The polygenic risk score genetic quantitative ultrasound speed of sound (gSOS) was developed using machine learning algorithms in adults of European ancestry and associates with reduced odds of fracture in adults. We aimed to determine if gSOS was associated with bone health in children.
Two observational studies of children were evaluated: (1) children enrolled in the Bone Mineral Density in Childhood Study (BMDCS) with genetic data (N=1,727); and (2) children with genetic data for research at the Children’s Hospital of Philadelphia (CHOP; N=10,301).
Genetic variants were used to calculate gSOS and genetic ancestry. For the BMDCS, puberty stage, dietary calcium, physical activity and fracture accumulation (none or ≥1 fracture) were self-reported, height and weight were measured and BMI calculated. Areal bone mineral density (aBMD) of the lumbar spine, hip, radius, and whole body were assessed by dual energy X-ray absorptiometry and expressed as Z-scores. The CHOP study paired genetic data with documentation of fracture in the electronic health record (EHR).
gSOS associated with higher aBMD Z-scores across 7 skeletal sites [e.g., a 1 SD increase in gSOS associated with 0.17 (95% CI: 0.10-0.24) higher lumbar spine aBMD Z-score]. These associations were consistent for males and females, age, puberty stage, and lifestyle factors, and most consistent among children of European genetic ancestry. A 1 SD increase in gSOS associated with 12% and 16% reduced likelihood of self-reported fracture in the BMDCS (OR=0.84, 95% CI: 0.74, 0.95) and a recorded fracture in the CHOP EHR (OR=0.88; 95% CI: 0.82, 0.95). No sex or genetic ancestry differences were found.
A higher gSOS score associated with higher aBMD at multiple skeletal sites and reduced odds of fracture in two independent pediatric samples. This genetic tool may have clinical utility to help enhance bone health in early life and protect against fracture across the lifespan.
In adults, the polygenic risk score gSOS associates with reduced fracture risk. This study evaluates the relationship of gSOS to bone density and fractures in two groups of children. We found that a 1 standard deviation increase in gSOS was associated with higher bone density at multiple skeletal sites. In our two groups of children, a 1 standard deviation increase in gSOS associated with reduced odds of fracture in children by 12% (95% CI: 0.82, 0.95) and 26% (95% CI: 0.74, 0.95). Having a higher gSOS may enhance bone accretion in early life, and protect against fracture across the lifespan.
- The gSOS Polygenic Score is Associated with Bone Density and Fracture Risk in Childhood
- Jonathan A. Mitchell - University of PennsylvaniaJonathan Bradfield - Children's Hospital of PhiladelphiaShana E. McCormack - Children's Hospital of PhiladelphiaAlessandra Chesi - University of PennsylvaniaHeidi J. Kalkwarf - University of CincinnatiJoan M. Lappe - Creighton UniversitySharon E. Oberfield - Columbia University Irving Medical CenterDana L. Duren - University of MissouriJohn A. Shepherd - University of Hawaii SystemKurt D. Hankenson - Department of Orthopedic Surgery, University of MichiganAndrea Kelly - Children's Hospital of PhiladelphiaHakon Hakonarson - Children's Hospital of PhiladelphiaStruan F.A. Grant - Children's Hospital of PhiladelphiaBabette S. Zemel - University of Pennsylvania
- medRxiv
- Cold Spring Harbor Laboratory Press
- 1.1
- 35
- 991006165210202656
- College of Nursing
- English
- Preprint