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Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents

Research output: Contribution to journalArticle

  • Lan Cheng
  • Hermann Pohlabeln
  • Wolfgang Ahrens
  • Paola Russo
  • Toomas Veidebaum
  • Charalambos Chadjigeorgiou
  • Denes Molnar
  • Gabrielle Eiben
  • Stefaan De Henauw
  • Luis Moreno
  • Angie Page
  • Antje Hebestreit
Original languageEnglish
Article number115162
Number of pages8
Early online date21 Nov 2019
DateAccepted/In press - 20 Nov 2019
DateE-pub ahead of print - 21 Nov 2019
DatePublished (current) - 1 Feb 2020


Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.

    Research areas

  • Body composition, Bone stiffness index, Longitudinal study, Pediatrics, Sex differences



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    Embargo ends: 21/11/20

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    Licence: CC BY-NC-ND


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