Age at Onset of Puberty Predicts Bone Mass in …青春期发病年龄预测骨量在u2026.pdfVIP

Age at Onset of Puberty Predicts Bone Mass in Young Adulthood Vicente Gilsanz, MD, PhD, James Chalfant, BS, Heidi Kalkwarf, PhD, Babette Zemel, PhD, Joan Lappe, PhD, Sharon Oberfield, MD, John Shepherd, PhD, Tishya Wren, PhD, and Karen Winer, MD Objective To determine whether the commencement and length of puberty influences dual x-ray absorptiometry (DXA) values of bone mineral content (BMC) and bone mineral density (BMD) in the axial and appendicular skeleton at skeletal maturity. Study design From the Bone Mineral Density in Childhood Study, we identified children who began puberty and completed sexual and skeletal development and examined whether the timing and length of puberty influence DXA values of BMC and BMD at skeletal maturity. Results A total of 78 girls and 85 boys began puberty and completed skeletal maturity; 4.4 0.8 and 4.5 0.8 years later, respectively. Multiple linear regression analyses indicated that the age of onset of puberty was a strong negative predictor of DXA bone measurements at skeletal maturity, independent of bone values at the beginning of puberty, and the length of puberty. This negative relation was observed for all BMC and BMD measurements at all skeletal sites, in both boys and girls (all P .0001). In contrast, length of puberty had no relation to any measures of bone. Conclusions In healthy adolescent males and females, bone mass and bone density at skeletal maturity are in- versely related to the timing of puberty. (J Pediatr 2011;158:100-5). eak bone mass (PBM), a major determinant of the future risk of fractures in the elderly, is largely achieved by the end of sexual and skeletal maturity.1,2 The greatest accretion of bone occurs during puberty, and low PBM may result from P 1-3 clinical states associated with abnormal pubertal development.