Arm bone loading index predicts DXA musculoskeletal outcomes in two samples of post-menarcheal girls

OBJECTIVE: A site-specific bone loading index was developed to predict post-menarcheal arm bone mass, geometry, areal density and non-bone lean mass using organized activity records. METHODS: Two cohorts of post-menarcheal girls (A= 55, B= 48) met analysis inclusion criteria: 1) Whole body and non-dominant radius DXA scans +1.0 to +2.6 years post-menarche; 2) detailed, organized activity records available for 36 months prior to the focal DXA scan; 3) accompanying anthropometric data. DXA non-dominant arm and radius regions of interest (1/3, Ultradistal (UD)) were evaluated. An arm bone loading index (arm totBLI) was developed and refined to describe >50 activities. Separate regression analyses for Cohorts A&B tested explanatory value of arm totBLI for DXA outcomes, accounting for gynecological age, height and whole body non-bone lean mass. RESULTS: In both cohorts, arm totBLI reflecting 3 years of peri-menarcheal activity exposure exhibited strong explanatory value for post-menarcheal radius and arm outcomes (squared semi-partial r =0.07-0.34, p<0.05), except Arm Area. For both cohorts and most outcomes, arm totBLI explained significant variance, even after adjusting for local muscle mass. CONCLUSIONS: In two independent cohorts, arm totBLI may consistently indicate osteogenic and sarcogenic properties of represented activities; additional research is necessary for further refinement and validation.