Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents

Cheng, Lan; Pohlabeln, Hermann; Ahrens, Wolfgang; Russo, Paola; Veidebaum, Toomas; Chadjigeorgiou, Charalambos; Molnár, Dénes; Eiben, Gabriele; De Henauw, Stefaan; Moreno, Luis; Page, Angie; Hebestreit, Antje

Affiliations

¹Leibniz Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany

²Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany

³Institute of Food Sciences, National Research Council, Avellino, Italy

⁴Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia

⁵Research and Education Institute of Child Health, Strovolos, Cyprus

⁶Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary

⁷Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden

⁸Department of Public Health, Ghent University, 9000 Ghent, Belgium

⁹GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009 Zaragoza, Spain

¹⁰Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK

Abstract and keywords

Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: −0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = −3.70, 99% CI: −6.99, −0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.

Keywords: Pediatrics; Body composition; Bone stiffness index; Sex differences; Longitudinal study

Links

DOI: 10.1016/j.bone.2019.115162

PubMed: 31760215

WoS: 000507697800023

History

Received: 2019-07-31

Revised: 2019-10-20

Accepted: 2019-11-20

Online: 2019-11-21