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Accepted manuscript

Associations of linear growth and weight gain in the first 2 years with bone mass at 4 years of age in children in Dhaka, Bangladesh

Published online by Cambridge University Press:  22 November 2024

Maimuna Gias ,
Huma Qamar ,
Farzana Fariha ,
Abdullah Al Mahmud ,
Prakesh Shah ,
Steven A Abrams ,
Daniel E Roth  and
Karen M O’Callaghan
Maimuna Gias
Affiliation:
Department of Nutritional Sciences, University of Toronto, Toronto, Canada Centre for Global Child Health, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
Huma Qamar
Affiliation:
Centre for Global Child Health, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada
Farzana Fariha
Affiliation:
Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
Abdullah Al Mahmud
Affiliation:
Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
Prakesh Shah
Affiliation:
Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
Steven A Abrams
Affiliation:
Department of Pediatrics, Dell Medical School at the University of Texas at Austin, Austin, Texas, USA
Daniel E Roth
Affiliation:
Department of Nutritional Sciences, University of Toronto, Toronto, Canada Centre for Global Child Health, SickKids Research Institute, The Hospital for Sick Children, Toronto, Canada Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
Karen M O’Callaghan*
Affiliation:
Department of Nutritional Sciences, King’s College London, London, UK
*
Address correspondence to: Dr Karen M O’Callaghan, Department of Nutritional Sciences, King’s College London, 150 Stamford St, London SE1 9NH, United Kingdom; [email protected]
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Abstract

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Objective:

Growth faltering is widespread in many low- and middle-income countries, but its effects on childhood bone mass accrual are unknown. The objective of this study was to estimate associations between length (conditional length-for-age z-scores, cLAZ) and weight (conditional weight-for-age z-scores, cWAZ) gain in 3 age intervals (ages 0-6, 6-12, 12-24 months) with dual-energy x-ray absorptiometry (DEXA)-derived measures of bone mass (total-body-less-head (TBLH) bone mineral content (BMC), areal bone mineral density (aBMD), and bone area) at 4 years of age.

Design:

Associations between interval-specific growth parameters (cLAZ and cWAZ) and bone outcomes were estimated using linear regression models, adjusted for maternal, child, and household characteristics.

Setting:

Data collection occurred in Dhaka, Bangladesh.

Participants:

599 healthy children enrolled in the BONe and mUScle Health in Kids Study.

Results:

cLAZ in each age interval was positively associated with TBLH BMC, aBMD, and bone area at 4 years; however, associations attenuated towards null upon adjustment for concurrent height-for-age z-scores (HAZ) at age 4 years and confounders. cWAZ from 0-6 and 6-12 months was not associated with bone mass, but every SD increase in cWAZ between 12-24 months was associated with greater BMC (7.6g; 95%CI:3.2, 12.0) and aBMD (0.008g/cm2; 95%CI:0.003, 0.014) after adjusting for concurrent WAZ, HAZ, and confounders.

Conclusions:

Associations of linear growth (birth to 2 years) with bone mass at age 4 years were explained by concurrent HAZ. Weight gain in the second year of life may increase bone mass independently of linear growth in settings where growth faltering is common.

Keywords

Bone masslinear growthweight gainchild growth
Type
Research Paper
Information
Public Health Nutrition , Accepted manuscript , pp. 1 - 26
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Authors 2024

Footnotes

*

Authors contributed equally to this manuscript