Sex differences in the rate of abdominal adipose accrual during adulthood: the Fels Longitudinal Study.

OBJECTIVES: The purpose of this analysis was to evaluate sex differences in the rate of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) accrual in adults. Secondary analyses examined differences in the rate of VAT and SAT accrual in premenopausal, perimenopausal and postmenopausal women. SUBJECTS/METHODS: Participants were 472 (60% female) non-Hispanic whites and aged 18-84 years at baseline in whom abdominal VAT and SAT were assessed using multiple-image magnetic resonance imaging at two time points, with an average follow-up of 7.3±2.6 years. Linear regression models were used to examine the effects of sex, baseline age and their interaction on rate of change per year in body composition measures (ΔBMI, ΔVAT and ΔVAT/SAT ratio (ΔVSR)) independent of baseline body composition measures, visit year, income, marital status, physical activity, smoking and alcohol intake. Secondary analyses examined differences in the rate of fat change by menopausal status (premenopausal, perimenopausal, postmenopausal). RESULTS: Levels of body mass index (BMI), VAT and VSR all increased over the 7-year period on average (P<0.001); however, the change in BMI (mean ΔBMI=+0.5%) was far smaller than for VAT (mean ΔVAT=+6.8%), SAT (mean ΔSAT=+2.4%) and VSR (mean ΔVSR=+3.6%). ΔBMI, ΔVAT and ΔSAT decreased linearly with age in both sexes (P<0.01), such that older individuals had lower rates of BMI, VAT and SAT gain, and this deceleration in BMI, VAT and SAT accrual was greater in men than women (P for interaction <0.05). ΔVSR did not vary with age in either sex but remained higher in men than women throughout adulthood. There were no differences in rate of weight or fat gain by menopausal status after adjustment for age. CONCLUSIONS: Men and women continue to accrue abdominal adiposity with age, but the rate of weight and fat gain decreases over time, particularly in men.

Axial quantitative ultrasound assessment of pediatric bone quality in eastern Nepal.

UNLABELLED: This study presents quantitative ultrasonography (QUS) bone quality data for an underrepresented, south Asian pediatric population from Nepal. Data were collected as part of a longitudinal study of growth and development. This study offers normative data and documents the effect of stunting, wasting, and underweight on the bone properties measured by QUS. INTRODUCTION: The purpose of this study was to (1) examine the bone quality of a rural, non-Western pediatric population using QUS, (2) explore variation in the trajectory of bone quality development between males and females, and (3) examine the impact of growth disruption(s) on bone quality. METHODS: A cross-sectional study of 860 children and adolescents aged 5-18 years from the Jirel ethnic group in eastern Nepal was performed. The Sunlight Omnisense 7000P was used to assess bone quality of the distal 1/3 radius and midshaft tibia. WHO reference standards were used to assess growth disruptions of height, weight, and BMI. RESULTS: QUS bone quality data for an underrepresented, non-Western pediatric population are presented for the radius and tibia. A sizable portion of the study participants were classified as stunted, wasted, and/or underweight. Despite this prevalence of growth disruption in the study sample, bone quality data conform to other documented populations with less growth disruption. Thus, this study offers normative data and documents the minimal effect of stunting, wasting, and underweight on the bone properties measured by QUS. CONCLUSIONS: Non-Western pediatric populations are significantly underserved with regard to simple, non-invasive screening tools that may help identify developmental disorders and assess bone health. The children and adolescents examined here represent normal growth and development for an underrepresented south Asian population. While this work demonstrates that stunting, wasting, or underweight status at time of QUS assessment is not associated with poor bone quality, we do suggest that further study is needed to examine possible cumulative effects of persistent disruptions that may lead to compromised bone quality in later adolescence.

Patterns of linear growth and skeletal maturation from birth to 18 years of age in overweight young adults.

