Are birth characteristics related to bone quality measures in young adults? The HUNT study, Norway

Osteoporos IntPublished Population-based cohort study

Authors' conclusion

Birth characteristics are associated with both bone strength and geometry in young adulthood. These associations are partly independent of BMD, highlighting the value of DXA-derived bone quality measures in assessing skeletal health.

Study context

Population
Young adults aged 20–54 years (60% women) from the Trøndelag Health Study (HUNT3 and HUNT4), Norway
Participants
2,680 adults
Exposure
Birth characteristics and DXA-derived bone quality in young adults
Outcome
DXA-derived bone quality measures: cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), buckling ratio, hip axis length
Methodological detailslinked with Medical Birth Registry of Norway, linear regression
  • Linked with Medical Birth Registry of Norway
  • Linear regression

Main finding

As reported in the abstract

CSA and CSMI per SD increase in birth weight and length

CSA increase per SD birth weight

4.33 mm²

CSA increase per SD birth length

4.29 mm²

CSMI increase per SD birth weight

0.74 mm4

CSMI increase per SD birth length

0.45 mm4

Observational data: associations, not effects.

Further findings

CSA and CSMI per SD, after bone mineral density (BMD) adjustment (attenuated)

Birth weight: CSA
1.90 mm²
Birth weight: CSMI
0.55 mm4
Birth length: CSA
2.13 mm²
Birth length: CSMI
0.58 mm4

Buckling ratio and hip axis length

Weaker and less consistent associations with birth characteristics; association of birth weight and SGA with buckling ratio somewhat strengthened after BMD adjustment

Original publication

Are birth characteristics related to bone quality measures in young adults? The HUNT study, Norway. Osteoporos Int. Published 18 March 2026. doi:10.1007/s00198-026-07928-4

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