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Bone status of adolescent girls in Pune (India) compared to age-matched South Asian and white Caucasian girls in the UK

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Abstract

Summary

Underprivileged adolescent girls in Pune, India, were shorter and lighter, and had reduced lean body mass (LBM) compared with relatively ‘well off’ age-matched South Asian and white Caucasian girls in the UK. Pune girls had low bone mass for projected bone area (BA) in comparison to their UK counterparts, but they had the appropriate amount of bone mineral content (BMC) for their LBM.

Purpose

To determine whether adolescent girls from a low socioeconomic group in Pune, India, who had low dietary calcium intake (449 mg/day; range 356–538 mg/day) and hypovitaminosis D (median serum 25-hydroxyvitamin D 23.4 nmol/l; range 13.5–31.9 nmol/l), would have lower lumbar spine (LS) bone mineral apparent density (BMAD), and total body (TB) BMC adjusted for LBM.

Methods

Dual energy X-ray absorptiometry was used to measure TB and LS BMC, BA and TB LBM in 50 postmenarcheal girls in Pune. These variables were compared with data from 34 South Asian and 82 white Caucasian age-matched girls in the UK.

Results

Pune girls were shorter and lighter, and had less LBM for height, compared to both UK groups, and they had later age of menarche than UK Asians. BA-adjusted TB BMC and LS BMAD were lower in Pune girls (mean±SE 1,778±17 g; 0.332±0.005 g/cm3), compared to the UK South Asians (mean±SE 1,864±18 g; 0.355±0.006 g/cm3) and UK white Caucasians (mean±SE 1,864±13 g; 0.345±0.004 g/cm3). In contrast both LS and TB BMC adjusted for TB LBM were not significantly different between the groups.

Conclusion

Pune girls had low bone mass for projected BA relative to UK South Asian and white Caucasian girls, but had the appropriate amount of BMC for their LBM.

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References

  1. Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ 312:1254–1259

    CAS  PubMed  Google Scholar 

  2. Bailey D (1997) The Saskatchewan pediatric bone mineral accrual study: bone mineral acquisition during the growing years. Int J Sports Med 18:191–194

    Article  Google Scholar 

  3. Bailey DA, Martin AD, McKay HA, Whiting S, Mirwald R (2000) Calcium accretion in girls and boys during puberty: a longitudinal analysis. J Bone Miner Res 15:2245–2250

    Article  CAS  PubMed  Google Scholar 

  4. Matkovic V, Jelic T, Wardlaw GM, Ilich JZ, Goel PK, Wright JK, Andon MB, Smith KT, Heaney RP (1994) Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Invest 93:799–808

    Article  CAS  PubMed  Google Scholar 

  5. Rajeswari J, Balasubramanian K, Bhatia V, Sharma VP, Agarwal AK (2003) Aetiology and clinical profile of osteomalacia in adolescent girls in northern India. Natl Med J India 16:139–142

    CAS  PubMed  Google Scholar 

  6. Gopalan C, Rama-Sastri B, Balasubramanian S (1989) Nutritive value of Indian foods. National Institute of Nutrition, Indian Council for Medical Research, Hyderabad, India

  7. Crabtree N, Oldroyd B, Truscott J, Fordham J, Kibirge M, Fewtrell M, Gordon I, Shaw N (2005) UK paediatric DXA reference data (GE Lunar Prodigy): effects of ethnicity, gender and pubertal status. Bone 36:S42

    Google Scholar 

  8. Freeman J, Cole TJ, Chinn S, Jones P, White E, Preece M (1995) Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child 73:17–24

    Article  CAS  PubMed  Google Scholar 

  9. Engelke K, Gluer CC (2006) Quality and performance measures in bone densitometry: part 1: errors and diagnosis. Osteoporos Int 17:1283–1292

