Association between linear growth and bone accrual in a diverse cohort of children and adolescents

Shana E. McCormack, Diana L. Cousminer, Alessandra Chesi, Jonathan A. Mitchell, Sani M. Roy, Heidi J. Kalkwarf, Joan M. Lappe, Vicente Gilsanz, Sharon E. Oberfield, John A. Shepherd, Karen K. Winer, Andrea Kelly, Struan F.A. Grant, Babette S. Zemel

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

IMPORTANCE Prevention of osteoporosis in adulthood begins with optimizing bone health in early life. The longitudinal association between growth and bone accretion during childhood is not fully understood. OBJECTIVES To assess the acquisition of whole-body (WB) and skeletal site-specific bone mineral content (BMC) relative to linear growth in a healthy, diverse, longitudinal cohort of children, adolescents, and young adults and to test for differences related to sex and African American race. DESIGN, SETTING, AND PARTICIPANTS This investigationwas a mixed longitudinal study with annual assessments for up to 7 years at 5 US clinical centers. Participants were healthy children, adolescents, and young adults. The study dates were July 2002 through March 2010. The dates of the analysis were June through December 2016. MAIN OUTCOMES AND MEASURES Anthropometrics, BMC, and body composition via dual-energy x-ray absorptiometry. The superimposition by translation and rotation (SITAR) analysis method was used to define the mean trajectories for height,WB lean soft tissue, appendicular lean soft tissue, and WB and skeletal site-specific BMC acquisition and to measure the age and magnitude of peak velocity for each parameter. The SITAR modeling was performed separately by sex and self-reported race. RESULTS Among 2014 healthy children, adolescents, and young adults (1022 [50.7%] female and 479 [23.8%] African American) aged 5 to 19 years at study entry, the mean age of peak height velocity was 13.1 years (95%CI, 13.0-13.2 years) in African American boys vs 13.4 years (95%CI, 13.3-13.4 years) in non-African American boys (difference, -0.3 years; 95%CI, -0.4 to -0.1 years) and 11.0 years (95%CI, 10.8-11.1 years) in African American girls vs 11.6 years (95%CI, 11.5-11.6 years) in non-African American girls (difference, -0.6 years; 95%CI, -0.7 to -0.5 years). Age of peak acquisition of WB BMC was 14.0 years (95%CI, 13.8-14.1 years) in African American boys vs 14.0 years (95%CI, 13.9-14.1 years) in non-African American boys (difference, -0.0 years; 95%CI, -0.2 to 0.2 years) and 12.1 years (95%CI, 12.0-12.3 years) in African American girls vs 12.4 years (95%CI, 12.3-12.5 years) in non-African American girls (difference, -0.3 years; 95%CI, -0.4 to -0.1 years). At age 7 years, children had acquired 69.5%to 74.5%of maximal observed height but only 29.6%to 38.1% of maximal observed WB BMC. Adolescents gained 32.7%to 35.8% of maximal observedWB BMC during the 2 years before and 2 years after peak height velocity. Another 6.9% to 10.7%of maximal observedWB BMC occurred after linear growth had ceased. In the group at highest risk for fracture, non-African American boys, peak fracture incidence occurred approximately 1 year before peak height velocity. CONCLUSIONS AND RELEVANCE In this longitudinal study, height gains substantially outpaced gains in BMC during childhood, which could contribute to fracture risk. A significant proportion of bone is accrued after adult height is achieved. Therefore, late adolescence represents a potentially underrecognized window of opportunity to optimize bone mass.

Original languageEnglish (US)
JournalJAMA Pediatrics
Volume171
Issue number9
DOIs
StatePublished - Sep 1 2017

Fingerprint

Bone Development
Bone Density
African Americans
Young Adult
Bone and Bones
Longitudinal Studies
Body Height
Growth
Body Composition
Osteoporosis
Healthy Volunteers
X-Rays
Outcome Assessment (Health Care)
Incidence
Health

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

McCormack, S. E., Cousminer, D. L., Chesi, A., Mitchell, J. A., Roy, S. M., Kalkwarf, H. J., ... Zemel, B. S. (2017). Association between linear growth and bone accrual in a diverse cohort of children and adolescents. JAMA Pediatrics, 171(9). https://doi.org/10.1001/jamapediatrics.2017.1769

Association between linear growth and bone accrual in a diverse cohort of children and adolescents. / McCormack, Shana E.; Cousminer, Diana L.; Chesi, Alessandra; Mitchell, Jonathan A.; Roy, Sani M.; Kalkwarf, Heidi J.; Lappe, Joan M.; Gilsanz, Vicente; Oberfield, Sharon E.; Shepherd, John A.; Winer, Karen K.; Kelly, Andrea; Grant, Struan F.A.; Zemel, Babette S.

