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Medicine (Baltimore). 2019 Feb;98(8):e14005. doi: 10.1097/MD.0000000000014005.

Analysis of bone mass and its relationship with body composition in school-aged children and adolescents based on stage of puberty and site specificity: A retrospective case-control study.

Song C1,2, Zhu M1,2, Zheng R3, Hu Y1,2, Li R1,2, Zhu G1,2, Chen L1,2, Xiong F1,2.

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Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders.
China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing.
Endocrinology Departments, Shenzhen Children's Hospital, Shenzhen, P.R. China.


The aim of this study was to better understand the relationship of bone mass with body composition based on different stages of puberty and to illuminate the contribution of site-specific fat mass and lean mass (FM and LM) compared with bone mass in school-aged children and adolescents in Chongqing, China.A total of 1179 healthy subjects of both sexes were recruited. Bone mineral content (BMC), bone mineral density (BMD), bone area, and both FM and LM were measured by dual-energy X-ray absorptiometry (DXA). The fat mass and lean mass indexes (FMI and LMI, respectively) were calculated as the FM (kg) and LM (kg) divided by the height in meters squared, respectively.Most of the bone mass indicators were significantly higher for postpubertal boys than for girls at the same stage (P < .001). The proportion of subjects with normal bone mass increased, while the proportion of subjects with osteopenia and osteoporosis decreased with increased body weight regardless of gender and puberty stage (P < .01). FM and LM were significantly positively related to bone mass regardless of gender and puberty stage (P < .0001). FMI and LMI were significantly positively related to bone mass in most conditions (P < .05 and P < .0001, respectively). Four components of the FM and LM were linearly and significantly associated with BMD and BMC for TB and TBHL. Among them, the head fat mass and head lean mass showed the greatest statistical contribution.In the process of assessing bone status, we recommend measuring fat and lean masses, including the fat and lean masses of the head.

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