Low bone mass in children and adolescents

Abstract

Osteoporosis is a disease characterized by low bone mass and micro architectural alterations of bone tissue leading to enhanced bone fragility and increased fracture risk. Although research in osteoporosis has focused mainly on the role of bone loss in the elderly population, it is becoming increasingly clear that the amount of bone that is gained during growth is also an important determinant of future resistance to fractures. Thus, considerable interest is being placed on defining preventive strategies that optimize the gain of bone mass during childhood and adolescence. Knowledge of the determinants accounting for the physiologic and genetic variations in bone accumulation in children will provide the best means toward the early diagnosis and treatment of osteoporosis. This article reviews the techniques available for bone mass measurements in children and the major determinants and diseases influencing bone accretion during childhood and adolescence. RESUMOBaixa Massa Óssea em Crianças e Adolescentes. Osteoporose é uma doença caracterizada pela baixa massa óssea e alterações de micro arquitetura do tecido ósseo, levando ao aumento da fragilidade óssea e aumento do risco de fratura. Apesar da pesquisa em osteoporose ter focalizado principalmente no papel da perda óssea na população idosa, está começando a ficar claro que a quantidade de osso que é ganho durante o crescimento é também um determinante importante de resistência futura para fraturas. Portanto, interesse considerável está sendo colocado na definição de estratégias preventivas que otimizam o ganho de massa óssea durante a infância e adolescência. O conhecimento dos determinantes responsáveis pelas variações fisiológicas e genéticas, na acumulação óssea nas crianças, irá levar aos melhores meios para o diagnóstico precoce e tratamento da osteoporose. Este artigo revê as técnicas disponíveis para a medida da massa óssea em crianças e os maiores determinantes e doenças que influenciam a aquisição óssea durante a infância e adolescência. Descritores: Baixa massa óssea; Medidas da massa óssea; DXA na infân-cia e adolesência; Atualização em DXA; Controvérsia em DXA

Plasma and urinary levels of cytokines in patients with idiopathic hypercalciuria

“…In this study, age was addressed as a possible confounder. Bone remodeling regulatory mechanisms may vary according to age, once children and adolescents experience different stages in skeletal development [43]. In spite of that, no significant difference in cytokine measurements was found in the comparison between school age and adolescents in the control group and in patients with IH.…”

Skeletal growth, body composition, and metabolic risk among North Sudanese immigrant children

“…Poor nutrition during childhood also increases risk for low bone density and osteoporosis. By age 17, boys have attained approximately 86%, and girls have attained approximately 93% of their maximal bone mass (Borges & Brandao, 2006;Clark, Bond, & Hecker, 2007;Fewtrell et al, 2009). Peak bone density is a major determinant of osteoporosis and fracture; failure to attain peak bone density increases risk of fracture by as much as 89% (Clark et al, 2007).…”

Effect of oligofructose-enriched inulin on bone metabolism in girls with low calcium intakes

“…This pointed the necessity of future studies with populations that have low calcium intakes in order to evaluate calcium absorption and bone mass. One of the factors that determines thefracture resistance at adult age is the quantity of bone mass that was gained during the growth (Borges and Brandão, 2006), which demonstrates the importance of this kind of study in children and adolescents. Frazão and Naveira (2006), in a review of studies about the prevalence of osteoporosis in Brazil, observed a small number of studies and the necessity of implementing projects mainly in developed regions of the country aiming to use prevalence data in public health projects.…”