Pubertal timing and bone phenotype in early old age: findings from a British birth cohort study.
Pubertal timing and bone phenotype in early old age: findings from a British birth cohort study.
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DOI：
10.1093/ije/dyw131
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发表时间：
2016-08
影响因子：
7.7
通讯作者：
Ward KA
中科院分区：
文献类型：
--
作者：
Kuh D;Muthuri SG;Moore A;Cole TJ;Adams JE;Cooper C;Hardy R;Ward KA
目的：研究青春期发育时间对老年早期男性和女性骨大小、强度和密度的影响。 设计图：一项英国出生队列研究，在866名女性和792名男性中进行，基于初潮年龄、青春期阶段的临床评估和来自连续身高测量的生长克里思以及来自外周定量计算机断层扫描（pQCT）和双能X线吸收测定法（DXA）的60-64岁骨骼测量的青春期时间前瞻性指标。 研究方法：第一组回归模型研究了青春期时间与骨骼大小，强度和密度之间的关系，调整了当前的身高和体重，吸烟和成年社会经济地位。为了在男性和女性之间进行等效比较，计算了初潮年龄5岁差异的骨骼结果百分比差异，并在男性中比较了14.5岁时完全成熟或青春期前的人。第二组模型研究了从纵向生长模型（平移和旋转叠加模型; SITAR）得出的峰值身高速度（身高克里思）时间的5年差异的骨结局百分比差异。 结果如下：在调整了目前的身高和体重后，初潮年龄增加5岁与骨小梁体积骨密度（vBMD）降低8%（95%置信区间（CI）-17%，0.5%，P = 0.07）相关; 14.5岁时处于青春期前的男性有9%，（95% CI-14%，-4%; P = 0.001）与完全成熟的患者相比，骨小梁vBMD较低。其他混杂因素没有进一步削弱这些估计值。腰椎和全髋区域BMD的相关模式相似，但稍弱。高峰身高增长速度的年龄与男性和女性BMD的更大差异相关，与骨大小和强度呈负相关。 结论：青春期延迟和低BMD之间的关联持续到老年早期。考虑到从中年开始每年1-2%的骨丢失率以及BMD和骨折之间的负相关性，晚成熟者的骨小梁vBMD比早成熟者低9-10%可能具有临床意义。
Objectives: To investigate the effect of pubertal timing, assessed in adolescence, on bone size, strength and density in men and women in early old age. Design: A British birth cohort study with prospective indicators of pubertal timing based on age at menarche, clinical assessment of pubertal stage, and growth tempo from serial height measures, and bone measures derived from peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) at 60-64 years of age among 866 women and 792 men. Methods: A first set of regression models investigated the relationships between pubertal timing and bone size, strength and density, adjusting for current height and weight, smoking and adult socioeconomic position. To make an equivalent comparison between men and women, the percentage difference in bone outcomes was calculated for a 5-year difference in age at menarche, and in men a comparison between those who were fully mature or pre-adolescent at 14.5 years. A second set of models investigated the percentage difference in bone outcomes for a 5-year difference in timing of peak height velocity (height tempo) derived from longitudinal growth modelling (Superimposition by Translation and Rotation model; SITAR). Results: After adjustment for current height and weight, a 5-year increase in age at menarche was associated with an 8% [95% confidence interval (CI) -17%, 0.5%, P = 0.07) lower trabecular volumetric bone mineral density (vBMD); men who were pre-adolescent at 14.5 years had a 9%, (95% CI -14%, -4%; P = 0.001) lower trabecular vBMD compared with those who had been fully mature. Other confounders did not attenuate these estimates further. Patterns of association were similar but somewhat weaker for lumbar spine and total hip areal BMD. Age at peak height velocity was associated with even larger differences in BMD in men and women, and was negatively associated with bone size and strength. Conclusions: The association between later puberty and lower BMD persists into early old age. The 9-10% lower trabecular vBMD in later compared with earlier maturers could be clinically important given a rate of bone loss from midlife of 1-2% a year and the negative association between BMD and fracture.