OBJECTIVE: To estimate differences in skeletal maturity and stature from birth to age 18 years between individuals who are overweight vs normal weight in young adulthood. PATIENTS AND METHODS: Weight, length and height, and relative skeletal age (skeletal-chronological age) were assessed annually from birth to age 18 years in 521 subjects (255 women) in the Fels Longitudinal Study who were overweight or obese (body mass index (BMI) >25 kg m(-2), n=131) or normal weight (n=390) in young adulthood (18-30 years). Generalized estimating equations were used to test for skeletal maturity and stature differences by young adult BMI status. RESULTS: Differences in height increased during puberty, being significant for girls at ages 10 to 12 years, and for boys at ages 11 to 13 years (P-values<0.001), with overweight or obese adults being ∼3 cm taller at those ages than normal weight adults. These differences then diminished so that by age 18 years, overweight or obese adults were not significantly different in stature to their normal weight peers. Differences in skeletal maturity were similar, but more pervasive; overweight or obese adults were more skeletally advanced throughout childhood. Skeletal maturity differences peaked at chronological age 12 in boys and 14 in girls (P-values<0.001), with overweight or obese adults being ∼1 year more advanced than normal weight adults. CONCLUSIONS: This descriptive study is the first to track advanced skeletal maturity and linear growth acceleration throughout infancy, childhood and adolescence in individuals who become overweight, showing that differences occur primarily around the time of the pubertal growth spurt. Increased BMI in children on a path to becoming overweight adults precedes an advancement in skeletal development and subsequently tall stature during puberty. Further work is required to assess the predictive value of accelerated pubertal height growth for assessing obesity risk in a variety of populations.

Longitudinal changes in calcaneal quantitative ultrasound measures during childhood.

UNLABELLED: This longitudinal study examined how calcaneal quantitative ultrasound (QUS) measures change during childhood while taking into account skeletal maturation, body mass index (BMI), and physical activity. The study reported sex differences in QUS growth curves and an inverse relationship between BMI and speed of sound (SOS) measures. INTRODUCTION: The aim of this study was to examine how calcaneal QUS parameters change over time during childhood and to determine what factors influence these changes. METHODS: The study sample consisted of a total of 192 Caucasian children participating in the Fels Longitudinal Study. A total of 548 calcaneal broadband ultrasound attenuation (BUA) and SOS observations were obtained between the ages of 7.6 and 18 years. The best fitting growth curves were determined using statistical methods for linear mixed effect models. RESULTS: There are significant sex differences in the pattern of change in QUS parameters (p < 0.05). The relationship between QUS measures and skeletal age is best described by a cubic growth curve in boys and a linear pattern among girls. Boys experience their most rapid growth in BUA and SOS in early and late adolescence, while girls experience constant growth throughout childhood. Adiposity levels were significantly associated with the changes in SOS among boys (p < 0.001) and girls (p < 0.01), indicating that children with higher BMI are likely to have lower SOS over time compared to children with lower BMI. For girls, physical activity levels showed positive associations with changes in QUS measures (p < 0.05). CONCLUSION: This study documents significant sex differences in the pattern of change in QUS measures over childhood and adolescence. Our study also shows significant influences of adiposity and physical activity on the pattern of change in QUS measures during childhood.

The first seriatim study into old age for weight, stature and BMI: the Fels Longitudinal Study.

PURPOSE: To document the serial status of measures of weight, stature and BMI from birth into old age. METHODS: Longitudinal measures of weight, stature and BMI were taken from birth to 76 years of age for 5 men and 7 women as part of the Fels Longitudinal Study. RESULTS: Sex-specific plots of means for weight, stature and BMI are presented that describe the changes and sex differences in these measurements between birth (or the first year of life) into old age. These serial data demonstrate a continuous increase in body weight through much of adulthood and a small decline in stature starting in late middle age. The plots for BMI indicate the early onset of overweight and subsequent obesity early in adulthood and its continuance into old age for men and women. CONCLUSIONS: These are the first plots of serial means for weight, stature and BMI measured from the same group of individuals from birth into old age. These findings demonstrate the changes in these measurements through childhood and maturity into old age. Similar data are needed for individuals from other racial/ethnic groups and countries in order to understand the aging process better.

A review of body water status and the effects of age and body fatness in children and adults.

