Influence of Heredity and Environment on Peak Bone Density: A Review of Studies in Croatia

Abstract

One of the main determinants of who will develop osteoporosis is the amount of bone accumulated at peak bone density. There is poor agreement, however, on when peak bone density occurs. Ethnic differences were observed in age at peak bone density and their correlates. Since the diagnosis of osteoporosis and osteopaenia is based on the comparison between patients' bone mineral density (BMD) and optimal peak bone density in healthy young people (T-score), it is of great importance that each country should provide its own reference peak bone density data. This review article presents our published results on peak bone density in Croatia and compares them with fi ndings in other populations. Our research included 18 to 25-year-old students from Zagreb University and their parents. The results showed that peak bone mass in young Croatian women was achieved before the age of twenty, but BMD continued to increase after the mid-twenties in the long-bone cortical skeleton. BMD was comparable to the values reported by the National Health and Nutrition Examination Survey (NHANES) and other studies that included the same age groups, except for the cortical part of the radius, where it was signifi cantly lower. Men achieved peak bone density in the spine later than women, which cannot be explained by different diet or physical activity. As expected, heredity was more important for peak bone density than the environmental factors known to be important for bone health. However, the infl uence of heredity was not as strong as observed in most other populations. It was also weaker in the cortical than in the trabecular parts of the skeleton. Future research should include young adolescent population to defi ne the exact age of achieving peak bone density in different skeletal sites.

Epigenetics of Osteoporosis: Critical Analysis of Epigenetic Epidemiology Studies

“…Peak bone mass appears to have a strong genetic component. Thus, direct correlations between the bone mass of parents of various ethnicities and their children have been reported [ 6 , 7 ]. However, despite large cooperative efforts, the genes explaining the hereditary influence on bone mass have not been completely elucidated.…”

The Influence of Non-preventable Risk Factors on the Development of Osteoporosis in Postmenopausal Women

“…Vitamin D receptor (VDR) gene is the most widely studied since this vitamin plays a central role in calcium metabolism and homeostasis, regulating calcium absorption, bone resorption and mineralization, bone cell differentiation and parathyroid hormone secretion (PTH) (7). With the help of modern molecular diagnostic methods today, people with genetic predisposition to osteoporosis can be identified, which can significantly influence these people in timely instruction on screening osteodensitometry, the FRAX model of fracture risk calculation, and timely advice on prevention measures and adequate treatment (8).…”

Osteoporosis – an increasingly important issue for both young and aging citizens of Malaysia

“…In both sexes, peak bone mineral density (BMD) occurs in early adulthood. 1 Thereafter, there is a gradual decrease in BMD which is hardly noticeable until the middle years, and which in a significant proportion of the population leads to an incipient osteopenia that may eventually progress to frank osteoporosis. Such gradual change is but one of a plethora of slow functional declines in tissue activity that start in early middle age and inevitably contribute progressively to morbidity in the aged.…”