The impact of anorexia nervosa and obesity polygenic risk on childhood growth: a 20-year longitudinal population-based study

AbstractBackgroundDeviating growth from the norm during childhood has been associated with anorexia nervosa (AN) and obesity later in life. In this study, we examined whether polygenic scores (PGS) for AN and obesity are associated, individually or combined, with a range of anthropometric trajectories spanning the first two decades of life.MethodsAN-PGS and obesity-PGS were calculated for participants of the Avon Longitudinal Study of Parents and Children (ALSPAC; N= 8,654 participants with genotype data and at least one outcome measure). Using generalized (mixed) linear models, we associated PGS with trajectories of weight, height, body mass index (BMI), fat mass index (FMI), lean mass index (LMI), and bone mineral density (BMD). Growth trajectories were derived using spline modeling or mixed effects modeling.ResultsBetween age 5-24 years, Females with one SD higher AN-PGS had on average a 0.01% lower BMI trajectory, and between age 10-24 years a 0.01% lower FMI trajectory and 0.05% lower weight trajectory. Higher obesity-PGS was associated with higher BMI, FMI, LMI, BMD, weight, and lower height trajectories in both sexes. The average growth trajectories of females with high AN-PGS/low obesity-PGS remained consistently lower than those with low AN-PGS/low obesity-PGS; this difference did not reach statistical significance. However, post-hoc comparisons suggest that females with high AN-PGS/low obesity-PGS did follow lower growth trajectories compared to those with high PGS for both traits.ConclusionAN-PGS and obesity-PGS have detectable sex-dependent effects on a range of anthropometry trajectories. These findings encourage further research in understanding how the AN-PGS and the obesity-PGS co-influence growth during childhood in which the obesity-PGS can mitigate the effects of the AN-PGS.

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Absence of Association between Previous Mycoplasma pneumoniae Infection and Subsequent Myasthenia Gravis: A Nationwide Population-Based Matched Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147677 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7677

Author(s):

Kuan Chen ◽

James Cheng-Chung Wei ◽

Hei-Tung Yip ◽

Mei-Chia Chou ◽

Renin Chang

Keyword(s):

Cohort Study ◽

Myasthenia Gravis ◽

Mycoplasma Pneumoniae ◽

Pathogenic Bacteria ◽

Case Reports ◽

Statistical Significance ◽

Subsequent Development ◽

Population Based ◽

Cox Proportional Hazards ◽

The Impact

Mycoplasma pneumoniae (M. pneumoniae) is not only one of the most common pathogenic bacteria for respiratory infection but also a trigger for many autoimmune diseases. Its infection process shared many similarities with the pathogenesis of myasthenia gravis (MG) at cellular and cytokine levels. Recent case reports demonstrated patients present with MG after M. pneumoniae infection. However, no epidemiological studies ever looked into the association between the two. Our study aimed to investigate the relationship between M. pneumoniae infection and subsequent development of MG. In this population-based retrospective cohort study, the risk of MG was analyzed in patients who were newly diagnosed with M. pneumoniae infection between 2000 and 2013. A total of 2428 M. pneumoniae patients were included and matched with the non-M. pneumoniae control cohort at a 1:4 ratio by age, sex, and index date. Cox proportional hazards regression analysis was applied to analyze the risk of MG development after adjusting for sex, age, and comorbidities, with hazard ratios and 95% confidence intervals. The incidence rates of MG in the non-M. pneumoniae and M. pneumoniae cohorts were 0.96 and 1.97 per 10,000 person-years, respectively. Another case–control study of patients with MG (n = 515) was conducted to analyze the impact of M. pneumoniae on MG occurrence as a sensitivity analysis. The analysis yielded consistent absence of a link between M. pneumoniae and MG. Although previous studies have reported that M. pneumoniae infection and MG may share associated immunologic pathways, we found no statistical significance between M. pneumoniae infection and subsequent development of MG in this study.

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Impact of tumor Epstein-Barr virus status on presenting features and outcome in age-defined subgroups of patients with classic Hodgkin lymphoma: a population-based study

Blood ◽

10.1182/blood-2004-09-3759 ◽

2005 ◽

Vol 106 (7) ◽

pp. 2444-2451 ◽

Cited By ~ 134

Author(s):

Ruth F. Jarrett ◽

Gail L. Stark ◽

Jo White ◽

Brian Angus ◽

Freda E. Alexander ◽

...