BACKGROUND: Most investigations of TBW, ECW and body composition and reports of their intra-body relationships were published prior to 1980. Distributional TBW and ECW relationships within the body have been considered fixed, but there was evidence these relationships were affected by the level of fatness. Body composition models based on past findings and assumptions could produce inaccurate estimates when the majority of the population is overweight to obese. METHODS: TBW and ECW volumes, their proportions of body weight, FFM and percent body fat and associations with age are considered in U.S. children and adults. This review focuses on studies reporting measured body water volumes from large samples except for the national predicted values from NHANES III. RESULTS: Measured TBW volumes for children and adults are almost exclusively from whites with the exception of the estimated values from NHANES III for non-Hispanic black and Mexican-Americans. Mean adult TBW volumes are as much as 9 liters greater than those reported prior to 1980. Low mean percentages of TBW%WT reflect the greater level of adiposity in children and adults, and this level of adiposity affects the value of TBW% FFM. Mean ECW volumes for white adults are 10 to 12 liters larger than those reported previously. With greater fatness in adults, ECW%TBW has increased to near 60%, and this implies that a calculation of FFM based on 73% and an ECW%TBW of 25-45% could produce an overestimation but more important clinically an underestimation of body fatness. CONCLUSION: There is inadequate timely information on measured total and extra-cellular water volumes for the population. Available data indicate a coincident increase in body water with overweight and obesity, and a shifting in the proportion of ECW in TBW. Clinical and pharmacological treatments based upon past assumptions of body water volumes, proportions and relationships could produce inaccurate estimates.

Is infant body mass index associated with adulthood body composition trajectories? An exploratory analysis.

BACKGROUND: Infant body mass index (BMI) is increasingly used as a marker of obesity risk based on its association with young-adulthood BMI. OBJECTIVES: The aim of this study is to test the association of infant BMI with young-adulthood fat mass and fat-free mass, and how this association changes during advancing adulthood. METHODS: Body mass index Z-score at age 9 months was measured in 350 White, non-Hispanic Fels Longitudinal Study participants. This exposure was entered into multilevel models to test its association with trajectories describing 2665 BMI observations and 1388 observations of fat mass index (FMI, kg m-2 ) and fat-free mass index (FFMI, kg m-2 ) between ages 20 and 60 years. RESULTS: Partitioning young-adulthood BMI into its fat and fat-free components, infant BMI Z-score was associated with FFMI (ß = 0.745; 95% confidence interval = 0.367 to 1.124) but not FMI (0.528; -0.055 to 1.110) at age 20 years. Greater infant BMI Z-score was associated with slower age-related increases in all outcomes, such that (looking at 10-year intervals) only FFMI at age 30 years was related to infant BMI Z-score (0.338; 0.119, 0.557). CONCLUSIONS: Focus on infant BMI reduction for adulthood obesity prevention warrants caution as high infant BMI values are associated with greater lean mass, which is protective against ageing changes.

Quantitative genetic analysis of blood pressure reactivity to orthostatic tilt using principal components analysis.

Blood pressure (BP) reactivity to orthostatic tilt may be predictive of cardiovascular disease. However, the genetic and environmental influences on BP reactivity to tilt have not been well examined. Identifying different influences on BP at rest and BP during tilt is complicated by the intercorrelation among multiple measurements. In this study, we use principal components analysis (PCA) to reduce multivariate BP data into components that are orthogonal. The objective of this study is to characterize and examine the genetic architecture of BP at rest and during head-up tilt (HUT). Specifically, we estimate the heritability of individual BP measures and three principal components (PC) derived from multiple BP measurements during HUT. Additionally, we estimate covariate effects on these traits. The study sample consisted of 444 individuals, distributed across four large families. HUT consisted of 70 degrees head-up table tilting while strapped to a tilt table. BP reactivity (deltaBP) was defined as BP during HUT minus BP while supine. Three PC extracted from the PCA were interpreted as 'general BP' (PC1), 'pulse pressure' (PC2) and 'BP reactivity' (PC3). Variance components methods were used to estimate the heritabilities of resting BP, HUT BP, deltaBP, as well as the three BP PC. Significant (P<0.05) heritabilities were found for all BP measurements, except for systolic deltaBP at 1 and 3 min, and diastolic deltaBP at 2 min. Significant genetic effects were also found for the three PC. Each of these orthogonal components is significantly influenced by somewhat different sets of covariates.

Occurrence of soil-transmitted helminths in women at the Himalayan region of Nepal.

