Bone Mineral Density and Nutritional Status of Healthy Sri Lankan pre-school children

Background: We wished to assess bone mineral density (BMD) values and factors that contribute to bone mineral accrual among preschool children in Sri Lanka. Currently, this information is not available.Objectives: To measure BMDs of spine and hip, using a central-type DXA, in a representative sample of preschool children in Southern Sri Lanka and to study their anthropometry and micronutrient status in order to study the associations of such measurements with bone mineral status.Patients and Methods: We measured BMD of the spine and hip using dual-energy absorptiometry in 105 preschool children (52 boys) aged 3–5 years in Southern Sri Lanka. We also studied their anthropometric characteristics and micronutrient status (iron, zinc, calcium, ceruloplasmin, free thyroxine, and vitamins A and D).Results: Although spine BMD showed no sex difference (mean BMD 0.451 g/cm2 and 0.447 g/cm2 in boys and girls, respectively; p = 0.70), proximal femur BMD values were significantly higher (p = 0.02) among boys (0.594 g/cm2) than among girls (0.557 g/cm2). Boys had significantly higher bone area in the spine, compared to girls (mean 25.58 vs. 24.05 cm2; p = 0.02). After controlling for other independent variables studied (anthropometry and biochemistry), weight and serum calcium accounted for 26% of the BMD variation (R2 = 0.26). One unit change in body weight (1 kg) or serum calcium level (1 mmol/L) was associated with a change in spine BMD of 0.051 g/cm2 or 0.016 g/cm2, respectively.Conclusions: In addition to higher BMD in the proximal femur boys have broader bones, particularly in the spine. Among different indices of body measurements and multiple nutritional factors, body weight and serum calcium appear to be the main determinants of BMD accrual.