Keyword(s):

Hodgkin Lymphoma ◽

Older Patients ◽

Epstein Barr Virus ◽

Statistical Significance ◽

Survival Rates ◽

Population Based ◽

Population Based Study ◽

Barr Virus ◽

Epstein Barr ◽

The Impact

AbstractThe association between tumor Epstein-Barr virus (EBV) status and clinical outcome in Hodgkin lymphoma (HL) is controversial. This population-based study assessed the impact of EBV status on survival in age-stratified cohorts of adults with classic HL (cHL). Data from 437 cases were analyzed with a median follow-up of 93 months. Overall survival (OS) was significantly better for EBV-negative compared with EBV-positive patients (P < .001), with 5-year survival rates of 81% and 66%, respectively; disease-specific survival (DSS) was also greater for EBV-negative patients (P = .03). The impact of EBV status varied with age at diagnosis. In patients aged 16 to 34 years, EBV-associated cases had a survival advantage compared with EBV-negative cases, but differences were not statistically significant (P = .21). Among patients 50 years or older, EBV positivity was associated with a significantly poorer outcome (P = .003). Excess deaths occurred in EBV-positive patients with both early- and advanced-stage disease. In multivariate analysis of OS in the older patients, EBV status retained statistical significance after adjusting for the effects of sex, stage, and B symptoms (P = .01). Impaired immune status may contribute to the development of EBV-positive cHL in older patients, and strategies aimed at boosting the immune response should be investigated in the treatment of these patients. (Blood. 2005;106:2444-2451)

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Abstract P254: Health-Related Internet Use in Patients with Hypertension: A Population-Based Analysis

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.4.suppl_2.ap254 ◽

2011 ◽

Vol 4 (suppl_2) ◽

Author(s):

Joseph Finkelstein ◽

Eunme Cha

Keyword(s):

Health Status ◽

Statistical Significance ◽

Age Groups ◽

Population Based ◽

Sampling Weights ◽

Logistic Regression Models ◽

Income Ratio ◽

Health Related ◽

The Difference ◽

The Impact

Background: With widely available web-based information about hypertension, internet has the potential to improve health literacy and to affect clinical outcomes. In this study we assessed the prevalence of health-related internet (HRI) usage by patients with hypertension and its association with health outcomes. Methods: Hypertension was defined by the question, “Have you ever been told by a doctor or health profession that you have high blood pressure?” Participants who answered “Yes” were included in the sample. If the participants stated that they accessed the Internet to look up health information, to learn about health topics in chat groups, to refill prescriptions, to schedule appointments, or to communicate with their provider, they were included in ‘HRI user’ group. Two logistic regression models were run to assess predictors of HRI usage and to explore the impact of HRI use on health status among hypertension patients. All models were controlled by age, gender, marital status, race, education, and poverty income ratio (PIR). Sampling weights were utilized to produce population-based results. Results: The prevalence of HRI use in hypertension patients was: 57% (40-55 yrs), 50% (56-65 yrs) and 26% (>65 yrs). In comparison, 58% (40-55 yrs), 56% (56-65 years) and 29% (>65 yrs) of population without hypertension used HRI. The difference between two groups was not statistically significant. Younger age (OR 4.0, p <.0001 for 40-55 group, and OR 2.6, p=0.001 for 50-65 group), women (OR 1.4, p <.0001), higher education (OR 3.8, p <.0001 for 12+ years of education), or higher PIR (OR 1.3, p=0.02 for PIR=2, and OR=3.1, p <.0001 for PIR>=3) were predictors of using HRI with statistical significance. Compared to Caucasians, Africans Americans (OR 0.5, p=0.04) were less likely to use the HRI. After adjusting for socio-demographic variables, patients who used HRI in the last 12 months were 1.3 time more likely to report improvement in health status (p=0.04). Conclusions: HRI usage between the hypertension patients and general population did not differ significantly in different age groups. Age, gender, education, PIR, and race were significant predictors of HRI usage pattern. HRI use was associated with improvement in health status within 12 months of using internet.

