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Open Access 01-12-2017 | Original Article

Changes and tracking of bone mineral density in late adolescence: the Tromsø Study, Fit Futures

Authors: Ole Andreas Nilsen, Luai Awad Ahmed, Anne Winther, Tore Christoffersen, Anne-Sofie Furberg, Guri Grimnes, Elaine Dennison, Nina Emaus

Published in: Archives of Osteoporosis | Issue 1/2017

Abstract

Summary

Areal bone mineral density (aBMD) predicts future fracture risk. This study explores the development of aBMD and associated factors in Norwegian adolescents. Our results indicate a high degree of tracking of aBMD levels in adolescence. Anthropometric measures and lifestyle factors were associated with deviation from tracking.

Purpose

Norway has one of the highest reported incidences of hip fractures. Maximization of peak bone mass may reduce future fracture risk. The main aims of this study were to describe changes in bone mineral levels over 2 years in Norwegian adolescents aged 15–17 years at baseline, to examine the degree of tracking of aBMD during this period, and to identify baseline predictors associated with positive deviation from tracking.

Methods

In 2010–2011, all first year upper secondary school students in Tromsø were invited to the Fit Futures study and 1038 adolescents (93%) attended. We measured femoral neck (FN), total hip (TH), and total body (TB) aBMD as g/cm² by DXA. Two years later, in 2012–2013, we invited all participants to a follow-up survey, providing 688 repeated measures of aBMD.

Results

aBMD increased significantly (p < 0.05) at all skeletal sites in both sexes. Mean annual percentage increase for FN, TH, and TB was 0.3, 0.5, and 0.8 in girls and 1.5, 1.0, and 2.0 in boys, respectively (p < 0.05). There was a high degree of tracking of aBMD levels over 2 years. In girls, several lifestyle factors predicted a positive deviation from tracking, whereas anthropometric measures appeared influential in boys. Baseline z-score was associated with lower odds of upwards drift in both sexes.

Conclusions

Our results support previous findings on aBMD development in adolescence and indicate strong tracking over 2 years of follow-up. Baseline anthropometry and lifestyle factors appeared to alter tracking, but not consistently across sex and skeletal sites.

Kanis JA, Oden A, McCloskey EV, Johansson H, Wahl DA, Cooper C, Epidemiology IOFWGo, Quality of L (2012) A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporos Int 23(9):2239–2256. doi:10.1007/s00198-012-1964-3 CrossRefPubMedPubMedCentral

Cooper C, Westlake S, Harvey N, Javaid K, Dennison E, Hanson M (2006) Review: developmental origins of osteoporotic fracture. Osteoporos Int 17(3):337–347. doi:10.1007/s00198-005-2039-5 CrossRefPubMed

Baxter-Jones AD, Faulkner RA, Forwood MR, Mirwald RL, Bailey DA (2011) Bone mineral accrual from 8 to 30 years of age: an estimation of peak bone mass. J Bone Miner Res Off J Am Soc Bone Miner Res 26(8):1729–1739. doi:10.1002/jbmr.412 CrossRef

Rizzoli R, Bianchi ML, Garabedian M, McKay HA, Moreno LA (2010) Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone 46(2):294–305. doi:10.1016/j.bone.2009.10.005 CrossRefPubMed

Bailey D (1997) The Saskatchewan Pediatric Bone Mineral Accrual Study: bone mineral acquisition during the growing years. Int J Sports Med 18:S191–S194CrossRefPubMed

Weaver C, Gordon C, Janz K, Kalkwarf H, Lappe J, Lewis R, O’Karma M, Wallace T, Zemel B (2016) The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int 27(4):1281–1386CrossRefPubMedPubMedCentral

Karlsson MK, Linden C, Karlsson C, Johnell O, Obrant K, Seeman E (2000) Exercise during growth and bone mineral density and fractures in old age. Lancet 355(9202):469–470CrossRefPubMed

Seeman E, Karlsson MK, Duan Y (2000) On exposure to anorexia nervosa, the temporal variation in axial and appendicular skeletal development predisposes to site-specific deficits in bone size and density: a cross-sectional study. J Bone Miner Res Off J Am Soc Bone Miner Res 15(11):2259–2265. doi:10.1359/jbmr.2000.15.11.2259 CrossRef

Fujita Y, Iki M, Ikeda Y, Morita A, Matsukura T, Nishino H, Yamagami T, Kagamimori S, Kagawa Y, Yoneshima H (2011) Tracking of appendicular bone mineral density for 6 years including the pubertal growth spurt: Japanese population-based osteoporosis kids cohort study. J Bone Miner Metab 29(2):208–216. doi:10.1007/s00774-010-0213-0 CrossRefPubMed

10.

Kalkwarf HJ, Gilsanz V, Lappe JM, Oberfield S, Shepherd JA, Hangartner TN, Huang X, Frederick MM, Winer KK, Zemel BS (2010) Tracking of bone mass and density during childhood and adolescence. J Clin Endocrinol Metab 95(4):1690–1698. doi:10.1210/jc.2009-2319 CrossRefPubMedPubMedCentral

11.

