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Background: High bone mass (HBM, BMD Z-score ≥  + 3.2) and cam morphology (bulging of lateral femoral head) are associated with greater odds of prevalent radiographic hip osteoarthritis (rHOA). As cam morphology is itself a manifestation of increased bone deposition around the femoral head, it is conceivable that cam morphology may mediate the relationship between HBM and rHOA. We therefore aimed to determine if individuals with HBM have increased odds of prevalent cam morphology. In addition, we investigated whether the relationship between cam and prevalent and incident osteoarthritis was preserved in a HBM population.Methods: In the HBM study, a UK based cohort of adults with unexplained HBM and their relatives and spouses (controls), we determined the presence of cam morphology using semi-automatic methods of alpha angle derivation from pelvic radiographs. Associations between HBM status and presence of cam morphology, and between cam morphology and presence of rHOA (or its subphenotypes: osteophytes, joint space narrowing, cysts, and subchondral sclerosis) were determined using multivariable logistic regression, adjusting for age, sex, height, weight, and adolescent physical activity levels. The association between cam at baseline and incidence of rHOA after an average of 8 years was determined. Generalised estimating equations accounted for individual-level clustering.Results: The study included 352 individuals, of whom 235 (66.7%) were female and 234 (66.5%) had HBM. Included individuals contributed 694 hips, of which 143 had a cam deformity (20.6%). There was no evidence of an association between HBM and cam morphology (OR = 0.97 [95% CI: 0.63-1.51], p = 0.90) but a strong relationship was observed between cam morphology and rHOA (OR = 3.96 [2.63-5.98], p = 5.46 × 10-11) and rHOA subphenotypes joint space narrowing (OR = 3.70 [2.48-5.54], p = 1.76 × 10-10), subchondral sclerosis (OR = 3.28 [1.60-6.60], p = 9.57 × 10-4) and osteophytes (OR = 3.01 [1.87-4.87], p = 6.37 × 10-6). Cam morphology was not associated with incident osteoarthritis (OR = 0.76 [0.16-3.49], p = 0.72).Conclusions: The relationship between cam morphology and rHOA seen in other studies is preserved in a HBM population. This study suggests that the risk of OA conferred by high BMD and by cam morphology are mediated via distinct pathways. [ABSTRACT FROM AUTHOR]

Summary: We investigated an intrauterine influence of maternal smoking during pregnancy on childhood bone mass. Daughters, but not sons, of mothers who smoked had higher bone mass at age 10 years. This appears to be due to familial factors related to parental smoking influencing increased offspring adiposity rather than a direct intrauterine effect. Introduction: Neonatal studies have demonstrated an adverse relationship between maternal smoking in pregnancy and foetal bone mineral accrual. We aimed to investigate an intrauterine influence of maternal smoking during pregnancy on offspring bone mass at mean age 9.9 years. Methods: We compared associations of maternal and paternal smoking in pregnancy with offspring total body less head (TBLH) and spine bone mineral content (BMC), bone area (BA), bone mineral density (BMD) and area-adjusted BMC (ABMC) in 7,121 children in the Avon Longitudinal Study of Parents and Children. Results: Maternal smoking in any trimester was associated with increased TBLH BMC, BA and BMD in girls (mean difference [95% CI] (sex-specific SD scores), 0.13 [0.05-0.22], 0.13 [0.04-0.21], 0.13 [0.04-0.22], respectively) but not boys (0.01 [−0.07-0.09], 0.00 [−0.08-0.08], 0.04 [−0.05-0.12]), and also with spine BMC, BA and BMD in girls (0.13 [0.03-0.23], 0.12 [0.03-0.22], 0.10 [0.00-0.21]) but not boys (0.03 [−0.06-0.12], 0.00 [−0.09-0.09], 0.05 [−0.04-0.14]), but not with ABMC. Paternal smoking associations were similar, with no statistical evidence for a difference between maternal and paternal effects. Maternal associations increased on adjustment for offspring birth weight and gestational age, but attenuated to the null after adjustment for current height and weight. Conclusions: We found little evidence that maternal smoking was related to bone mass in boys. In girls, maternal smoking associations were similar to those of paternal smoking, suggesting that these were attributable to shared familial characteristics, not intrauterine mechanisms. [ABSTRACT FROM AUTHOR]

