survival, although surpassed in this sense by encephalopathy, ascites, and nutritional parameters.

Correlation trends for bone mineral density in Mexican women: evidence of familiar predisposition

Genetic factors determine bone mineral density (BMD) and peak bone density between 20 and 30 years of age, as well as bone mineral loss after menopause. BMD is a predictor of fractures due to osteoporosis and the impact of genetic factors on osteoporosis. The variation in BMD for each individual is determined by an underlying genetic structure, common genetic effects, particularly with respect to compact bones as compared to those that are primarily trabecular. This article presents the correlation of BMD by anatomical site among different samples of Mexican grandmothers, mothers and granddaughters of mixed race. The present analysis was performed of healthy employees and their healthy relatives from three different health and academic institutions: the Instituto Mexicano del Seguro Social and the Instituto Nacional de Salud Pública, both located in Cuernavaca, Morelos, as well as the Universidad Autónoma del Estado de México. We selected family-related female participants in order to obtain pairs of mothers and daughters and, whenever possible, grandmother-mother-daughter groups. We were able to match 591 mother-daughter pairs for analysis. Additionally, we were able to include grandmothers to create grandmother-mother-daughter triads for further analysis. Bone density measurements were performed of the non-dominant proximal femur, the lumbar spine (L1-L4) and the whole body using a dual X-ray absorptiometry (DXA) Lunar DPX NT instrument. This study included 591 granddaughters, 591 mothers and 69 grandmothers; mean ages were 20, 47 and 72 years old, respectively. A close relationship existed with respect to body mass index (BMI) between mothers and grandmothers (27.9 vs. 27.3). The largest proportion of body fat mass was observed in the group of mothers (28.5%), but was also high in grandmothers (25.7%) and granddaughters (21.1%). The percentage of lean body mass was similar among the three family groups. The correlation of BMD between mothers and grandmothers was greatest for subtotal BMD (0.44) and was very high for the hips (0.39). Using predictive models for hip BMD among grandmothers, mothers and grandchildren, we observed that hip BMD of grandmothers is a predictor of BMD in mothers, with a beta of 0.46 (p 0.001, CI95% 0.19-0.73); (R(2): 0.41). A predictor of BMD of the lumbar spine in grandchildren is BMD of the lumbar spine in mothers (beta 0.30 CI95% 0.07-0.53). The results obtained in this study suggest that daughters whose mothers have a low BMD for their age will tend to develop the same condition. This indicates the importance of monitoring for girls and adolescent females whose mothers have problems related to osteopenia or osteoporosis. It will therefore be necessary to conduct studies to identify the most significant genes and specific anatomical sites among our population for the purpose of establishing the polymorphic variants for high-risk in the Mexican population.