Foley S, Quinn S, Jones G (2009) Tracking of bone mass from childhood to adolescence and factors that predict deviation from tracking. Bone 44(5):752–757. doi:10.1016/j.bone.2008.11.009 CrossRefPubMed

12.

Wren TA, Kalkwarf HJ, Zemel BS, Lappe JM, Oberfield S, Shepherd JA, Winer KK, Gilsanz V, Bone Mineral Density in Childhood Study G (2014) Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents: persistence of low bone mass to maturity. J Pediatr 164(6):1280–1285 . doi:10.1016/j.jpeds.2013.12.040e1282CrossRefPubMedPubMedCentral

13.

Budek A, Mark T, Michaelsen KF, Mølgaard C (2010) Tracking of size-adjusted bone mineral content and bone area in boys and girls from 10 to 17 years of age. Osteoporos Int 21(1):179–182CrossRefPubMed

14.

Gafni RI, Baron J (2007) Childhood bone mass acquisition and peak bone mass may not be important determinants of bone mass in late adulthood. Pediatrics 119(Suppl 2):S131–S136. doi:10.1542/peds.2006-2023D CrossRefPubMed

15.

Buttazzoni C, Rosengren BE, Tveit M, Landin L, Nilsson JA, Karlsson MK (2014) A pediatric bone mass scan has poor ability to predict adult bone mass: a 28-year prospective study in 214 children. Calcif Tissue Int 94(2):232–239. doi:10.1007/s00223-013-9802-y CrossRefPubMed

16.

Buttazzoni C, Rosengren BE, Karlsson C, Dencker M, Nilsson JA, Karlsson MK (2015) A pediatric bone mass scan has poor ability to predict peak bone mass: an 11-year prospective study in 121 children. Calcif Tissue Int 96(5):379–388. doi:10.1007/s00223-015-9965-9 CrossRefPubMed

17.

Jacobsen BK, Eggen AE, Mathiesen EB, Wilsgaard T, Njolstad I (2012) Cohort profile: the Tromso Study. Int J Epidemiol 41(4):961–967. doi:10.1093/ije/dyr049 CrossRefPubMed

18.

Healthcare G (2010) Lunar enCORE Referansesupplement. vol Revisjon 1

19.

Omsland TK, Gjesdal CG, Emaus N, Tell GS, Meyer HE (2009) Regional differences in hip bone mineral density levels in Norway: the NOREPOS study. Osteoporos Int 20(4):631–638. doi:10.1007/s00198-008-0699-7 CrossRefPubMed

20.

Petersen AC, Crockett L, Richards M, Boxer A (1988) A self-report measure of pubertal status: reliability, validity, and initial norms. J Youth Adolesc 17(2):117–133. doi:10.1007/BF01537962 CrossRefPubMed

21.

Grimby G, Borjesson M, Jonsdottir IH, Schnohr P, Thelle DS, Saltin B (2015) The “Saltin-Grimby Physical Activity Level Scale” and its application to health research. Scand J Med Sci Sports 25(Suppl 4):119–125. doi:10.1111/sms.12611 CrossRefPubMed

22.

Emaus A, Degerstrom J, Wilsgaard T, Hansen BH, Dieli-Conwright CM, Furberg AS, Pettersen SA, Andersen LB, Eggen AE, Bernstein L, Thune I (2010) Does a variation in self-reported physical activity reflect variation in objectively measured physical activity, resting heart rate, and physical fitness? Results from the Tromso Study. Scand J Public Health 38(5 Suppl):105–118. doi:10.1177/1403494810378919 CrossRefPubMed

23.

Hosmer DW, Lemeshow S, Sturdivant RX (2013) Applied logistic regression, Wiley series in probability and statistics, 3rd edn. Wiley, HobokenCrossRef

24.

Berger C, Goltzman D, Langsetmo L, Joseph L, Jackson S, Kreiger N, Tenenhouse A, Davison KS, Josse RG, Prior JC, Hanley DA, CaMos Research G (2010) Peak bone mass from longitudinal data: implications for the prevalence, pathophysiology, and diagnosis of osteoporosis. J Bone Miner Res Off J Am Soc Bone Miner Res 25(9):1948–1957. doi:10.1002/jbmr.95 CrossRef

25.

Sundberg M, Gardsell P, Johnell O, Ornstein E, Karlsson MK, Sernbo I (2003) Pubertal bone growth in the femoral neck is predominantly characterized by increased bone size and not by increased bone density—a 4-year longitudinal study. Osteoporos Int 14(7):548–558. doi:10.1007/s00198-003-1406-3 CrossRefPubMed

26.

Theintz G, Buchs B, Rizzoli R, Slosman D, Clavien H, Sizonenko PC, Bonjour JP (1992) Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab 75(4):1060–1065. doi:10.1210/jcem.75.4.1400871 PubMed

27.

