Abstract
Purpose
Prematurity and low birth weight are associated with a decrease in bone mass. Aim of the study was to investigate bone geometry, strength, and quality in children born at term small for gestational age (term SGA), premature appropriate for gestational age (prem AGA), and premature SGA (prem SGA).
Methods
91 patients (46 f, 45 m), mean age 11.28 years, height SDS 0.03 ± 0.21, and BMI SDS −0.31 ± 0.19. 20 were term SGA, 22 prem SGA, and 49 prem AGA. Bone geometry was assessed on the 2nd metacarpal bone, by evaluating the outer and inner diameter, the cortical area, medullary area, metacarpal index, cross-sectional area, and bone strength. Bone quality was evaluated by ultrasound and expressed as amplitude-dependent speed of sound and bone transmission time (BTT).
Results
Term SGA, prem SGA, and prem AGA had values of bone geometry, strength, and quality significantly lower than our reference range (p < 0.05). Findings in the three groups were similar, apart from BTT, which was significantly reduced in prem SGA (p < 0.05). Fat percentage was the main determinant of BTT.
Conclusions
Children born either prematurely or SGA seem to have smaller and weaker bones. Those born both premature and SGA were the most affected.
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References
Saenger P, Czernichow P, Hughes I, Reiter EO (2007) Small for gestational age: short stature and beyond. Endocr Rev 28:219–251
Rowe DL, Derraik JG, Robinson E, Cutfield WS, Hofman PL (2011) Preterm birth and the endocrine regulation of growth in childhood and adolescence. Clin Endocrinol (Oxf) 75:661–665
Hofman PL, Regan F, Jefferies CA, Cutfield WS (2006) Prematurity and programming: are there later metabolic sequelae? Metab Syndr Relat Disord 4:101–112
Hovi P, Andersson S, Eriksson JG et al (2007) Glucose regulation in young adults with very low birth weight. N Engl J Med 356:2053–2063
Radetti G, Renzullo L, Gottardi E, D’Addato G, Messner H (2004) Altered thyroid and adrenal function in children born at term and preterm, small for gestational age. J Clin Endocrinol Metab 89:6320–6324
Radetti G, Fanolla A, Pappalardo L, Gottardi E (2007) Prematurity may be a risk factor for thyroid dysfunction in childhood. J Clin Endocrinol Metab 92:155–159
Antoniades L, MacGregor AJ, Andrew T, Spector TD (2003) Association of birth weight with osteoporosis and osteoarthritis in adult twins. Rheumatology (Oxford) 42:791–796
Cooper C, Fall C, Egger P, Hobbs R, Eastell R, Barker D (1997) Growth in infancy and bone mass in later life. Ann Rheum Dis 56:17–21
Putzker S, Pozza RD, Schwarz HP, Schmidt H, Bechtold S (2012) Endosteal bone storage in young adults born small for gestational age—a study using peripheral quantitative computed tomography. Clin Endocrinol (Oxf) 76:485–491
Bertino E, Spada E, Occhi L et al (2010) Neonatal anthropometric charts: the Italian neonatal study compared with other European studies. J Pediatr Gastroenterol Nutr 51:353–361
Lubchenko LO, Hansman C, Boyd R (1966) Intrauterine growth in length and head circumference as estimated from live births at gestational ages from 26 to 41 wk. Pediatrics 37:403–408
Cacciari E, Milani S, Balsamo A et al (2006) Italian cross-sectional growth charts for height, weight and BMI (2 to 20 years). J Endocrinol Invest 29:581–593
McCarthy HD, Jarrett KV, Crawley HF (2001) The development of waist circumference percentiles in British children aged 5.0–16.9 years. Eur J Clin Nutr 55:902–907
Slaughter NH, Lohman TG, Boileau RA et al (1988) Skinfold equation for estimation of body fatness in children and youth. Hum Biol 60:709–723
Greulich WW, Pyle SL (1969) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford University Press, California
Zamberlan N, Radetti G, Paganini C et al (1996) Evaluation of cortical thickness and bone density by roentgen microdensitometry in growing males and females. Eur J Pediatr 155:377–382
