NICHD Conference Abstracts: Determinants of Peak Bone Mass
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چکیده
Peak bone mass (PBM) is has been defined as: (1) the maximum bone mass attained in adulthood; (2) the amount of bone acquired when bone gain ceases; and the BMD during the plateau that follows growth and bone mass accrual and precedes the bone loss that occurs later in adulthood. These definitions lead to different approaches for identifying PBM. Most commonly, PBM has been defined based on cross-sectional studies. However, this approach fails to determine when bone accretion ceases at the individual level. Peak gains in bone mass occur about 6 months after the adolescent growth spurt in height, but gains in total bone mineral content continue for years after that point. Only a few studies have considered the gains that occur in late adolescence and into adulthood. A prospective longitudinal study of Swedish ~800 military recruits showed that between 18 and 24 years of age, gain in BMD were related to the timing of adolescent growth spurt, and to changes in physical activity over a 5 year period. The Canadian Multicentre Osteoporosis Study (Berger et al. 2010) demonstrated differences between males and females by skeletal site in the timing of PBM. Lastly, examination of longitudinal changes in cortical and trabecular bone (Riggs et al. 2008) show very different trajectories of PBM for different bone compartments. Overall, these studies demonstrate that estimates of PBM vary depending on study design, skeletal site, the bone outcome measured and methodology used, sex, population ancestry, maturational timing, and physical activity in young adulthood. Characterizing the development of PBM is central to understanding skeletal biology and the human life cycle, and has clinical implications diagnosing osteoporosis in adulthood. Understanding the long term health implications of timing and magnitude of PBM is important for public health initiatives and clinical decisions.
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تاریخ انتشار 2015