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Background: Cross-sectional studies in childhood have suggested associations between body composition and bone mass. However, there is scant evidence relating to longitudinal change in childhood lean or fat mass in relation to development of bone size, mineralization and density. We therefore investigated, in a population-based cohort, relationships between change in body composition between birth and 6–7 years (assessed by DXA), and childhood bone indices at 6–7 years, assessed by DXA and pQCT. Methods: Participants were recruited from the Southampton Women’s Survey (SWS), a prospective mother-offspring cohort study. Body composition [(total fat mass (FM) and total lean mass (LM)] of the offspring was assessed at birth, 4 years and 6–7 years by DXA (Hologic Discovery). At 6–7 years, total cross sectional area (CSA) and trabecular volumetric BMD (vBMD) were assessed at the 4% (metaphysis) site of the right tibia, using peripheral quantitative computed tomography (pQCT, Stratec XCT-2000). Total CSA, cortical CSA, cortical vBMD were measured at the 38% site (diaphysis). FM and LM were adjusted for age and sex and standardized to create within-cohort z-scores. Change in LM or FM was represented by change in z-score between birth and 4 years and between 4 and 6–7 years. Linear regression was used to explore the relationships between change in LM or FM and standardized pQCT outcomes (adjusted for age and sex), with the regression coefficient representing SD change in outcome per unit SD change in predictor. Results: pQCT scans and change in body composition z-scores were available for 122 children from birth to 4years and 181 children from 4 to 7 years. Change in LM z-score ( LM) from 0–4 years was positively associated with CSA at both 4% and 38% sites: 4% total CSA (b1⁄4 0.26 SD/SD, P1⁄40.009), 38% total CSA (b1⁄4 0.29 SD/SD, P1⁄40.001) and 38% cortical CSA (b1⁄40.24 SD/SD, P1⁄40.008). Similarly, LM from 4–7 years was positively associated with 4% total CSA (b1⁄4 0.27 SD/SD, P1⁄4 0.08) and 4% trabecular vBMD (b1⁄4 0.32 SD/SD, P1⁄40.04). Although change in fat mass z-score from 0 to 4 years was also associated with 4% total CSA (b1⁄4 0.16 SD/SD, P1⁄40.04), there were no associations between FM from 4 to 7 years and bone geometry or mineralization. Conclusion: In this prospective observational study, gain lean mass during childhood was positively associated with bone size and trabecular vBMD, assessed by pQCT at 6–7 years. In contrast, relationships between bone and change in fat mass were weaker, suggesting that muscle growth, rather than accrual of fat mass, may be a more important determinant of childhood bone development. RJM and ZAC are joint first authors. Disclosure statement: The authors have declared no conflicts of interest.

rheumatology

O50. Early Growth of Lean Rather than Fat Mass Predicts Bone Size, Mineralization and Density in Childhood: Findings from the Southampton Women's Survey