OBJECTIVE: To find the occurrence pattern and prevalence of the soil transmitted helminths in women of child bearing age group. METHODS AND MATERIALS: The study was conducted in Jiri , an area of Dolakha district at the altitude of 2100 meter from sea level. The faecal sample of 478 women of childbearing age (15 to 45 years) were taken randomly and examined for the ova of soil transmitted helianthus. RESULT: The occurrence pattern was 53.0%, 20.0% and 2.7% for Hookworms, Ascaries lumbricoids and Trichuris Trichuria respectively. Both Ascaries and Hookworm prevalence rates noticeably increased with increasing age, with the highest infection rate between the age of 36-45 years while trichuris infection reached the highest in women of 15-25 years of age. CONCLUSION: There is a high prevalence of hookworm and ascaries in women of childbearing age and necessary intervention is needed according to WHO guidelines.

Long-term use of indwelling multipurpose silastic catheters in pediatric cancer patients treated with aggressive chemotherapy.

We studied the complications related to the use of 53 multipurpose silastic catheters (MSC) placed in 46 pediatric cancer patients over a 1-year period. We documented the longest duration of catheter placement in the pediatric oncology literature. There were 7,650 Broviac days (range, 9 to 365 days; mean, 163 days) with 255 patient months of catheter use and a mean of 5.5 months per catheter. Of the 53 MSCs, 90% were Broviacs (72% adult size, 18% pediatric size) and 10% Hickman. There were 23 episodes of bacteremias or 0.31 episodes per 100 days of catheter use. Coagulase-negative staphylococci were isolated in 20% of the episodes of bacteremia. Only 34% had an absolute granulocyte count (AGC) (Polymorphonuclear cells [PMN] + band cells) less than 500 in the 23 MSCs with bacteremia. Ten percent were removed: 4% for mechanical problems, 6% for bacteremia unresponsive to appropriate antibiotic therapy. There were no deaths related to bacteremia, embolism, or vascular damage. This study demonstrated that despite the recent use of more aggressive immunosuppressive therapy, the incidence of MSC bacteremias was 43%, similar to earlier National Cancer Institute studies (39%) American Society of Clinical Oncology, (abstract C-219, 1982). Based on these findings, we have currently modified our MSC care and have recently throughout the past 6 months reduced our infectious complication rate by 50%.

Total-body and regional bone mineral content and areal bone mineral density in children aged 8-18 y: the Fels Longitudinal Study.

BACKGROUND: Techniques for cross-calibration of bone mineral content (BMC) and bone mineral density (BMD) between manufacturers of dual-energy X-ray absorptiometry (DXA) instruments are currently inadequate for total body measurements. Therefore, manufacturer-specific data for BMC and BMD in children are needed. OBJECTIVE: We provided age- and sex-specific means and SDs for total-body and regional BMC and areal BMD in 8-18-y-old white children. DESIGN: BMC and BMD of the head, arms, legs, pelvis, spine, and total body were determined by DXA. Data include 465 annual measurements from 148 healthy children with body weights between 30 and 100 kg and statures <190 cm. RESULTS: There were significant sex differences in BMC at ages 15-18 y for the total body and legs, at ages 12 and 15-18 y for arms and pelvis, at ages 11-13 and 16-18 y for the spine, and at ages 10-11 y for the head. There were significant sex differences in BMD at ages 16-18 y for total body, arms, and legs; at ages 12-13 and 16-18 y for the pelvis; at ages 12-14 and 18 y for the spine; and at ages 13-18 y for the head. CONCLUSIONS: Data presented in this investigation can be used to compare the BMC and BMD of 8-18-y-old white children (with statures <190 cm and body weights between 30 and 100 kg) using DXA.

Genetic and state variables of neurocognitive dysfunction in schizophrenia: a twin study.

To characterize the familiality of cognitive dysfunction in schizophrenia, we studied performance on three tasks (visuospatial attention; visuolinguistic conflict, arrow-word; and Wisconsin Card Sorting Test [WCST]) by monozygotic (MZ) and dizygotic (DZ) twin pairs discordant for schizophrenia. The subject sample consisted of six MZ twin pairs, nine DZ twin pairs, and one MZ and one DZ nonschizophrenia cotwin of a patient with schizophrenia. There were two sources of cognitive dysfunction: a nonheritable, state component and a heritable, trait component. Deficits surfaced during the WCST in nonschizophrenia MZ cotwins; this impairment resolved following training in nonschizophrenia MZ cotwins, but not in the probands with schizophrenia, who performed abnormally in all tasks. The results suggest that nonheritable protective factors modulate the specific, plastic, and sometimes subtle neurocognitive deficits related to the schizophrenia genotype.

