University of Oulu

Sandboge, S., Kuula, J., Björkqvist, J., Hovi, P., Mäkitie, O., & Kajantie, E. (2022). Bone mineral density in very low birthweight adults—A sibling study. Paediatric and Perinatal Epidemiology, 36(5), 665–672.

Bone mineral density in very low birthweight adults : a sibling study

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Author: Sandboge, Samuel1,2; Kuula, Juho1,3; Björkqvist, Johan1;
Organizations: 1Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
2Psychology/Welfare Sciences, Faculty of Social Sciences, University of Tampere, Tampere, Finland
3Department of Radiology, Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
4Pediatric Research Center, Children's Hospital, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
5Folkhälsan Research Center, Institute of Genetics, Helsinki, Finland
6Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki Helsinki, Finland
7Department of Molecular Medicine and Surgery, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
8PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
9Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.4 MB)
Persistent link:
Language: English
Published: John Wiley & Sons, 2022
Publish Date: 2022-11-03


Background: Children and adults born very low birthweight (VLBW, <1500 g) at preterm gestations have lower bone mineral density (BMD) and/or bone mineral content (BMC) than those born at term, but causality remains unknown.

Objectives: Our aim was to assess BMD and BMC in adults born at VLBW in a sibling comparison setting to account for shared genetic and environmental confounders.

Methods: We conducted a cohort study of 77 adults born VLBW and 70 same-sex term-born siblings at mean age of 29 years. The primary outcome variables were BMD Z-scores, and BMC, of the femoral neck, lumbar spine, and whole body, measured using dual-energy X-ray absorptiometry. We analysed data by linear mixed models.

Results: The VLBW adults had a 0.25 (95% CI 0.02, 0.47) Z-score unit lower femoral neck BMD, and 0.35 (95% CI 0.16, 0.54) grams lower femoral neck BMC than their term-born siblings, after adjustment for sex, age, and maternal smoking. Additional adjustment for adult body size attenuated the results. Lumbar spine, and whole body BMC were also lower in the VLBW group.

Conclusions: Individuals born at VLBW had lower BMC values at all three measurement sites, as well as lower femoral neck BMD Z-scores, compared to term-born siblings, partly explained by their smaller adult body size, but the differences were smaller than those reported previously with unrelated controls. This suggests that genetic or environmental confounders explain partly, but not exclusively, the association between preterm VLBW birth and adult bone mineralisation.

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Series: Paediatric and perinatal epidemiology
ISSN: 0269-5022
ISSN-E: 1365-3016
ISSN-L: 0269-5022
Volume: 36
Issue: 5
Pages: 665 - 672
DOI: 10.1111/ppe.12876
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: Doctoral Programme in Clinical Research, University of Helsinki; Academy of Finland (Grants 274794 and 315680 to Eero Kajantie); the European Commission (Horizon2020 award 733280 RECAP Research on Children and Adults Born Preterm); the Finnish Foundation for Pediatric Research; Finska Läkaresällskapet; the Juho Vainio Foundation; the Paulo Foundation; the Päivikki and Sakari Sohlberg Foundation; the Jalmari and Rauha Ahokas Foundation; the Novo Nordisk Foundation; the Einar and Karin Stroem Foundation; the Signe and Ane Gyllenberg Foundation; the Sigrid Jusélius Foundation; and the Yrjö Jahnsson Foundation
Copyright information: © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.