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Pattern of Obstetric Clinic Attendance, Deliveries and Neonatal Outcome at a Tertiary Hospital during and after a Free Medical Care Programme

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i230363 ◽

2020 ◽

pp. 22-31

Author(s):

P. A. Awoyesuku ◽

D. A. MacPepple ◽

B. O. Altraide ◽

D. H. John ◽

N. J. Kwosah

Keyword(s):

Medical Care ◽

Neonatal Outcome ◽

Statistical Significance ◽

Tertiary Hospital ◽

Population Based ◽

Clinic Attendance ◽

Care Programme ◽

Middle Income ◽

Significant Difference ◽

The Impact

Background: Policies and programs aimed at giving access to healthcare free of charge for some segments of the population are increasingly being put in place by low and middle-income countries. The impact of such policies has so far been rather mixed. Objective: This study sought to determine the pattern of obstetrics clinic attendance, deliveries and neonatal outcome during and after a Free Medical Care (FMC) Programme. Was there any significant difference during and after the FMC programme? Methodology: This was a retrospective population-based study involving the three years of a free medical care programme (2012-2014) and the three years after the programme (2015-2017). Data on antenatal/postnatal clinic attendance, method of deliveries and neonatal outcome were retrieved from the hospital records. The Epi-Info 7 statistical software was used for analysis and statistical significance was set at p<0.05. Results: Mean antenatal attendance was 20763.67±6085.71 and 14269.00±1932.71 during and after the programme respectively, but this difference was not significant (P = 0.143). The mean postnatal attendance of 1457.7±447.69 during and 1025.7±193.52 after was not significant (P=0.200). There was more total number of deliveries during (8596) than after (5989) but this was not significant (P=0.171). There were more operative deliveries during (51.9%) than after (39.3%) and this was significant (P=0.0001). The CS rate was 43.1% with previous CS and CPD both responsible for over 40%. Livebirths were 8,272 (58.8%) during and 5,796 (41.2%) after, which was significant (P=0.0001). There was significant difference (P=0.006) in the macerated stillborn (MSB) rate during (44.2%) and after (55.8%). The stillborn rate was 66.9 during and 98.2 after the programme. Conclusion: There were more clinic attendance and deliveries during the programme, but it was not statistically significant. There was however statistically significant increase in operative delivery, total births and livebirths, and reduced MSB rate during the programme.

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Prediction performance of linear models and gradient boosting machine on complex phenotypes in outbred mice

10.1101/2021.08.02.454826 ◽

2021 ◽

Author(s):

Bruno C. Perez ◽

Marco C.A.M. Bink ◽

Gary A. Churchill ◽

Karen L. Svenson ◽

Mario P.L. Calus

Keyword(s):

Complex Traits ◽

Linear Models ◽

Superior Performance ◽

Gradient Boosting ◽

Phenotypic Variance ◽

Mineral Density ◽

Epistatic Effects ◽

Gradient Boosting Machine ◽

Outbred Mice ◽

The Impact

Recent literature suggests machine learning methods can capture interactions between loci and therefore could outperform linear models when predicting traits with relevant epistatic effects. However, investigating this empirically requires data with high mapping resolution and phenotypes for traits with known non-additive gene action. The objective of the present study was to compare the performance of linear (GBLUP, BayesB and elastic net [ENET]) methods to a non-parametric tree-based ensemble (gradient boosting machine GBM) method for genomic prediction of complex traits in mice. The dataset used contained phenotypic and genotypic information for 835 animals from 6 non-overlapping generations. Traits analyzed were bone mineral density (BMD), body weight at 10, 15 and 20 weeks (BW10, BW15 and BW20), fat percentage (FAT%), circulating cholesterol (CHOL), glucose (GLUC), insulin (INS) and triglycerides (TGL), and urine creatinine (UCRT). After quality control, the genotype dataset contained 50,112 SNP markers. Animals from older generations were considered as a reference subset, while animals in the latest generation as candidates for the validation subset. We also evaluated the impact of different levels of connectedness between reference and validation sets. Model performance was measured as the Pearsons correlation coefficient and mean squared error (MSE) between adjusted phenotypes and the models prediction for animals in the validation subset. Outcomes were also compared across models by checking the overlapping top markers and animals. Linear models outperformed GBM for seven out of ten traits. For these models, accuracy was proportional to the traits heritability. For traits BMD, CHOL and GLU, the GBM model showed better prediction accuracy and lower MSE. Interestingly, for these three traits there is evidence in literature of a relevant portion of phenotypic variance being explained by epistatic effects. We noticed that for lower connectedness, i.e., imposing a gap of one to two generations between reference and validation populations, the superior performance of GBM was only maintained for GLU. Using a subset of top markers selected from a GBM model helped for some of the traits to improve accuracy of prediction when these were fitted into linear and GBM models. The GBM model showed consistently fewer markers and animals in common among the top ranked than linear models. Our results indicate that GBM is more strongly affected by data size and decreased connectedness between reference and validation sets than the linear models. Nevertheless, our results indicate that GBM is a competitive method to predict complex traits in an outbred mice population, especially for traits with assumed epistatic effects.