Sex differences in bone mass acquisition during growth: the Fels Longitudinal Study.

Risk of osteoporosis in later life may be determined during adolescence and young adulthood. The present study used longitudinal data to examine the accumulation of bone mineral content (BMC) and bone mineral density (BMD) in Caucasian subjects ages 6-36 yr. Growth in BMC and BMD (measured by dual X-ray absorptiometry; Lunar, Madison, WI) of 94 males and 92 females was monitored for a mean period of 4.29 yr. The main findings were that there were no sex differences in BMC or BMD during the prepubertal stage; however, females had significantly higher BMD of the pelvis and BMC and BMD of the spine during puberty, and postpubertal males generally had significantly higher BMC and BMD than their female counterparts. In addition, the longitudinal rate of bone accumulation in both sexes increased rapidly during childhood and adolescence and was nearly complete at the end of puberty. Finally, peak BMC and BMD was achieved between the ages of 20 and 25 and occurred earlier in females than in males. The rates of growth and timing of peak bone mass as reported here define the crucial period during which intervention protocols should be developed for maximizing skeletal mass to prevent the development of osteoporosis.

The problem of "giant" omphalocele.

"Giant" omphalocele implies an abdominal wall defect that is 5 cm or more in diameter with the liver in a central position. Giant omphalocele is often associated with other significant anomalies. Technically it is often difficult to close the abdominal wall defect and a staged repair utilizing prosthetic materials may be necessary. The morbidity and mortality associated with this entity remain significant despite advances in management techniques. Hospitalization is often prolonged and costly. For the best outcome in managing patients with giant omphalocele early attention to hypothermia and other metabolic requirements and long-term attention to nutritional needs are important. Techniques of closing the omphalocele should be adapted to the individual characteristics of the defect, but mobilization and stretching of the abdominal muscles should be begun as a newborn. The term hepatomphalocele implying "liver-containing omphalocele" is suggested to refer to this particular entity.

Long-term follow-up of infants and children treated with extracorporeal membrane oxygenation (ECMO): a preliminary report.

Extracorporeal Membrane Oxygenation (ECMO) has been used clinically as a life-saving treatment modality in infants and children who are dying of respiratory insufficiency. From 1973 to 1980 47 children less than 10 years of age were treated in a study to determine the feasibility and effectiveness of ECMO in the pediatric population. Despite a predicted mortality of 90% or greater, 24 patients survived. Eighteen of those patients have been seen in long-term follow-up. Thirteen patients (72%) demonstrate basically normal growth and development. Five patients (28%) have definite handicaps which are severe in two. Despite ligation of one common carotid artery and systemic heparinization, the risk of intracranial hemorrhage and/or neurodevelopmental problems appears to be no higher in this ECMO group and may even be lower than in the high-risk population treated with conventional therapy. The incidence of chronic respiratory problems, especially bronchopulmonary dysplasia, is zero in this group of patients. Only one patient (4%) has a defect that lateralizes to the right hemisphere which may have been affected by ligation of the carotid artery. Further study is required; however, it appears that ECMO offers life-saving intervention without increasing morbidity in select children with severe respiratory insufficiency.

Acquired aganglionosis.

A documented case of acquired aganglionosis is presented in which transrectal biopsies taken 4 mo apart first showed the presence then subsequently the absence of ganglion cells. Colostomy followed by a Soave procedure was curative.

Obstruction of the suprahepatic inferior vena cava as a complication of giant omphalocele repair.

Obstruction of the inferior vena cava with resultant Budd-Chiari syndrome after giant omphalocele repair has not previously been reported. Such a case is presented. We hypothesize the mechanism of this blockage to be posterior displacement of the inferior vena cava during reduction of the viscera and closure of the anterior abdominal wall, thereby creating angulation and mechanical blockage of the inferior vena cava at the diaphragmatic hiatus.

Adult changes in body composition are associated with changes in cholesterol levels: the Fels longitudinal study.

Serial data from 507 adult participants in the Fels Longitudinal Study were used to study relationships between average annual changes in serum cholesterol levels and annual changes in total body fat, fat-free mass, percent body fat or body mass index in men and women aged 18-45 years or 45-65 years. Average annual changes in adiposity before and after 45 years of age for men and women show statistically significant, strong, positive relationships with corresponding changes in cholesterol levels.

