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How ALSPAC improves our understanding of skeletal epidemiology

How ALSPAC improves our understanding of skeletal epidemiology. Dr Emma Clark, Consultant Senior Lecturer, University of Bristol 18th April 2012. ALSPAC bone programme. determinants of bone quality. fractures. scoliosis. hypermobility. pain. Why use ALSPAC to look at bone development?.

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How ALSPAC improves our understanding of skeletal epidemiology

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  1. How ALSPAC improves our understanding of skeletal epidemiology Dr Emma Clark, Consultant Senior Lecturer, University of Bristol 18th April 2012

  2. ALSPAC bone programme determinants of bone quality fractures scoliosis hypermobility pain

  3. Why use ALSPAC to look at bone development? osteoporosis

  4. Why use ALSPAC to look at bone development? • Repeat measures • DXA scan at aged 9, 11, 13, 15 and 17 • pQCT at aged 15 and 17

  5. Total body DXA

  6. Hip DXA

  7. Why use ALSPAC to look at bone development? • Repeat measures • DXA scan at aged 9, 11, 13, 15 and 17 • pQCT at aged 15 and 17

  8. Clark EM et al (2005) J Bone Miner Res 20:2082-2089

  9. Fat and bone Clark EM et al (2006) J Clin Endocrin Metab 91:2534-2541

  10. Fat and bone

  11. (2010) J Clin Endocrinol Metab 95(2):699-706.

  12. Pediatrics (2006) 117:e291 2 P = 0.001 1.8 1.6 1.4 OR for fracture risk 1.2 1 0.8 0.6 SMD -0.26 (-0.4 to -0.12) 1 2 3 Tertiles of TBLH BA

  13. Physical activity and bone We examined relationships between physical activity as assessed by accelerometer recordings, and pQCT scans, in 1970 15-year olds Sayers A et al (2011) J Clin Endo Metab 96:E793-E802

  14. Physical activity and bone Vigorous physical activity (> 6200 cpm) • A strong positive association was observed between cortical bone mass and vigorous physical activity (P < 0.00001) • This was associated with a 2.8 square mm increase in cortical bone area per doubling of vigorous physical activity • This relationship reflected combined effects of vigorous physical activity on outer circumference and cortical thickness • No associations were observed between cortical bone and the amount of moderate or light physical activity

  15. Physical activity and bone Vigorous physical activity (> 6200 cpm) • A strong positive association was observed between cortical bone mass and vigorous physical activity (P < 0.00001) • This was associated with a 2.8 square mm increase in cortical bone area per doubling of vigorous physical activity • This relationship reflected combined effects of vigorous physical activity on outer circumference and cortical thickness • No associations were observed between cortical bone and the amount of moderate or light physical activity

  16. Physical activity and bone Vigorous physical activity (> 6200 cpm) • A strong positive association was observed between cortical bone mass and vigorous physical activity (P < 0.00001) • This was associated with a 2.8 square mm increase in cortical bone area per doubling of vigorous physical activity • This relationship reflected combined effects of vigorous physical activity on outer circumference and cortical thickness • No associations were observed between cortical bone and the amount of moderate or light physical activity

  17. We are also interested in a wide range of other areas involved in bone development

  18. Epidemiology of hypermobility • 45% of girls and 29% of boys aged 14 have hypermobile fingers1 • cut off ≥ 4: 27.5% girls and 10.6% boys have GJL [1] Clinch et al (2011) Arthritis & Rheum 63:2819-2827

  19. Scoliosis

  20. People involved in this research

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