In: JAMA Pediatrics, Vol. 171, No. 9, 01.09.2017.

Research output: Contribution to journalArticle

McCormack, SE, Cousminer, DL, Chesi, A, Mitchell, JA, Roy, SM, Kalkwarf, HJ, Lappe, JM, Gilsanz, V, Oberfield, SE, Shepherd, JA, Winer, KK, Kelly, A, Grant, SFA & Zemel, BS 2017, 'Association between linear growth and bone accrual in a diverse cohort of children and adolescents', JAMA Pediatrics, vol. 171, no. 9. https://doi.org/10.1001/jamapediatrics.2017.1769
McCormack, Shana E. ; Cousminer, Diana L. ; Chesi, Alessandra ; Mitchell, Jonathan A. ; Roy, Sani M. ; Kalkwarf, Heidi J. ; Lappe, Joan M. ; Gilsanz, Vicente ; Oberfield, Sharon E. ; Shepherd, John A. ; Winer, Karen K. ; Kelly, Andrea ; Grant, Struan F.A. ; Zemel, Babette S. / Association between linear growth and bone accrual in a diverse cohort of children and adolescents. In: JAMA Pediatrics. 2017 ; Vol. 171, No. 9.
@article{3ff510c4e0434b28a3941f0f3bc65eae,
title = "Association between linear growth and bone accrual in a diverse cohort of children and adolescents",
abstract = "IMPORTANCE Prevention of osteoporosis in adulthood begins with optimizing bone health in early life. The longitudinal association between growth and bone accretion during childhood is not fully understood. OBJECTIVES To assess the acquisition of whole-body (WB) and skeletal site-specific bone mineral content (BMC) relative to linear growth in a healthy, diverse, longitudinal cohort of children, adolescents, and young adults and to test for differences related to sex and African American race. DESIGN, SETTING, AND PARTICIPANTS This investigationwas a mixed longitudinal study with annual assessments for up to 7 years at 5 US clinical centers. Participants were healthy children, adolescents, and young adults. The study dates were July 2002 through March 2010. The dates of the analysis were June through December 2016. MAIN OUTCOMES AND MEASURES Anthropometrics, BMC, and body composition via dual-energy x-ray absorptiometry. The superimposition by translation and rotation (SITAR) analysis method was used to define the mean trajectories for height,WB lean soft tissue, appendicular lean soft tissue, and WB and skeletal site-specific BMC acquisition and to measure the age and magnitude of peak velocity for each parameter. The SITAR modeling was performed separately by sex and self-reported race. RESULTS Among 2014 healthy children, adolescents, and young adults (1022 [50.7{\%}] female and 479 [23.8{\%}] African American) aged 5 to 19 years at study entry, the mean age of peak height velocity was 13.1 years (95{\%}CI, 13.0-13.2 years) in African American boys vs 13.4 years (95{\%}CI, 13.3-13.4 years) in non-African American boys (difference, -0.3 years; 95{\%}CI, -0.4 to -0.1 years) and 11.0 years (95{\%}CI, 10.8-11.1 years) in African American girls vs 11.6 years (95{\%}CI, 11.5-11.6 years) in non-African American girls (difference, -0.6 years; 95{\%}CI, -0.7 to -0.5 years). Age of peak acquisition of WB BMC was 14.0 years (95{\%}CI, 13.8-14.1 years) in African American boys vs 14.0 years (95{\%}CI, 13.9-14.1 years) in non-African American boys (difference, -0.0 years; 95{\%}CI, -0.2 to 0.2 years) and 12.1 years (95{\%}CI, 12.0-12.3 years) in African American girls vs 12.4 years (95{\%}CI, 12.3-12.5 years) in non-African American girls (difference, -0.3 years; 95{\%}CI, -0.4 to -0.1 years). At age 7 years, children had acquired 69.5{\%}to 74.5{\%}of maximal observed height but only 29.6{\%}to 38.1{\%} of maximal observed WB BMC. Adolescents gained 32.7{\%}to 35.8{\%} of maximal observedWB BMC during the 2 years before and 2 years after peak height velocity. Another 6.9{\%} to 10.7{\%}of maximal observedWB BMC occurred after linear growth had ceased. In the group at highest risk for fracture, non-African American boys, peak fracture incidence occurred approximately 1 year before peak height velocity. CONCLUSIONS AND RELEVANCE In this longitudinal study, height gains substantially outpaced gains in BMC during childhood, which could contribute to fracture risk. A significant proportion of bone is accrued after adult height is achieved. Therefore, late adolescence represents a potentially underrecognized window of opportunity to optimize bone mass.",
author = "McCormack, {Shana E.} and Cousminer, {Diana L.} and Alessandra Chesi and Mitchell, {Jonathan A.} and Roy, {Sani M.} and Kalkwarf, {Heidi J.} and Lappe, {Joan M.} and Vicente Gilsanz and Oberfield, {Sharon E.} and Shepherd, {John A.} and Winer, {Karen K.} and Andrea Kelly and Grant, {Struan F.A.} and Zemel, {Babette S.}",
year = "2017",
month = "9",
day = "1",
doi = "10.1001/jamapediatrics.2017.1769",
language = "English (US)",
volume = "171",
journal = "JAMA Pediatrics",
issn = "2168-6203",
publisher = "American Medical Association",
number = "9",

