Later Age at Onset of Independent Walking Is Associated With Lower Bone Strength at Fracture-Prone Sites in Older Men.
Later Age at Onset of Independent Walking Is Associated With Lower Bone Strength at Fracture-Prone Sites in Older Men.
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DOI：
10.1002/jbmr.3099
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发表时间：
2017-06
期刊：
影响因子：
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通讯作者：
Cooper R
中科院分区：
文献类型：
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作者：
Ireland A;Muthuri S;Rittweger J;Adams JE;Ward KA;Kuh D;Cooper R
儿童和青少年开始独立行走的年龄较晚与小腿骨强度有关。然而，尚不清楚这些关联是否会持续到老年，或者它们是否在轴（中央）或上肢部位明显。因此，我们在一项具有全国代表性的英国人队列研究（MRC全国健康与发展调查）中，检查了2岁时获得的步行年龄和60至64岁时通过双能X射线吸收仪（DXA）和外周定量计算机断层扫描（pQCT）获得的骨骼结果。据推测，较晚的行走年龄与所有部位的骨强度降低有关。男性较晚的独立行走年龄与较低的身高调整后的髋部（95%可信区间[CI] -0.179[-0.251至-0.107]）、脊柱（-0.157[-0.232至-0.082]）和桡骨远端（-0.159[-0.245至-0.073]）骨矿物质含量（BMC，表明骨抗压强度）相关（均p < 0.001）。协变量的调整部分减弱了这些关联，主要是因为较晚学步者的瘦质量和青少年运动能力较低。这些关联在髋部几何参数（包括横截面惯性矩[CSMI]，表明骨弯曲/扭转强度）中也很明显，这些参数是通过髋部结构分析（HSA）从DXA扫描中评估的。在女性髋部、脊柱和上肢的一些结果中也观察到类似的身高调整相关性，尽管脂肪或瘦质量调整导致大多数结果完全衰减，但股骨干CSMI和脊柱骨面积（BA）除外。总之，较晚的独立行走年龄似乎与男性多个骨骼部位的骨强度具有终生相关性。这些影响可能是由于早期生活负荷对骨生长的直接影响和成人身体成分的中介作用。结果表明，较晚的步行年龄可能是随后低骨强度的一个新的危险因素。现有的干预措施有效地加快了步行年龄，可能对终生的骨骼有积极的影响。©2017作者。由威利期刊公司出版的骨与矿物研究杂志。
Later age at onset of independent walking is associated with lower leg bone strength in childhood and adolescence. However, it is unknown whether these associations persist into older age or whether they are evident at axial (central) or upper limb sites. Therefore, we examined walking age obtained at age 2 years and bone outcomes obtained by dual‐energy X‐ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) scans at ages 60 to 64 years in a nationally representative cohort study of British people, the MRC National Survey of Health and Development. It was hypothesized that later walking age would be associated with lower bone strength at all sites. Later independent walking age was associated with lower height‐adjusted hip (standardized regression coefficients with 95% confidence interval [CI] –0.179 [–0.251 to –0.107]), spine (–0.157 [–0.232 to –0.082]), and distal radius (–0.159 [–0.245 to –0.073]) bone mineral content (BMC, indicating bone compressive strength) in men (all p < 0.001). Adjustment for covariates partially attenuated these associations, primarily because of lower lean mass and adolescent sporting ability in later walkers. These associations were also evident for a number of hip geometric parameters (including cross‐sectional moment of inertia [CSMI], indicating bone bending/torsional strength) assessed by hip structural analysis (HSA) from DXA scans. Similar height‐adjusted associations were also observed in women for several hip, spine, and upper limb outcomes, although adjustment for fat or lean mass led to complete attenuation for most outcomes, with the exception of femoral shaft CSMI and spine bone area (BA). In conclusion, later independent walking age appears to have a lifelong association with bone strength across multiple skeletal sites in men. These effects may result from direct effects of early life loading on bone growth and mediation by adult body composition. Results suggest that late walking age may represent a novel risk factor for subsequent low bone strength. Existing interventions effective in hastening walking age may have positive effects on bone across life. © 2017 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.