Catch up in bone acquisition in young adult men with late normal puberty

Abstract

The aim of this study was to investigate the development of bone mineral density (BMD) and bone mineral content (BMC) in relation to peak height velocity (PHV), and to investigate whether late normal puberty was associated with remaining low BMD and BMC in early adulthood in men. In total, 501 men (mean AE SD, 18.9 AE 0.5 years of age at baseline) were included in this 5-year longitudinal study. Areal BMD (aBMD) and BMC, volumetric BMD (vBMD) and cortical bone size were measured using dual-energy X-ray absorptiometry (DXA) and pQCT. Detailed growth and weight charts were used to calculate age at PHV, an objective assessment of pubertal timing. Age at PHV was a strong positive predictor of the increase in aBMD and BMC of the total body (R 2 aBMD 11.7%; BMC 4.3%), radius (R 2 aBMD 23.5%; BMC 22.3%), and lumbar spine (R 2 aBMD 11.9%; BMC 10.5%) between 19 and 24 years (p < 0.001). Subjects were divided into three groups according to age at PHV (early, middle, and late). Men with late puberty gained markedly more in aBMD and BMC at the total body, radius, and lumbar spine, and lost less at the femoral neck (p < 0.001) than men with early puberty. At age 24 years, no significant differences in aBMD or BMC of the lumbar spine, femoral neck, or total body were observed, whereas a deficit of 4.2% in radius aBMD, but not in BMC, was seen for men with late versus early puberty (p < 0.001). pQCT measurements of the radius at follow-up demonstrated no significant differences in bone size, whereas cortical and trabecular vBMD were 0.7% (p < 0.001) and 4.8% (p < 0.05) lower in men with late versus early puberty. In conclusion, our results demonstrate that late puberty in males was associated with a substantial catch up in aBMD and BMC in young adulthood, leaving no deficits of the lumbar spine, femoral neck, or total body at age 24 years. ß

Genetically Determined Later Puberty Impacts Lowered Bone Mineral Density in Childhood and Adulthood

“…Consistent with these results, in a study of 19-year-old men, later age at attainment of peak height velocity was associated with lower aBMD, volumetric BMD, bone size and higher rates of previous fractures 35 . Another study of the 19-year-old men described above with later-normal puberty showed deficits in aBMD at all skeletal sites, but at a 5-year follow-up visit these deficits did not persist, except at the radius 7 . Despite this apparent “catch-up” in aBMD in young adulthood, lower aBMD during adolescence remains clinically relevant, as it is a period of high fracture risk 36,37 .…”

Modelling Height in Adolescence: A Comparison of Methods for Estimating the Age at Peak Height Velocity.

“…The age of peak height velocity (PHV) is often thought of as the gold standard of non-invasive measures of maturational status in observational studies. Age at PHV has been widely used as an outcome (Didcock et al, 1995;Mason et al, 2011;Nielsen, 1985;Price et al, 1988), exposure of interest (Gastin et al, 2013;Mao et al, 2013;Sherar et al, 2007), or as a covariate to control for confounding (Baxter-Jones et al, 2011;Darelid et al, 2012;Forwood et al, 2004). The appeal of age at PHV is twofold: (1) it applies equally to both boys and girls (Sherar et al, 2004); and (2) the measure appears to be objective, particularly in comparison to other methods that rely on subjective decisions about physical development of primary (Taranger et al, 1976) (orchoidometry) and secondary sex characteristics (Tanner, 1962) (Tanner Staging), recall of (semi-) specific biological events (age at menarche (Bergsten-Brucefors, 1976;Damon & Bajema, 1974;Damon et al, 1969)/voice breaking (Billewicz et al, 1981;Hagg & Taranger, 1980)), comparison of skeletal (Greulich & Pyle, 1959;Roche, 1988;Tanner et al, 1962Tanner et al, , 1975 and dental (Demirjian & Goldstein, 1976) radiographs with pre-defined standards or description or as a percentage of predicted adult stature (Bayley & Pinneau, 1952;Khamis & Roche, 1994;Roche et al, 1975;Tanner et al, 1975).…”

Bone mass of female dance students prior to professional dance training: A cross-sectional study

“…Finally, the use of two different DXA scans to assess participants and the need to adjust the data for potential bias is a limitation. Nevertheless, this approach has been previously used and it is deemed acceptable for studies of this kind [48, 49]. …”