Familial determinants of bone health parameters- a dual X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT)-based parent and offspring study in rural Indian children.

Patil, Sharvani, Shah, Nikhil, Ireland, Alex, Patwardhan, Vivek, Sanwalka, Neha, Kajale, Neha, More, Chidvilas, Gondhalekar, Ketan and Khadilkar, Anuradha (2025) Familial determinants of bone health parameters- a dual X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT)-based parent and offspring study in rural Indian children. Bone. p. 117685. ISSN 8756-3282

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Abstract

Skeletal health relationships in children and parents have been investigated over the years with contradictory results and often without accounting for the influence of modifiable factors. Limited data exist on sex specific relationships using advanced techniques like peripheral quantitative computed tomography (pQCT), especially in populations with generationally insufficient calcium intake, where nutritional insufficiency, gender differences and environmental constraints may override and influence heritability trends. We examined the effect of parental phenotype and shared environment on bone density and geometry parameters of rural children aged 8-10.<h4>Methods</h4>Healthy children aged 8-10 and their parents joined a multigenerational cohort. Bone health parameters were assessed for 689 and 428 triads using dual-energy x-ray absorptiometry (DXA) and pQCT (at the 4 % and 66 % radial site), respectively. Modifiable factors were recorded using standardized questionnaires. Hierarchical linear regression assessed parent-offspring relationships after accounting for these factors.<h4>Results</h4>The cohort had significant calcium inadequacy, with only 6.5 % having adequate dietary calcium intake. Even after accounting for modifiable factors, both parents' bone health parameters significantly (p < 0.05) influenced children's parameters, with a stronger effect in female children. The maternal-offspring relationship was stronger than the paternal-offspring relationship for total body bone mineral density (TBLHBMD) (β = 0.19 vs β = 0.12), anteroposterior lumbar spine BMD (β = 0.22 vs β = 0.16), cortical density (β = 0.39 vs β = 0.32), cortical thickness (β = 0.23 vs β = 0.17), periosteal (β = 0.23 vs β = 0.17), and endosteal circumference (β = 0.27 vs β = 0.23). Whereas, trabecular density showed a slightly higher influence from male parents (β = 0.17 vs β = 0.16). (all p < 0.01).<h4>Conclusion</h4>Maternal-paternal influence on bone health was significant for all parameters and stronger in female children, asserting the importance of sex-specific growth promotion interventions. Parental influence persisted after accounting for modifiable factors in a nutritionally inadequate population, suggesting a strong heritability component.