Objective Studies in neonates have demonstrated an adverse relationship between maternal smoking during pregnancy and fetal bone mineral accrual. We aimed to investigate an intrauterine influence of maternal smoking in pregnancy on offspring bone mass during childhood. Design Prospective birth cohort study: the Avon Longitudinal Study of Parents and Children (ALSPAC). Setting Mothers were resident in Avon, UK during pregnancy and had expected delivery dates between April 1991 and December 1992. Participants and Methods Our analysis included 7121 children attending a research clinic at mean age 9.9 years. We used multiple regression models to compare associations of maternal and paternal smoking at the time of pregnancy with measures of bone size and density in the children, since a greater maternal association would provide evidence of a direct intrauterine effect on the fetus. Multivariate multiple imputations were used to account for missing data. Main Outcome Measures DXA measured total body less head (TBLH) and spine bone mineral content (BMC), bone area (BA) and bone mineral density (BMD). Results Maternal smoking in any trimester of pregnancy was associated with increased TBLH BMC, BA and BMD in girls (mean difference (95% CI) (using sex-specific SD scores): 0.13 (0.05 to 0.22), 0.13 (0.04 to 0.21) and 0.13 (0.04 to 0.22), respectively) but not in boys (0.01 (−0.07 to 0.09), 0.00 (−0.08 to 0.08), 0.04 (−0.05 to 0.12)) in confounder-adjusted models. It was also associated with spine BMC, BA and BMD in girls (0.13 (0.03 to 0.23), 0.12 (0.03 to 0.22), 0.10 (0.00 to 0.21)) but not in boys (0.03 (−0.06 to 0.12), 0.00 (−0.09 to 0.09), 0.05 (−0.04 to 0.14)). Paternal smoking associations were similar, with no statistical evidence for a difference between maternal and paternal associations (all p values >0.15). Maternal associations increased on adjustment for offspring birth weight and gestational age but attenuated to the null on adjustment for the child's height and weight at age 9 years. Further investigation indicated that these relationships were driven mainly by offspring weight rather than height. Conclusions There was little evidence of a relationship between maternal smoking during pregnancy and bone mass in boys. Our parental comparisons and multivariable analyses suggested that the positive associations between maternal smoking and bone mass in girls were likely to be attributable to shared familial characteristics related to offspring adiposity rather than an intrauterine mechanism. [ABSTRACT FROM PUBLISHER]

Objective: To examine the extent to which geometric parameters derived from dual-energy x-ray absorptiometry (DXA) scans in the UK Biobank study are related to hip osteoarthritis (HOA) independently of sex, age and body size., Design: Femoral neck width (FNW), diameter of the femoral head (DFH) and hip axis length (HAL) were derived automatically from left hip DXA scans in UK Biobank using outline points placed around the hip by a machine-learning program. Correlations were calculated between geometric parameters, age, height, and weight. Logistic regression was used to examine the relationship of geometric parameters with radiographic HOA, hospital diagnosed HOA (HESOA), and Cox proportional hazards model to evaluate the relationship with total hip replacement (THR). Analyses were adjusted for sex, age, height, weight, and geometric parameters., Results: The study consisted of 40,312 participants. In age and sex-adjusted analyses, FNW, HAL and DFH were related to increased risk of radiographic HOA. In a model adjusted for age, sex, height, weight and other geometric parameters, both FNW and HAL retained independent relationships with radiographic HOA [FNW: odds ratios 2.38 (2.18-2.59), HAL: 1.25 (1.15-1.36)], while DFH was now protective [0.55 (0.50-0.61)]. Only FNW was independently related to HESOA [2.20 (1.80-2.68)] and THR [hazard ratios 2.51 (1.89-3.32)]., Conclusion: Greater FNW and HAL were independently related to an increased risk of radiographic HOA, whereas greater DFH appeared to be protective. Greater FNW was independently associated with HESOA and THR. These results suggest that DXA-derived geometric parameters, particularly FNW, could help determine HOA and THR risk., Competing Interests: Declaration of Competing Interest TC & CL have a patent image processing apparatus and method for fitting a deformable shape model to an image using random forest regression voting. This is licensed with royalties to Optasia Medical. NH reports consultancy fees and honoraria from UCB, Amgen, Kyowa Kirin, Thornton Ross, Consilient., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)