    Article  CAS  PubMed  Google Scholar 

  10. Kroger H, Kotaniemi A, Vainio P, Alhava E (1992) Bone densitometry of the spine and femur in children by dual-energy x-ray absorptiometry. Bone Miner 17:75–85

    Article  CAS  PubMed  Google Scholar 

  11. Kiebzak GM, Leamy LJ, Pierson LM, Nord RH, Zhang ZY (2000) Measurement precision of body composition variables using the lunar DPX-L densitometer. J Clin Densitom 3:35–41

    Article  CAS  PubMed  Google Scholar 

  12. Kalender W, Felsenberg D, Genant H, Fischer M, Dequeker J, Reeve J (1995) European Spine Phantom – a tool for standardization and quality control in spinal bone mineral measurements by DXA and QCT. Eur J Radiol 20:83–92

    Article  CAS  PubMed  Google Scholar 

  13. Cole TJ, Freeman JV, Preece MA (1998) British 1990 growth reference centiles for weight, height, body mass index and head circumference fitted by maximum penalized likelihood. Stat Med 17:407–429

    Article  CAS  PubMed  Google Scholar 

  14. Pettifor JM, What is the optimal 25(OH)D level for bone in children? In: Norman AW, Bouillon R, Thomasset M (eds) Vitamin D endocrine system: structural, biological, genetic and clinical aspects. Proceedings of the 11th Workshop on Vitamin D, 2000, University of California, Riverside (CA), pp 903–907

  15. Department of Health (1991) Dietary reference values for food energy and nutrients for the United Kingdom. Chief Medical Officer, Department of Health. HMSO, London

  16. National Institutes of Health (1994) Optimal calcium intake. NIH Consensus Statement 12:1–31

  17. Department of Health (1998) Nutrition and bone health: with particular reference to vitamin D and calcium. Report on Health and Social Subjects. Chief Medical Officer, Department of Health. The Stationary Office, London

  18. Molgaard C, Thomsen BL, Michaelsen KF (2004) Effect of habitual dietary calcium intake on calcium supplementation in 12–14-y-old girls. Am J Clin Nutr 80:1422–1427

    CAS  PubMed  Google Scholar 

  19. Frost H (1987) Bone “mass” and the “mechanostat”: a proposal. Anat Rec 219:1–9

    Article  CAS  PubMed  Google Scholar 

  20. Heaney R, Dowell S, Hale C, Bendich A (2003) Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 22:142–146

    CAS  PubMed  Google Scholar 

  21. Wagner CL, Greer FR (2008) Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 122(5):1142–1152

    Article  PubMed  Google Scholar 

  22. Crabtree NJ, Kibirige MS, Fordham JN, Banks LM, Muntoni F, Chinn D, Boivin CM, Shaw NJ (2004) The relationship between lean body mass and bone mineral content in paediatric health and disease. Bone 35(4):965–972

    Article  CAS  PubMed  Google Scholar 

  23. Shaw NJ, Crabtree NJ, Kibirige MS, Fordham JN (2007) Ethnic and gender differences in body fat in British schoolchildren as measured by DXA. Arch Dis Child 92:872–875

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank the participating youngsters, their parents and staff at the Dhole-Patil school, Pune. We are grateful to Dr Sadanand Naik, Mr M. Sayyad, Miss Neha Sanwalka, Miss Dhanashree Bhandari, Mrs Dhole-Patil, Mrs Shilpa Shirole, Mrs Shamim Momin and Ms Deepa Pillay for their help with the study in Pune. We are also grateful to participants of the UK GE Lunar BMD database subjects.

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Correspondence to M. Z. Mughal.

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Khadilkar, A., Crabtree, N.J., Ward, K.A. et al. Bone status of adolescent girls in Pune (India) compared to age-matched South Asian and white Caucasian girls in the UK. Osteoporos Int 21, 1155–1160 (2010). https://doi.org/10.1007/s00198-009-1040-9

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  • DOI: https://doi.org/10.1007/s00198-009-1040-9

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