}

TY - JOUR

T1 - Association between linear growth and bone accrual in a diverse cohort of children and adolescents

AU - McCormack, Shana E.

AU - Cousminer, Diana L.

AU - Chesi, Alessandra

AU - Mitchell, Jonathan A.

AU - Roy, Sani M.

AU - Kalkwarf, Heidi J.

AU - Lappe, Joan M.

AU - Gilsanz, Vicente

AU - Oberfield, Sharon E.

AU - Shepherd, John A.

AU - Winer, Karen K.

AU - Kelly, Andrea

AU - Grant, Struan F.A.

AU - Zemel, Babette S.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - IMPORTANCE Prevention of osteoporosis in adulthood begins with optimizing bone health in early life. The longitudinal association between growth and bone accretion during childhood is not fully understood. OBJECTIVES To assess the acquisition of whole-body (WB) and skeletal site-specific bone mineral content (BMC) relative to linear growth in a healthy, diverse, longitudinal cohort of children, adolescents, and young adults and to test for differences related to sex and African American race. DESIGN, SETTING, AND PARTICIPANTS This investigationwas a mixed longitudinal study with annual assessments for up to 7 years at 5 US clinical centers. Participants were healthy children, adolescents, and young adults. The study dates were July 2002 through March 2010. The dates of the analysis were June through December 2016. MAIN OUTCOMES AND MEASURES Anthropometrics, BMC, and body composition via dual-energy x-ray absorptiometry. The superimposition by translation and rotation (SITAR) analysis method was used to define the mean trajectories for height,WB lean soft tissue, appendicular lean soft tissue, and WB and skeletal site-specific BMC acquisition and to measure the age and magnitude of peak velocity for each parameter. The SITAR modeling was performed separately by sex and self-reported race. RESULTS Among 2014 healthy children, adolescents, and young adults (1022 [50.7%] female and 479 [23.8%] African American) aged 5 to 19 years at study entry, the mean age of peak height velocity was 13.1 years (95%CI, 13.0-13.2 years) in African American boys vs 13.4 years (95%CI, 13.3-13.4 years) in non-African American boys (difference, -0.3 years; 95%CI, -0.4 to -0.1 years) and 11.0 years (95%CI, 10.8-11.1 years) in African American girls vs 11.6 years (95%CI, 11.5-11.6 years) in non-African American girls (difference, -0.6 years; 95%CI, -0.7 to -0.5 years). Age of peak acquisition of WB BMC was 14.0 years (95%CI, 13.8-14.1 years) in African American boys vs 14.0 years (95%CI, 13.9-14.1 years) in non-African American boys (difference, -0.0 years; 95%CI, -0.2 to 0.2 years) and 12.1 years (95%CI, 12.0-12.3 years) in African American girls vs 12.4 years (95%CI, 12.3-12.5 years) in non-African American girls (difference, -0.3 years; 95%CI, -0.4 to -0.1 years). At age 7 years, children had acquired 69.5%to 74.5%of maximal observed height but only 29.6%to 38.1% of maximal observed WB BMC. Adolescents gained 32.7%to 35.8% of maximal observedWB BMC during the 2 years before and 2 years after peak height velocity. Another 6.9% to 10.7%of maximal observedWB BMC occurred after linear growth had ceased. In the group at highest risk for fracture, non-African American boys, peak fracture incidence occurred approximately 1 year before peak height velocity. CONCLUSIONS AND RELEVANCE In this longitudinal study, height gains substantially outpaced gains in BMC during childhood, which could contribute to fracture risk. A significant proportion of bone is accrued after adult height is achieved. Therefore, late adolescence represents a potentially underrecognized window of opportunity to optimize bone mass.

