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Early initiation of smoking and alcohol drinking as a predictor of lower forearm bone mineral density in late adolescence: a cohort study in girls.

Lucas R, Fraga S, Ramos E, Barros H - PLoS ONE (2012)

Bottom Line: Lower mean BMD at 17 years of age was observed in girls who had ever smoked by 13, as well as in those who reported drinking at that age.There were no significant cross-sectional associations between experience and frequency of smoking or drinking and BMD at 13 years of age.However, we observed significant associations between BMD z-score<-1 in late adolescence and having ever smoked by 13, after adjustment for menarche age and sports practice, (OR = 1.92; 95% CI: 1.21, 3.05) and with ever smoking and drinking in the same period (OR = 2.33; 95% CI: 1.36, 4.00).

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal. rlucas@med.up.pt

ABSTRACT

Background: Adolescence is a critical stage for bone accrual. It is also decisive for the establishment of behaviors such as smoking and alcohol drinking.

Objective: To quantify the short- and long-term associations between smoking and drinking initiation and bone mineral density in adolescent girls.

Methods: We used prospective data from 731 girls identified in public and private schools in Porto, Portugal. Evaluations were conducted when participants were 13 and 17 years old. Bone mineral density (BMD) was measured at the forearm by dual-energy X-ray absorptiometry and weight, height and fat-free mass were measured. Pubertal development status was estimated using menarche age. Self-administered questionnaires were used to collect data on smoking and alcohol drinking, physical exercise and calcium and vitamin D intakes. BMD in early and late adolescence was analyzed as a continuous or dichotomous (Z-score cutoff: -1.0) variable. Associations were calculated using linear or logistic regression.

Results: Over one quarter of these girls had tried smoking by 13, while 59% had drunk alcoholic beverages and 20% had experienced both behaviors by that age. Lower mean BMD at 17 years of age was observed in girls who had ever smoked by 13, as well as in those who reported drinking at that age. There were no significant cross-sectional associations between experience and frequency of smoking or drinking and BMD at 13 years of age. However, we observed significant associations between BMD z-score<-1 in late adolescence and having ever smoked by 13, after adjustment for menarche age and sports practice, (OR = 1.92; 95% CI: 1.21, 3.05) and with ever smoking and drinking in the same period (OR = 2.33; 95% CI: 1.36, 4.00).

Conclusion: Our study adds prospective evidence to the role of early initiation of smoking and alcohol drinking as relevant markers of lower bone mineral density in late adolescence.

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Related in: MedlinePlus

Associations between smoking and drinking and low forearm bone mineral density in late adolescence.Odds ratios and 95% confidence intervals for low bone density (z-score below −1 at 17 years of age) are presented adjusted for menarche age and regular sports practice at 17 years of age (squares), and with additional adjustment for body mass index at 17 (diamonds) or for bone mineral density at 13 years of age (triangles).
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pone-0046940-g001: Associations between smoking and drinking and low forearm bone mineral density in late adolescence.Odds ratios and 95% confidence intervals for low bone density (z-score below −1 at 17 years of age) are presented adjusted for menarche age and regular sports practice at 17 years of age (squares), and with additional adjustment for body mass index at 17 (diamonds) or for bone mineral density at 13 years of age (triangles).

Mentions: Figure 1 presents crude and adjusted odds ratios and 95% confidence intervals for the associations between smoking and drinking precocity and BMD z-score category. When considered dichotomously, there were clear significant associations between low 17 years BMD (z-score<−1) and having ever smoked by 13 years of age (OR = 1.92; 95% CI: 1.21, 3.05, adjusted for menarche age and sports practice) as well as with ever smoking and drinking in the same period (adjusted OR = 2.33; 95% CI: 1.36, 4.00). Associations remained significant after adjustment for body size or for baseline BMD. Although with lower precision and no statistical significance, an increasing trend of lower BMD z-score was found with increasing drinking precocity. Similarly to the results obtained with the linear model, there was an absence of dose-response relations between smoking and/or drinking frequency and BMD z-score categories.