Slosman DO, Rizzoli R, Pichard C, Donath A, Bonjour JP (1994) Longitudinal measurement of regional and whole body bone mass in young healthy adults. Osteoporos Int 4(4):185–190CrossRefPubMed

28.

Bachrach LK, Hastie T, Wang MC, Narasimhan B, Marcus R (1999) Bone mineral acquisition in healthy Asian, Hispanic, black, and Caucasian youth: a longitudinal study. J Clin Endocrinol Metab 84(12):4702–4712. doi:10.1210/jcem.84.12.6182 PubMed

29.

Bouillon R, Rosen V, Rosen CJ, Compston JE (2013) Primer on the metabolic bone diseases and disorders of mineral metabolism, 8th edn. Wiley-Blackwell, Ames

30.

Greene DA, Naughton GA (2006) Adaptive skeletal responses to mechanical loading during adolescence. Sports Med 36(9):723–732CrossRefPubMed

31.

Winther A, Dennison E, Ahmed LA, Furberg AS, Grimnes G, Jorde R, Gjesdal CG, Emaus N (2014) The Tromso Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health. Arch Osteoporos 9(1):185. doi:10.1007/s11657-014-0185-0 CrossRefPubMed

32.

Yoon V, Maalouf NM, Sakhaee K (2012) The effects of smoking on bone metabolism. Osteoporos Int 23(8):2081–2092. doi:10.1007/s00198-012-1940-y CrossRefPubMed

33.

Ward KD, Klesges RC (2001) A meta-analysis of the effects of cigarette smoking on bone mineral density. Calcif Tissue Int 68(5):259–270CrossRefPubMedPubMedCentral

34.

Kanis JA, Johnell O, Oden A, Johansson H, De Laet C, Eisman JA, Fujiwara S, Kroger H, McCloskey EV, Mellstrom D, Melton LJ, Pols H, Reeve J, Silman A, Tenenhouse A (2005) Smoking and fracture risk: a meta-analysis. Osteoporos Int 16(2):155–162. doi:10.1007/s00198-004-1640-3 CrossRefPubMed

35.

Dorn LD, Beal SJ, Kalkwarf HJ, Pabst S, Noll JG, Susman EJ (2013) Longitudinal impact of substance use and depressive symptoms on bone accrual among girls aged 11–19 years. J Adolesc Health 52(4):393–399. doi:10.1016/j.jadohealth.2012.10.005 CrossRefPubMed

36.

Wosje KS, Kalkwarf HJ (2007) Bone density in relation to alcohol intake among men and women in the United States. Osteoporos Int 18(3):391–400. doi:10.1007/s00198-006-0249-0 CrossRefPubMed

37.

Jackowski SA, Baxter-Jones AD, McLardy AJ, Pierson RA, Rodgers CD (2015) The associations of exposure to combined hormonal contraceptive use on bone mineral content and areal bone mineral density accrual from adolescence to young adulthood: a longitudinal study. Bone Reports

38.

Tremollieres F (2013) Impact of oral contraceptive on bone metabolism. Best Pract Res Clin Endocrinol Metab 27(1):47–53. doi:10.1016/j.beem.2012.09.002 CrossRefPubMed

39.

Nappi C, Bifulco G, Tommaselli GA, Gargano V, Di Carlo C (2012) Hormonal contraception and bone metabolism: a systematic review. Contraception 86(6):606–621. doi:10.1016/j.contraception.2012.04.009 CrossRefPubMed

40.

Bratberg GH, Nilsen TIL, Holmen TL, Vatten LJ (2005) Sexual maturation in early adolescence and alcohol drinking and cigarette smoking in late adolescence: a prospective study of 2,129 Norwegian girls and boys. Eur J Pediatr 164(10):621–625. doi:10.1007/s00431-005-1721-0 CrossRefPubMed

41.

Cummings SR, Palermo L, Browner W, Marcus R, Wallace R, Pearson J, Blackwell T, Eckert S, Black D (2000) Monitoring osteoporosis therapy with bone densitometry: misleading changes and regression to the mean. Fracture intervention trial research group. JAMA 283(10):1318–1321. doi:10.1001/jama.283.10.1318 CrossRefPubMed

42.

Crabtree NJ, Arabi A, Bachrach LK, Fewtrell M, El-Hajj Fuleihan G, Kecskemethy HH, Jaworski M, Gordon CM, International Society for Clinical D (2014) Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD pediatric official positions. J Clin Densitom 17(2):225–242. doi:10.1016/j.jocd.2014.01.003 CrossRefPubMed

Title: Changes and tracking of bone mineral density in late adolescence: the Tromsø Study, Fit Futures
Authors: Ole Andreas Nilsen
Luai Awad Ahmed
Anne Winther
Tore Christoffersen
Anne-Sofie Furberg
Guri Grimnes
Elaine Dennison
Nina Emaus
Publication date: 01-12-2017
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-017-0328-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Changes and tracking of bone mineral density in late adolescence: the Tromsø Study, Fit Futures

Abstract

Summary

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusions

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