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MO054VASCULAR CALCIFICATION IMPAIRS BONE MINERALIZATION

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa140.mo054 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Maria Lerche Mace ◽

Eva Gravesen ◽

Anders Nordholm ◽

Soeren Egstrand ◽

Marya Morevati ◽

...

Keyword(s):

Wnt Signaling ◽

Vascular Calcification ◽

Bone Mineralization ◽

Statistical Significance ◽

Control Group ◽

Mrna Levels ◽

Mineral Density ◽

High Calcium ◽

And Control ◽

The Impact

Abstract Background and Aims Several studies report an association between low BMD and vascular calcification (VC) in the general population and in CKD patients. Development of VC in CKD is a cell regulated process where the vascular smooth muscle cell alters phenotype to a bone-like secretory cell. Our group has previously demonstrated the expression of Wnt inhibitors in VC and so we ask if the presence of VC affects bone metabolism. Method A novel model of isogenic aorta transplantation (ATx) was developed and used in the study. Severe uremic vascular calcifications were induced in inbred Dark Aguti (DA) rats by 5/6 nephrectomy, high phosphate diet and calcitriol treatment. After 14 weeks the calcified abdominal aorta of the uremic rat was transplanted into a normal DA rat (uremic ATx, n=16). A normal aorta was transplanted into a normal DA rat as sham group (normal ATx, n=9) and age-matched normal rats were used as one more control group (control, n=6). Rats were sacrificed 4 weeks after ATx and plasma biochemistry, bone and vessels were analyzed. Data are presented as mean±SEM or median [range]. Statistical significance *p<0.5,**p<0.01,*** p<0.001. Results The uremic donor rat suffered from severe kidney disease with disturbed mineral balance and its aorta had a high calcium content of 15.7±0.8 µg Ca/mg vs. none in the normal aorta. Uremic ATx, normal ATx and control rats had same plasma levels of creatinine, Ca2+, phosphate, PTH, FGF23 and sclerostin. The uremic ATx had significant lower bone mineral density (BMD) compared to normal ATx and control rats (1576±5 vs. 1592±5* & 1613±6* mg/cc). The impact on bone mineralization was also detected in the bone histomorphometry analysis, where the uremic ATx had less osteoid compared to normal ATx (median 3% [0,3%;8%] vs. 5% [2%;8%]*). Moreover, the uremic ATx had fewer osteoblasts and more osteoclasts. The effect on bone was supported by substantial gene analysis of several genes related to bone remodeling, mineralization and Wnt signaling. The uremic ATx rats had significant changes in mRNA levels of several genes in bone compared to normal ATX and control rats such as increased alkaline phosphatase (3.26±0.29 vs. 1.56±0.32*** & 0.86±0.12***), decreased osteoblast marker osteocalcin (0.54±0.06 vs. 0.92±0.14* & 1.19±0.06***) and increased osteoclast marker cathepsin K (2.36±0.24 vs. 1.19±0.23** & 1.01±0.07***). In addition, we found upregulation of the bone mineralization inhibitors osteopontin (1.46±0.18 vs. 0.69±0.17** & 0.49±0.06**) and progressive ankylosis protein homolog (8.10±0.60 vs. 3.21±0.74** & 2.39±0.48**) as well as collagen I (9.30 [2.73;14.81] vs. 2.30 [0.31;19.33]* & 2.78 [1.63;7.52]***). The inhibitor of bone formation sclerostin was significant increased (2.90 [1.54;13,29] vs. 1,23 [0.32;3.20]** & 0.93 [0.39;2,19]**) along with a slight downregulation of bone stimulator BMP2 (3.18±0.15 vs. 4.06±0.30* & 3.98±0.44*. Finally, the Wnt signaling pathway was affected by upregulation of β-catenin (3.15±0.25 vs. 1.28±0.26*** & 1.03±0.13***) and the downstream gene Snail1 (3.73±0.33 vs. 1.54±0.45*** & 1.04±0.12***). Conclusion These novel findings indicate the existence of a tissue crosstalk between vessels and bone. The presence of vascular calcification lowers BMD, decreases the amount of osteoid and affects several pathways in bone.

