The effect of pubertal timing, as reflected by height tempo, on proximal femur shape: Findings from a population-based study in adolescents

Monika Frysz; Jennifer S Gregory; Richard M Aspden; Lavinia Paternoster; Jonathan H Tobias

doi:10.1016/j.bone.2019.115179

The effect of pubertal timing, as reflected by height tempo, on proximal femur shape: Findings from a population-based study in adolescents

Bone. 2020 Feb:131:115179. doi: 10.1016/j.bone.2019.115179. Epub 2019 Nov 30.

Authors

Monika Frysz¹, Jennifer S Gregory², Richard M Aspden², Lavinia Paternoster³, Jonathan H Tobias⁴

Affiliations

¹ Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK. Electronic address: monika.frysz@bristol.ac.uk.
² Aberdeen Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK.
³ Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
⁴ Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK.

Abstract

Objective: To examine the relationship between pubertal timing (using measures of height tempo) and proximal femur shape in a large adolescent cohort.

Methods: Hip DXA scans were obtained in offspring from the Avon Longitudinal Study of Parents and Children. To quantify hip morphology, the images were analyzed using Shape software based on a 53-point statistical shape model and independent modes of variation (hip shape mode (HSM) scores) for each image were generated. Height tempo (which corresponds to age at peak height velocity (aPHV)) was estimated from serial height measurements collected between age 5-20 years. Multivariable linear regression was used to examine cross-sectional associations between height tempo and the top ten HSMs at age 14 and 18, adjusting for sex and fat mass index (FMI).

Results: Complete outcome and covariate data were available from 3827 and 3507 participants at age 14 and 18 years, respectively. Mean aPHV was 13.5 and 11.8 years for males and females, respectively. At age 14, height tempo was associated with a majority of modes, except for HSM4 and there was strong evidence of interaction by sex. In males, all modes showed evidence of an association with tempo, independent of FMI, with the strongest observed for HSM8 (adjusted β 0.38 (0.33, 0.43) p = 4.1 × 10^-50). Compared with males, the associations were generally weaker in females, with the strongest effect observed for HSM8 (adjusted β 0.10 (0.05, 0.14) p = 1.6 × 10^-5). The overall effect of later pubertal timing on proximal femur shape in males was a narrower femoral neck and larger superolateral head, whereas in females these changes were hard to discern. When assessed at age 18, there was little relationship between tempo and proximal femur shape in either sex.

Conclusion: Our results indicate that significant changes in hip shape occur during puberty, including aspects of shape which may be related to future risk of hip OA and/or fracture. However, puberty timing per se does not appear to exert long lasting effects on proximal femur shape.

Keywords: ALSPAC; Joint shape; Proximal femur shape; Pubertal growth; Statistical shape modelling.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Absorptiometry, Photon
Adolescent
Adult
Child
Child, Preschool
Cross-Sectional Studies
Female
Femur* / diagnostic imaging
Humans
Longitudinal Studies
Male
Puberty*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding