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A longitudinal comparison of appendicular bone growth and markers of strength through adolescence in a South African cohort using radiogrammetry and pQCT

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Abstract

Summary

To compare growth patterns and strength of weight- and non-weight-bearing bones longitudinally. Irrespective of sex and ethnicity, metacarpal growth was similar to that of the non-weight-bearing radius but differed from that of the weight-bearing tibia. Weight- and non-weight-bearing bones have different growth and strength patterns.

Introduction

Functional loading modulates bone size and strength.

Methods

To compare growth patterns and strength of weight- and non-weight-bearing bones longitudinally, we performed manual radiogrammetry of the second metacarpal on hand-wrist radiographs and measured peripheral quantitative computed tomography images of the radius (65%) and tibia (38% and 65%), annually on 372 black and 152 white South African participants (ages 12–20 years). We aligned participants by age from peak metacarpal length velocity. We assessed bone width (BW, mm); cortical thickness (CT, mm); medullary width (MW, mm); stress-strain index (SSI, mm3); and muscle cross-sectional area (MCSA, mm2).

Results

From 12 to 20 years, the associations between metacarpal measures (BW, CT and SSI) and MCSA at the radius (males R2 = 0.33–0.45; females R2 = 0.12–0.20) were stronger than the tibia (males R2 = 0.01–0.11; females R2 = 0.007–0.04). In all groups, radial BW, CT and MW accrual rates were similar to those of the metacarpal, except in white females who had lower radial CT (0.04 mm/year) and greater radial MW (0.06 mm/year) accrual. In all groups, except for CT in white males, tibial BW and CT accrual rates were greater than at the metacarpal. Tibial MW (0.29–0.35 mm/year) increased significantly relative to metacarpal MW (− 0.07 to 0.06 mm/year) in males only. In all groups, except white females, SSI increased in each bone.

Conclusion

Irrespective of sex and ethnicity, metacarpal growth was similar to that of the non-weight-bearing radius but differed from that of the weight-bearing tibia. The local and systemic factors influencing site-specific differences require further investigation.

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Acknowledgements

The contribution of the Bone Health staff, participants and caregivers is gratefully acknowledged. The authors thank Dr. Simon Schoenbuchner for assisting with the preparation of the pQCT data.

Funding

The Bone Health Cohort was supported financially by the Wellcome Trust (UK) and the South African Medical Research Council. JMP received funding from the National Research Foundation.

Author information

Authors and Affiliations

  1. South African MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, 2193, South Africa

    A. Magan, L. K. Micklesfield, L. H. Nyati, S. A. Norris & J. M. Pettifor

Authors
  1. A. Magan
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  2. L. K. Micklesfield
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  3. L. H. Nyati
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  4. S. A. Norris
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  5. J. M. Pettifor
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Corresponding author

Correspondence to A. Magan.

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Electronic supplementary material

Supplementary Figure 1

Participant recruitment (N) and the number of participants (n) aged between 12 and 20 years with their respective number of observations (PNG 26 kb)

High Resolution Image (TIF 510 kb)

Supplementary Figure 2

Metacarpal stress-strain index in relation to radial muscle cross-sectional area in black and white females and males (PNG 246 kb)

High Resolution Image (TIF 1784 kb)

Supplementary Figure 3

Metacarpal stress-strain index in relation to tibial muscle cross-sectional area in black and white females and males (PNG 252 kb)

High Resolution Image (TIF 1854 kb)

Supplementary Figure 4

Mixed model growth curves of metacarpal, radial and tibial bone width against years from peak metacarpal length velocity in black and white females and males (PDF 442 kb)

Supplementary Figure 5

Mixed model growth curves of metacarpal, radial and tibial cortical thickness against years from peak metacarpal length velocity in black and white females and males (PDF 440 kb)

Supplementary Figure 6

Mixed model growth curves of metacarpal, radial and tibial medullary width against years from peak metacarpal length velocity in black and white females and males (PDF 439 kb)

Supplementary Figure 7

Mixed model growth curves of metacarpal, radial and tibial stress-strain index against years from peak metacarpal length velocity in black and white females and males (PDF 448 kb)

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Magan, A., Micklesfield, L.K., Nyati, L.H. et al. A longitudinal comparison of appendicular bone growth and markers of strength through adolescence in a South African cohort using radiogrammetry and pQCT. Osteoporos Int 30, 451–460 (2019). https://doi.org/10.1007/s00198-018-4761-9

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  • DOI: https://doi.org/10.1007/s00198-018-4761-9

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