Stronger influence of maternal than paternal obesity on infant and early childhood body mass index: the Fels Longitudinal Study.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: Excessive early childhood adiposity is a prevalent and increasing concern in many parts of the world. Parental obesity is one of the several factors previously associated with infant and early childhood weight, length and adiposity. Parental obesity represents a surrogate marker of the complex interplay among genetic, epigenetic and shared environmental factors, and is potentially modifiable. The relative contributions of maternal and paternal body mass index (BMI) to infant and early childhood growth, as well as the timing of such effects, have not been firmly established. WHAT THIS STUDY ADDS: Utilizing serial infant measurements and growth curve modelling, this is the largest study to fully characterize and formally compare associations between maternal and paternal BMI and offspring growth across the entire infancy and early childhood period. Maternal obesity is a stronger determinant of offspring BMI than paternal obesity at birth and from 2 to 3 years of age, suggesting that prevention efforts focused particularly on maternal lifestyle and BMI may be important in reducing excess infant BMI. The observation that maternal BMI effects are not constant, but rather present at birth, wane and re-emerge during late infancy, suggests that there is a window of opportunity in early infancy when targeted interventions on children of obese mothers may be most effective. BACKGROUND/OBJECTIVE: Parental obesity influences infant body size. To fully characterize their relative effects on infant adiposity, associations between maternal and paternal body mass index (BMI) category (normal: ≤25 kg m(-2) , overweight: 25 - <30 kg m(-2) , obese: ≥30 kg m(-2) ) and infant BMI were compared in Fels Longitudinal Study participants. METHODS: A median of 9 serial weight and length measures from birth to 3.5 years were obtained from 912 European American children born in 1928-2008. Using multivariable mixed effects regression, contributions of maternal vs. paternal BMI status to infant BMI growth curves were evaluated. Cubic spline models also included parental covariates, infant sex, age and birth variables, and interactions with child's age. RESULTS: Infant BMI curves were significantly different across the three maternal BMI categories (Poverall < 0.0001), and offspring of obese mothers had greater mean BMI at birth and between 1.5 and 3.5 years than those of over- and normal weight mothers (P ≤ 0.02). Average differences between offspring of obese and normal weight mothers were similar at birth (0.8 kg m(-2) , P = 0.0009) and between 2 and 3.5 years (0.7-0.8 kg m(-2) , P < 0.0001). Infants of obese fathers also had BMI growth curves distinct from those of normal weight fathers (P = 0.02). Infant BMI was more strongly associated with maternal than paternal obesity overall (P < 0.0001); significant differences were observed at birth (1.11 kg m(-2) , P = 0.006) and from 2 to 3 years (0.62 kg m(-2) , P3 years = 0.02). CONCLUSION: At birth and in later infancy, maternal BMI has a stronger influence on BMI growth than paternal BMI, suggesting weight control in reproductive age women may be of particular benefit for preventing excess infant BMI.

Genome-wide linkage scan for quantitative trait loci underlying normal variation in heel bone ultrasound measures.

Quantitative ultrasound (QUS) traits are correlated with bone mineral density (BMD), but predict risk for future fracture independent of BMD. Only a few studies, however, have sought to identify specific genes influencing calcaneal QUS measures. The aim of this study was to conduct a genome-wide linkage scan to identify quantitative trait loci (QTL) influencing normal variation in QUS traits. QUS measures were collected from a total of 719 individuals (336 males and 383 females) from the Fels Longitudinal Study who have been genotyped and have at least one set of QUS measurements. Participants ranged in age from 18.0 to 96.6 years and were distributed across 110 nuclear and extended families. Using the Sahara ® bone sonometer, broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (QUI) were collected from the right heel. Variance components based linkage analysis was performed on the three traits using 400 polymorphic short tandem repeat (STR) markers spaced approximately 10 cM apart across the autosomes to identify QTL influencing the QUS traits. Age, sex, and other significant covariates were simultaneously adjusted. Heritability estimates (h²) for the QUS traits ranged from 0.42 to 0.57. Significant evidence for a QTL influencing BUA was found on chromosome 11p15 near marker D11S902 (LOD = 3.11). Our results provide additional evidence for a QTL on chromosome 11p that harbors a potential candidate gene(s) related to BUA and bone metabolism.