The association between emotional and behavioural problems and bone health: Is there a link in childhood? — ASN Events
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  3. The association between emotional and behavioural problems and bone health: Is there a link in childhood?

The association between emotional and behavioural problems and bone health: Is there a link in childhood? (#230)

Natalie Hyde 1 , Mia A Percival 1 , Lana J Williams 1 , Esma Fazlic 1 , Kara Anderson 1 , Julie A Pasco 1
  1. School of Medicine, Deakin University, Geelong, Victoria, Australia

Aim

There is a growing body of evidence to suggest a link between mental health and bone health. However, to date most of this research has been conducted in adult populations. Thus, this study aimed to determine the association between fracture, bone mineral density (BMD) and emotional and behavioural problems in children.

Methods

Data were collected as part of the Vitamin D in Pregnancy Study. Briefly, pregnant women were recruited from University Hospital Geelong over an 18-month period (2002-04). Radiologically confirmed fractures in the children were ascertained from birth until July 16th 2019. At approximately 11 years of age mother and child pairs were invited to return and children underwent a DXA scan (Lunar Prodigy) to determine BMD at the spine and total body (less head) regions of interest (ROI). As a measure of child emotional and behavioural problems, the Strengths and Difficulties Questionnaire (SDQ) was parentally completed. Linear regression models were used to determine associations between child behaviour and BMD, and Cox regression models were used to determine association with fracture.

Results

There were 188 mother child pairs that completed both the SDQ and DXA scan. Of these, 60 (31.9%) of children had at least one fracture. The median total SDQ score was 6.5/40 (IQR: 4-12) and using recommended cut-offs there were 146 (77.7%), 12 (6.4%) and 30 (16.0%) with normal, borderline and abnormal scores respectively. Total SDQ scores were associated with fracture risk (HR: 1.04, 95% CI 1.003,1.071). Similarly, compared to those with normal scores, those with abnormal scores were at increased risk (HR: 1.83, 95% CI 1.02,3.30). There was no association between either continuous or categorical SDQ scores and BMD at either ROI at 11 years of age.

 

Conclusion

Child emotional and behavioural problems are associated with risk of fracture, however there was no association detected with measures of bone density. It is plausible that increased risk of fracture is attributable to increased risk-taking behaviour, or changes in bone structure not captured by DXA. Future studies are needed to further elucidate this observed association.