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Outcome Among Adolescents and Young Adults with Mature B-Cell Non Hodgkin Lymphoma at Pediatric Versus Adult Centers: A Population-Based Study Using the IMPACT Cohort

Blood ◽

10.1182/blood-2020-136588 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 2-3

Author(s):

Sumit Gupta ◽

Nancy Baxter ◽

Rinku Sutradhar ◽

Sarah Alexander ◽

Jason Pole ◽

...

Keyword(s):

Acute Lymphoblastic Leukemia ◽

B Cell ◽

Lymphoblastic Leukemia ◽

Statistical Significance ◽

Population Based ◽

Income Quintile ◽

Rural Residence ◽

Non Hodgkin Lymphoma ◽

The Impact ◽

Pediatric Center

Background: Disparities in survival between adolescents and young adults (AYA) treated for acute lymphoblastic leukemia in pediatric versus adult centers are well documented. Whether similar disparities exist among AYA with mature B-cell non-Hodgkin lymphoma (B-NHL) is unknown, despite substantial differences between pediatric and adult treatment protocols. We compared outcomes among AYA with B-NHL by locus of care (LOC; pediatric versus adult) using a population-based clinical AYA database. We also assessed whether socioeconomic status or geographic area impacted outcome in this population. Methods: The IMPACT cohort comprises all Ontario, Canada AYA aged 15-21 years diagnosed with one of six common cancers (including NHL) between 1992-2012. Detailed demographic, disease (histology, stage), treatment, and outcome data were collected through chart abstraction and validated by content experts. Postal code at diagnosis allowed determination of neighbourhood income quintile and rural residence. Linkage to population-based health administrative data identified additional events (second cancers, relapse, death). Event-free (EFS) and overall survival (OS) were determined using Kaplan-Meier methods. The impact of LOC on EFS and OS was determined using multivariable Cox proportional hazard models, adjusted for demographics and disease-related variables. Results: Among 176 AYA with B-NHL, 62 (35.2%) received therapy at a pediatric center. Pediatric center AYA were more likely to have Burkitt lymphoma (BL) than diffuse large B-cell lymphoma (DLBCL) as compared to adult center AYA [26/62 (41.9%) vs. 21/114 (18.4%); p<0.001], and more likely to have advanced stage (i.e. Stage III/IV) disease [38/62 (61.3%) vs. 46/114 (40.4%); p=0.006]. The 5-year EFS and OS (with standard errors) for the whole cohort were 72.2%±3.4% and 76.1%±3.2%. Both EFS and OS were superior among pediatric center patients (EFS 82.2%±4.9% vs. 66.7%±4.4%; p=0.02), (OS 85.5%±4.5% vs. 71.1%±4.3%; p=0.03). When stratified by histology (BL vs. DLBCL), the EFS and OS were similar. However, the superior outcome of pediatric center AYA retained statistical significance only among those with DLBCL (Table 1). Adjusted for histology (BL vs. DLBCL), stage, and time period of diagnosis, adult center AYA had inferior EFS [hazard ratio (HR) 2.4, 95% confidence interval (95CI) 1.1-4.9, p=0.02] and OS (HR 2.5, CI 1.1-5.7, p=0.03). Neither neighbourhood income quintile nor rural residence was associated with EFS or OS. Conclusions: In this population-based cohort, AYA with B-NHL treated at pediatric centers experienced substantially superior EFS and OS compared to those treated at adult centers, even accounting for disease characteristics. In subgroup analyses, this difference retained statistical significance among patients with DLBCL but not among patients with BL, though the latter analyses were limited by small sample sizes. Future analyses will analyze whether patterns of treatment failure and late effects vary by locus of care. Further confirmatory studies are warranted, as are studies to determine the relative contribution of pediatric protocols versus other components of care. Our results nonetheless suggest that similar to AYA with acute lymphoblastic leukemia, AYA with B-NHL may benefit from being treated in pediatric centers with pediatric protocols. Disclosures Baxter: Servier: Membership on an entity's Board of Directors or advisory committees.