Turner CH, Burr DB (1993) Basic biomechanical measurements of bone: a tutorial. Bone 14:595–608
Genant HK, Engelke K, Fuerst T et al (1996) Noninvasive assessment of bone mineral and structure: state of the art. J Bone Miner Res 11:707–730
Kardinaal AF, Hoorneman G, Väänänen K et al (2000) Determinants of bone mass and bone geometry in adolescent and young adult women. Calcif Tissue Int 66:81–89
Baroncelli GI, Federico G, Vignolo M et al (2006) Phalangeal quantitative ultrasound group. cross-sectional reference data for phalangeal quantitative ultrasound from early childhood to young-adulthood according to gender, age, skeletal growth, and pubertal development. Bone 39:159–173
Baroncelli GI, Federico G, Bertelloni S et al (2003) Assessment of bone quality by quantitative ultrasound of proximal phalanges of the hand and fracture rate in children and adolescents with bone and mineral disorders. Pediatr Res 54:125–136
Wilczek ML, Kälvesten J, Algulin J, Beiki O, Brismar TB (2013) Digital X-ray radiogr ammetry of hand or wrist radiographs can predict hip fracture risk-a study in 5,420 women and 2,837 men. Eur Radiol 23:1383–1391
Forsblad-d’Elia H, Carlsten H (2011) Bone mineral density by digital X-ray radiogrammetry is strongly decreased and associated with joint destruction in long-standing rheumatoid arthritis: a cross-sectional study. BMC Musculoskelet Disord 12:242
Adami S, Zamberlan N, Gatti D et al (1996) Computed radiographic absorptiometry and morphometry in the assessment of postmenopausal bone loss. Osteoporos Int 6:8–13
Beltrand J, Alison M, Nicolescu R et al (2008) Bone mineral content at birth is determined both by birth weight and fetal growth pattern. Pediat Res 64:86–90
McGuigan FE, Murray L, Gallagher A et al (2002) Genetic and environmental determinants of peak bone mass in young men and women. J Bone Miner Res 17:1273–1279
Dennison EM, Syddall HE, Sayer AA, Gilbody HJ, Cooper C (2005) Birth weight and weight at 1 year are independent determinants of bone mass in the seventh decade: the Hertfordshire cohort study. Pediatr Res 57:582–586
Boguszewski M, Rosberg S, Albertsson-Wikland K (1995) Spontaneous 24-h growth hormone profiles in prepubertal small for gestational age children. J Clin Endocrinol Metab 80:2599–2606
Bechtold S, Ripperger P, Dalla Pozza R et al (2010) Dynamics of body composition and bone in patients with juvenile idiopathic arthritis treated with growth hormone. J Clin Endocrinol Metab 95:178–185
Radetti G, D’Addato G, Gatti D, Bozzola M, Adami S (2006) Influence of two different GH dosage regimens on final height, bone geometry and bone strength in GH-deficient children. Eur J Endocrinol 154:479–482
Backström MC, Kuusela AL, Koivisto AM, Sievänen H (2005) Bone structure and volumetric density in young adults born prematurely: a peripheral quantitative computed tomography study. Bone 36:688–693
Kuh D, Wills AK, Shah I, Prentice A et al (2014) Growth from birth to adulthood and bone phenotype in early old age: a British birth cohort study. J Bone Miner Res 29:123–133
Bakker I, Twisk JW, Van Mechelen W, Kemper HC (2003) Fat-free body mass is the most important body composition determinant of 10-year longitudinal development of lumbar bone in adult men and women. J Clin Endocrinol Metab 88:2607–2613
Edwards M, Gregson C, Patel H et al (2013) Muscle size, strength and physical performance and their associations with bone structure in the Hertfordshire cohort study. J Bone Miner Res 28:2295–2304
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This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
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Longhi, S., Mercolini, F., Carloni, L. et al. Prematurity and low birth weight lead to altered bone geometry, strength, and quality in children. J Endocrinol Invest 38, 563–568 (2015). https://doi.org/10.1007/s40618-014-0230-2
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DOI: https://doi.org/10.1007/s40618-014-0230-2