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      The Association of Body Size, Shape and Composition with Vertebral Size in Midlife – The Northern Finland Birth Cohort 1966 Study

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          Abstract

          Small vertebral size increases the risk of osteoporotic vertebral fractures. Obese individuals have larger vertebral size and potentially lower fracture risk than lean individuals, but scarce data exist on the association between vertebral size and anthropometric measures beyond height, weight, and body mass index (BMI). Here, we evaluated several anthropometric measures (height, weight, BMI, waist circumference, hip circumference, waist-to-hip ratio [WHR], waist-to-height ratio [WHtR], fat mass [FM], lean body mass [LBM], percentage FM [%FM], percentage LBM [%LBM]) as predictors of vertebral cross-sectional area (CSA). We used a representative sample from the Northern Finland Birth Cohort 1966 (n = 1087), with anthropometric measurements from the ages of 31 and 46, bioimpedance analysis from the age of 46, and lumbar magnetic resonance imaging from the age of 46 years. In our data, height and LBM correlated most strongly with vertebral CSA among both sexes (0.469 ≤  r ≤ 0.514), while WHR, WHtR, %FM, and %LBM had the weakest correlations with vertebral CSA (| r| ≤ 0.114). We conclude that height and LBM have the highest, yet only moderate correlations with vertebral size. High absolute LBM, rather than FM or abdominal mass accumulation, correlates with large vertebral size and thus potentially also with lower osteoporotic vertebral fracture risk.

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          Most cited references29

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          Osteoporosis

          The Lancet, 367(9527), 2010-2018
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            Bone mechanical properties and changes with osteoporosis.

            This review will define the role of collagen and within-bone heterogeneity and elaborate the importance of trabecular and cortical architecture with regard to their effect on the mechanical strength of bone. For each of these factors, the changes seen with osteoporosis and ageing will be described and how they can compromise strength and eventually lead to bone fragility.
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              Epidemiology of fracture risk with advancing age.

              Bone loss and structural damage with advancing age lead to skeletal fragility as manifested by low bone mass and deficits in bone geometry, microarchitecture, and material properties. Skeletal fragility, in combination with a greater propensity to fall, results in an increased susceptibility to fractures with aging, known as fragility fractures. Fragility fractures exceed 2 million per year in number and account for nearly 20 billion dollars per year in health care costs in the United States. Advanced age, low bone mass, and previous fracture are strong risk factors for fractures at nearly all skeletal sites, but each type of fracture also has its own set of unique risk factors. Hip fractures are most strongly associated with adverse consequences, but these account for only a minority of fragility fractures. Vertebral fractures comprise the most common manifestation of fragility fracture, but the majority of these fractures are asymptomatic. Most research has focused on the epidemiology of fractures at the hip, vertebrae, and wrist and less is known about other fracture types, which account for 40% of total fragility fractures that are clinically recognized. Future research focused on identification of older adults at high risk of disabling fractures is warranted.
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                Author and article information

                Contributors
                petteri.oura@oulu.fi
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                8 March 2019
                8 March 2019
                2019
                : 9
                : 3944
                Affiliations
                [1 ]ISNI 0000 0004 4685 4917, GRID grid.412326.0, Medical Research Center Oulu, , Oulu University Hospital and University of Oulu, ; P.O. Box 5000, FI-90014 Oulu, Finland
                [2 ]ISNI 0000 0001 0941 4873, GRID grid.10858.34, Center for Life Course Health Research, Faculty of Medicine, , University of Oulu, ; P.O. Box 5000, FI-90014 Oulu, Finland
                [3 ]ISNI 0000 0001 0941 4873, GRID grid.10858.34, Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, , University of Oulu, ; P.O. Box 5000, FI-90014 Oulu, Finland
                [4 ]ISNI 0000 0004 0450 4652, GRID grid.417779.b, Department of Sports and Exercise Medicine, , Oulu Deaconess Institute, ; P.O. Box 365, FI-90101 Oulu, Finland
                [5 ]ISNI 0000 0004 0410 5926, GRID grid.6975.d, Finnish Institute of Occupational Health, ; Aapistie 1, FI-90220 Oulu, Finland
                [6 ]ISNI 0000 0001 0941 4873, GRID grid.10858.34, Cancer and Translational Medicine Research Unit, Faculty of Medicine, , University of Oulu, ; P.O. Box 5000, FI-90014 Oulu, Finland
                [7 ]ISNI 0000 0001 0941 4873, GRID grid.10858.34, Department of Archaeology, Faculty of Humanities, , University of Oulu, ; P.O. Box 5000, FI-90014 Oulu, Finland
                Author information
                http://orcid.org/0000-0002-5591-3726
                Article
                40880
                10.1038/s41598-019-40880-4
                6408584
                30850701
                5186b938-44c2-4e36-a7c3-31e843599e3d
                © The Author(s) 2019

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 10 October 2018
                : 22 February 2019
                Funding
                Funded by: PO received financial support from the Signe and Ane Gyllenberg Foundation (Signe och Ane Gyllenbergs stiftelse), the Finnish Foundation for Nutrition Research (Ravitsemuksen tutkimussäätiö), the Vappu Uuspää Foundation (Vappu Uuspään säätiö), and the Päivikki and Sakari Sohlberg Foundation (Päivikki ja Sakari Sohlbergin säätiö). No grant numbers were given.
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