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Influence of birth size and body composition on bone mineral density in early adulthood: the PROGRAM study
Author(s) -
Leunissen R. W. J.,
Stijnen T.,
Boot A. M.,
HokkenKoelega A. C. S.
Publication year - 2008
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2008.03226.x
Subject(s) - medicine , bone mineral , lean body mass , endocrinology , osteoporosis , birth weight , bone density , weight gain , small for gestational age , cohort , peak bone mass , dual energy x ray absorptiometry , gestational age , physiology , pregnancy , body weight , biology , genetics
Summary Background/objectives Low bone mineral density (BMD) may lead to osteoporosis and is associated with increased fracture risk. Associations between BMD and various factors have been reported. Our objective was to investigate whether birth size, lean body mass (LBM) and fat mass (FM) are determinants of BMD of the total body (BMD TB ) and the lumbar spine (BMD LS ). Methods In the PROgramming factors for GRowth And Metabolism (PROGRAM) study of a cohort of 312 young adults aged 18–24 years, BMD TB and BMD LS were determined by dual‐energy X‐ray absorptiometry (DXA). Subsequently, differences in BMD TB and BMD LS were analysed in four subgroups: young adults born small for gestational age with short stature (SGA‐S) or with catch‐up growth (SGA‐CU), or born appropriate for gestational age (AGA) with idiopathic short stature (ISS) or with normal stature (controls). Results Adult weight, LBM, FM and weight gain during childhood were the main positive determinants for BMD TB in early adulthood, whereas birth size had no influence (adjusted R 2 = 0·50). Gender, adult weight, LBM, FM and weight gain were the significant determinants of BMD LS . In the subgroups, after correction for age, gender and adult body size, the ISS group had a significantly lower BMD TB than controls but there was no difference in BMD LS between the subgroups. Conclusions Prenatal growth has no significant influence on BMD TB and BMD LS in early adulthood. Gender and postnatal growth, particularly weight gain, are the main positive determinants. To achieve a normal BMD in adulthood, healthcare workers should aim for a normal weight gain in children.