AB - IMPORTANCE Prevention of osteoporosis in adulthood begins with optimizing bone health in early life. The longitudinal association between growth and bone accretion during childhood is not fully understood. OBJECTIVES To assess the acquisition of whole-body (WB) and skeletal site-specific bone mineral content (BMC) relative to linear growth in a healthy, diverse, longitudinal cohort of children, adolescents, and young adults and to test for differences related to sex and African American race. DESIGN, SETTING, AND PARTICIPANTS This investigationwas a mixed longitudinal study with annual assessments for up to 7 years at 5 US clinical centers. Participants were healthy children, adolescents, and young adults. The study dates were July 2002 through March 2010. The dates of the analysis were June through December 2016. MAIN OUTCOMES AND MEASURES Anthropometrics, BMC, and body composition via dual-energy x-ray absorptiometry. The superimposition by translation and rotation (SITAR) analysis method was used to define the mean trajectories for height,WB lean soft tissue, appendicular lean soft tissue, and WB and skeletal site-specific BMC acquisition and to measure the age and magnitude of peak velocity for each parameter. The SITAR modeling was performed separately by sex and self-reported race. RESULTS Among 2014 healthy children, adolescents, and young adults (1022 [50.7%] female and 479 [23.8%] African American) aged 5 to 19 years at study entry, the mean age of peak height velocity was 13.1 years (95%CI, 13.0-13.2 years) in African American boys vs 13.4 years (95%CI, 13.3-13.4 years) in non-African American boys (difference, -0.3 years; 95%CI, -0.4 to -0.1 years) and 11.0 years (95%CI, 10.8-11.1 years) in African American girls vs 11.6 years (95%CI, 11.5-11.6 years) in non-African American girls (difference, -0.6 years; 95%CI, -0.7 to -0.5 years). Age of peak acquisition of WB BMC was 14.0 years (95%CI, 13.8-14.1 years) in African American boys vs 14.0 years (95%CI, 13.9-14.1 years) in non-African American boys (difference, -0.0 years; 95%CI, -0.2 to 0.2 years) and 12.1 years (95%CI, 12.0-12.3 years) in African American girls vs 12.4 years (95%CI, 12.3-12.5 years) in non-African American girls (difference, -0.3 years; 95%CI, -0.4 to -0.1 years). At age 7 years, children had acquired 69.5%to 74.5%of maximal observed height but only 29.6%to 38.1% of maximal observed WB BMC. Adolescents gained 32.7%to 35.8% of maximal observedWB BMC during the 2 years before and 2 years after peak height velocity. Another 6.9% to 10.7%of maximal observedWB BMC occurred after linear growth had ceased. In the group at highest risk for fracture, non-African American boys, peak fracture incidence occurred approximately 1 year before peak height velocity. CONCLUSIONS AND RELEVANCE In this longitudinal study, height gains substantially outpaced gains in BMC during childhood, which could contribute to fracture risk. A significant proportion of bone is accrued after adult height is achieved. Therefore, late adolescence represents a potentially underrecognized window of opportunity to optimize bone mass.

UR - http://www.scopus.com/inward/record.url?scp=85029005866&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029005866&partnerID=8YFLogxK

U2 - 10.1001/jamapediatrics.2017.1769

DO - 10.1001/jamapediatrics.2017.1769

M3 - Article

VL - 171

JO - JAMA Pediatrics

JF - JAMA Pediatrics

SN - 2168-6203

IS - 9

ER -