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Randomized trials assessing calcium supplementation in healthy children: relationship between industry sponsorship and study outcomes

Public Health Nutrition ◽

10.1017/s136898000900487x ◽

2009 ◽

Vol 12 (10) ◽

pp. 1931-1937 ◽

Cited By ~ 20

Author(s):

Nancy Nkansah ◽

Thao Nguyen ◽

Hoda Iraninezhad ◽

Lisa Bero

Keyword(s):

Study Design ◽

Calcium Supplementation ◽

Statistical Significance ◽

Healthy Children ◽

Mineral Density ◽

Design Features ◽

Industry Sponsorship ◽

Nutrition Research ◽

Study Results ◽

The Impact

AbstractObjectiveTo explore the relationship between industry sponsorship of Ca supplementation studies in healthy children and study outcomes.DesignAn electronic search for published randomized controlled trials (RCT) was conducted. We collected data on study design features aimed at reducing bias, statistical significance of results, authors’ conclusions and financial sponsorship of study. We used Fischer’s exact test to examine associations between sponsorship and study results and conclusions.SubjectsHealthy children between the ages of 9 and 18 years.ResultsNineteen trials met our inclusion criteria. Seventeen out of nineteen studies reported a statistically significant improvement of supplementation on bone mineral density. Subjects in eight of the seventeen studies had a baseline daily Ca intake of 800–1300 mg. There was no significant association between study design features and the results or conclusions of the studies. Three studies received government funding, two of which (66·7 %) concluded in favour of additional supplementation. Sixteen studies were either industry-funded or had mixed industry funding, thirteen (81·3 %) of which had a conclusion supporting Ca supplementation in children. There was no significant association between study sponsorship and authors’ conclusions.ConclusionsThe majority of RCT assessing the effects of Ca supplementation in healthy children are industry-funded and support Ca supplementation. The clinical significance of the outcomes measured in Ca supplementation studies should be considered when examining associations between study design and results. Further non-industry funded research is needed to thoroughly assess the impact of funding on authors’ conclusions in nutrition research.

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The Impact of Neurofeedback-Training on the affective rating of different image categories in Anorexia Nervosa

Aktuelle Ernährungsmedizin ◽

10.1055/s-0032-1312557 ◽

2012 ◽

Vol 37 (03) ◽

Author(s):

A Trinker ◽

HF Unterrainer ◽

N Lackner ◽

A Novosel ◽

M Dunitz-Scheer ◽

...

Keyword(s):

Anorexia Nervosa ◽

Neurofeedback Training ◽

Affective Rating ◽

The Impact

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Association between reproductive factors and postmenopausal osteoporosis

Osteologie/Osteology ◽

10.1055/s-0037-1620001 ◽

2011 ◽

Vol 20 (03) ◽

pp. 248-251

Author(s):

H. R. Meybodi ◽

N. Khalili ◽

P. Khashayar ◽

R. Heshmat ◽

A. Hossein-nezhad ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Mineral ◽

Reproductive Factors ◽

Population Based ◽

Age At Menarche ◽

Mineral Density ◽

Cross Sectional ◽

Number Of Children ◽

Menstrual History ◽

Duration Of Breastfeeding

SummaryThe present cross-sectional research was designed to study possible correlations between clinical reproductive factors and bone mineral density (BMD) values.Using the data gathered by the population-based Iranian Multicenter Osteoporosis Study (IMOS), we investigated the correlation found between reproductive factors and osteoporosis. Subjects were recruited from five major cities of Iran. Bone mineral density was measured using Dual-Energy X-ray Absorptiometry and the results were analyzed against the age at menarche and at menopause, number of pregnancies, children and abortions, and the history (and duration) of breastfeeding.Data was available for 2528 women. Gravidity and number of children were reversely correlated with BMD. Younger age at menarche was associated with higher BMD values, whereas there was no significant correlation between age at menopause and menstrual history and BMD.Our study suggests that clinical reproductive factors, particularly number of children and breastfeeding, could be incorporated as predictors of BMD levels in women. Given the controversial results obtained in different studies, longitudinal studies should be carried out to enlighten the importance of these factors and the rationale of their use to predict BMD values in different settings.

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