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Heterogeneity in the growth of the axial and appendicular skeleton in boys : Implications for the pathogenesis of bone fragility in men

Bradney, Michelle ; Karlsson, Magnus K. LU ; Duan, Yunbo ; Stuckey, Stephen ; Bass, Shona and Seeman, Ego (2000) In Journal of Bone and Mineral Research 15(10). p.1871-1878
Abstract

Men with spine fractures have reduced vertebral body (VB) volume and volumetric bone mineral density (vBMD). Men with hip fractures have reduced femoral neck (FN) volume and vBMD, site-specific deficits that may have their origins in growth. To describe the tempo of growth in regional bone size, bone mineral content (BMC), and vBMD, we measured bone length, periosteal and endocortical diameters, BMC, and vBMD using dual-energy X-ray absorptiometry in 184 boys aged between 7 and 17 years. Before puberty, growth was more rapid in the legs than in the trunk. During puberty, leg growth slowed while trunk length accelerated. Bone size was more advanced than BMC in all regions, being ˜70% and ˜35% of their predicted peaks at 7 years of age,... (More)

Men with spine fractures have reduced vertebral body (VB) volume and volumetric bone mineral density (vBMD). Men with hip fractures have reduced femoral neck (FN) volume and vBMD, site-specific deficits that may have their origins in growth. To describe the tempo of growth in regional bone size, bone mineral content (BMC), and vBMD, we measured bone length, periosteal and endocortical diameters, BMC, and vBMD using dual-energy X-ray absorptiometry in 184 boys aged between 7 and 17 years. Before puberty, growth was more rapid in the legs than in the trunk. During puberty, leg growth slowed while trunk length accelerated. Bone size was more advanced than BMC in all regions, being ˜70% and ˜35% of their predicted peaks at 7 years of age, respectively. At 16 years of age, bone size had reached its adult peak while BMC was still 10% below its predicted peak. The legs accounted for 48%, whereas the spine accounted for 10%, of the 1878 g BMC accrued between 7 and 17 years. Peripubertal growth contributed (i) 55% of the increase in leg length but 78% of the mineral accrued and (ii) 69% of the increase in spine length but 87% of the mineral accrued. Increased metacarpal and midfemoral cortical thickness was caused by respective periosteal expansion with minimal change in the endocortical diameter. Total femur and VB vBMD increased by 30-40% while size and BMC increased by 200-300%. Thus, growth builds a bigger but only slightly denser skeleton. We speculate that effect of disease or a risk factor during growth depends on the regions maturational stage at the time of exposure. The earlier growth of a regions size than mass, and the differing growth patterns from region to region, predispose to site-specific deficits in bone size, vBMD, or both. Regions further from their peak may be more severely affected by illness than those nearer completion of growth. Bone fragility in old age is likely to have its foundations partly established during growth.

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Please use this url to cite or link to this publication:
author
publishing date
type
Contribution to journal
publication status
published
keywords
Growth, Males, Osteoporosis, Peak bone mass, Puberty
in
Journal of Bone and Mineral Research
volume
15
issue
10
pages
1871 - 1878
publisher
AMBMR
external identifiers
  • scopus:0033809726
  • pmid:11028438
ISSN
0884-0431
DOI
10.1359/jbmr.2000.15.10.1871
language
English
LU publication?
no
id
a17ff9d4-655c-4c0d-8f24-63cd960ffc4c
date added to LUP
2019-05-22 19:29:00
date last changed
2020-01-22 07:37:38
@article{a17ff9d4-655c-4c0d-8f24-63cd960ffc4c,
  abstract     = {<p>Men with spine fractures have reduced vertebral body (VB) volume and volumetric bone mineral density (vBMD). Men with hip fractures have reduced femoral neck (FN) volume and vBMD, site-specific deficits that may have their origins in growth. To describe the tempo of growth in regional bone size, bone mineral content (BMC), and vBMD, we measured bone length, periosteal and endocortical diameters, BMC, and vBMD using dual-energy X-ray absorptiometry in 184 boys aged between 7 and 17 years. Before puberty, growth was more rapid in the legs than in the trunk. During puberty, leg growth slowed while trunk length accelerated. Bone size was more advanced than BMC in all regions, being ˜70% and ˜35% of their predicted peaks at 7 years of age, respectively. At 16 years of age, bone size had reached its adult peak while BMC was still 10% below its predicted peak. The legs accounted for 48%, whereas the spine accounted for 10%, of the 1878 g BMC accrued between 7 and 17 years. Peripubertal growth contributed (i) 55% of the increase in leg length but 78% of the mineral accrued and (ii) 69% of the increase in spine length but 87% of the mineral accrued. Increased metacarpal and midfemoral cortical thickness was caused by respective periosteal expansion with minimal change in the endocortical diameter. Total femur and VB vBMD increased by 30-40% while size and BMC increased by 200-300%. Thus, growth builds a bigger but only slightly denser skeleton. We speculate that effect of disease or a risk factor during growth depends on the regions maturational stage at the time of exposure. The earlier growth of a regions size than mass, and the differing growth patterns from region to region, predispose to site-specific deficits in bone size, vBMD, or both. Regions further from their peak may be more severely affected by illness than those nearer completion of growth. Bone fragility in old age is likely to have its foundations partly established during growth.</p>},
  author       = {Bradney, Michelle and Karlsson, Magnus K. and Duan, Yunbo and Stuckey, Stephen and Bass, Shona and Seeman, Ego},
  issn         = {0884-0431},
  language     = {eng},
  month        = {01},
  number       = {10},
  pages        = {1871--1878},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Heterogeneity in the growth of the axial and appendicular skeleton in boys : Implications for the pathogenesis of bone fragility in men},
  url          = {http://dx.doi.org/10.1359/jbmr.2000.15.10.1871},
  doi          = {10.1359/jbmr.2000.15.10.1871},
  volume       = {15},
  year         = {2000},
}