title: Socioeconomic status and bone mass in Spanish adolescents. The HELENA Study.
abstract: OBJECTIVE
  Socioeconomic status (SES) has been frequently associated with body composition, particularly fat mass and obesity. However, the SES-bone mass association is not clear. We aimed to evaluate the associations between different SES indicators (Family Affluence Scale, parental education, and occupation) and bone mineral content in Spanish adolescents.
  
  
  METHODS
  Participants were 322 adolescents (164 boys and 158 girls, 12.5-17.5 years) from the Healthy Lifestyle in Europe by Nutrition in Adolescence study. The social background of the adolescents was self-reported using an SES questionnaire, and the bone variables were measured using dual-energy x-ray absorptiometry. Physical activity was measured using accelerometers. Calcium intake was estimated from two nonconsecutive 24 hours recalls. One-way analysis of covariance was performed to examine the relationships between SES indicators and bone mass using different sets of confounders: basic model (sex + sexual maturation), model 1 (basic model + height), model 2 (basic model + lean mass), and model 3 (basic model + calcium intake + average physical activity).
  
  
  RESULTS
  Adjusted results showed no association between SES indicators and whole-body or total hip bone mineral content. Additional analyses were performed in lumbar spine, pelvis, and hip subregions (femoral neck, trochanter, and intertrochanter), and no significant associations were observed at these sites either.
  
  
  CONCLUSIONS
  Our data do not support a link between different SES indicators (Family Affluence Scale, parental education, and occupation) and bone mass in adolescents.
authors.affiliation: GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain. lgracia@unizar.es
authors.forename: Luis
authors.initials: L
authors.lastname: Gracia-Marco
authors.forename: Francisco B
authors.initials: FB
authors.lastname: Ortega
authors.forename: José A
authors.initials: JA
authors.lastname: Casajús
authors.forename: Isabelle
authors.initials: I
authors.lastname: Sioen
authors.forename: Kurt
authors.initials: K
authors.lastname: Widhalm
authors.forename: Laurent
authors.initials: L
authors.lastname: Béghin
authors.forename: Germán
authors.initials: G
authors.lastname: Vicente-Rodríguez
authors.forename: Luis A
authors.initials: LA
authors.lastname: Moreno
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition; D049628:Body Size; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D002136:Calcium, Dietary; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D012923:Social Class; D012959:Socioeconomic Factors; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D002136:Calcium, Dietary