Early initiation of smoking and alcohol drinking as a predictor of lower forearm bone mineral density in late adolescence: a cohort study in girls.

Lucas R, Fraga S, Ramos E, Barros H - PLoS ONE (2012)

Associations between smoking and drinking and low forearm bone mineral density in late adolescence.Odds ratios and 95% confidence intervals for low bone density (z-score below −1 at 17 years of age) are presented adjusted for menarche age and regular sports practice at 17 years of age (squares), and with additional adjustment for body mass index at 17 (diamonds) or for bone mineral density at 13 years of age (triangles).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475705&req=5

pone-0046940-g001: Associations between smoking and drinking and low forearm bone mineral density in late adolescence.Odds ratios and 95% confidence intervals for low bone density (z-score below −1 at 17 years of age) are presented adjusted for menarche age and regular sports practice at 17 years of age (squares), and with additional adjustment for body mass index at 17 (diamonds) or for bone mineral density at 13 years of age (triangles).
Mentions: Figure 1 presents crude and adjusted odds ratios and 95% confidence intervals for the associations between smoking and drinking precocity and BMD z-score category. When considered dichotomously, there were clear significant associations between low 17 years BMD (z-score<−1) and having ever smoked by 13 years of age (OR = 1.92; 95% CI: 1.21, 3.05, adjusted for menarche age and sports practice) as well as with ever smoking and drinking in the same period (adjusted OR = 2.33; 95% CI: 1.36, 4.00). Associations remained significant after adjustment for body size or for baseline BMD. Although with lower precision and no statistical significance, an increasing trend of lower BMD z-score was found with increasing drinking precocity. Similarly to the results obtained with the linear model, there was an absence of dose-response relations between smoking and/or drinking frequency and BMD z-score categories.

Bottom Line: Lower mean BMD at 17 years of age was observed in girls who had ever smoked by 13, as well as in those who reported drinking at that age.There were no significant cross-sectional associations between experience and frequency of smoking or drinking and BMD at 13 years of age.However, we observed significant associations between BMD z-score<-1 in late adolescence and having ever smoked by 13, after adjustment for menarche age and sports practice, (OR = 1.92; 95% CI: 1.21, 3.05) and with ever smoking and drinking in the same period (OR = 2.33; 95% CI: 1.36, 4.00).

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal. rlucas@med.up.pt

ABSTRACT

Background: Adolescence is a critical stage for bone accrual. It is also decisive for the establishment of behaviors such as smoking and alcohol drinking.

Objective: To quantify the short- and long-term associations between smoking and drinking initiation and bone mineral density in adolescent girls.

Methods: We used prospective data from 731 girls identified in public and private schools in Porto, Portugal. Evaluations were conducted when participants were 13 and 17 years old. Bone mineral density (BMD) was measured at the forearm by dual-energy X-ray absorptiometry and weight, height and fat-free mass were measured. Pubertal development status was estimated using menarche age. Self-administered questionnaires were used to collect data on smoking and alcohol drinking, physical exercise and calcium and vitamin D intakes. BMD in early and late adolescence was analyzed as a continuous or dichotomous (Z-score cutoff: -1.0) variable. Associations were calculated using linear or logistic regression.

Results: Over one quarter of these girls had tried smoking by 13, while 59% had drunk alcoholic beverages and 20% had experienced both behaviors by that age. Lower mean BMD at 17 years of age was observed in girls who had ever smoked by 13, as well as in those who reported drinking at that age. There were no significant cross-sectional associations between experience and frequency of smoking or drinking and BMD at 13 years of age. However, we observed significant associations between BMD z-score<-1 in late adolescence and having ever smoked by 13, after adjustment for menarche age and sports practice, (OR = 1.92; 95% CI: 1.21, 3.05) and with ever smoking and drinking in the same period (OR = 2.33; 95% CI: 1.36, 4.00).

Conclusion: Our study adds prospective evidence to the role of early initiation of smoking and alcohol drinking as relevant markers of lower bone mineral density in late adolescence.

Show MeSH
Related in: MedlinePlus