Idiopathic juvenile osteoporosis – an analysis of the muscle-bone relationship

Płudowski, Paweł; Lebiedowski, M; Olszaniecka, M; Marowska, Joanna; Matusik, H; Lorenc, R

doi:10.1007/s00198-006-0183-1

Cited by 29 publications

(18 citation statements)

References 23 publications

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“…19 -22 For example, in the British children with fragility fractures, RBS Z score was Ϫ1.9Ϯ1.5, as reported by Crabtree et al 20 Furthermore, RBS Z scores of Ϫ2.9Ϯ1.1 and Ϫ2.6Ϯ1.5 were noted in girls and boys with fragility fractures resulting from idiopathic juvenile osteoporosis. 22 These observations have led us to speculate that bone strength of our PH patients was properly adapted to muscle demands; however, especially in girls, the risk for fracture may be still increased because of increased BW.…”

Section: Discussionmentioning

confidence: 85%

“…The intensity of a shadowed area reflects an increasing risk for fracture, as hypothesized previously. 20,22 The bolded line reflects the hypothetical fracture threshold value, as suggested by data obtained in children and adolescents with fragility fractures. 20,22 The P value reflects Mann-Whitney statistics for the comparison with control subjects.…”

Section: Discussionmentioning

confidence: 99%

“…The coefficient of variation percentage for repeated DXA measures in 30 children and adolescents was Ͻ1.25% for TBBMD and TBBMC and equal to 1.33% and 1.94% for LBM and FM, as assessed by the root mean square method. 21,22 …”

Section: Assessment Of Skeletal Status and Body Compositionmentioning

confidence: 99%

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Bone Mass and Body Composition in Children and Adolescents With Primary Hypertension

et al. 2008

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Abstract-Because primary hypertension (PH) is associated with calcium metabolism, it is hypothesized that PH may be related to osteoporosis risk. The study aimed to evaluate the relationship between body composition and bone strength in hypertensive adolescents. Total body scans using x-ray absorptiometry (DPX-L, GE Healthcare) were performed in 94 PH children aged 6 to 18 years (21 girls and 73 boys). References of healthy control subjects were used for the calculation of Z scores (age and gender matched), SD scores (height and gender matched), and SDs scores (weight and gender matched). Total body bone mineral density, total body bone mineral content (TBBMC), lean body mass (LBM), and fat mass (FM) were investigated. Relative bone strength index was calculated as the TBBMC:LBM ratio. As evidenced by Z scores, PH case subjects had slightly higher total body bone mineral density, TBBMC, and LBM compared with healthy subjects. Reduced LBM/body weight (BW) Z scores of Ϫ1.9Ϯ1.5 and Ϫ1.2Ϯ1.4, increased FM Z scores of ϩ2.5Ϯ2.5 and ϩ1.7Ϯ2.0, and increased FM/BW Z scores of ϩ1.6Ϯ1.3 and ϩ1.1Ϯ1.4 were noted in girls and boys compared with healthy subjects, respectively (PϽ0.001). On the other hand, PH is strictly related to sedentary behavior and nutritional habits with high-sodium and low-calcium intake, and both PH and decreased bone mass are among the main problems of elderly persons. 2,5 Calcium, vitamin D metabolites, proper nutrition, and physical activity (PA) are crucial determinants of peak bone mass. 6 -13 It was shown recently that low serum vitamin D levels correlate with higher blood pressure. 14 Therefore, PH, through its possible associations with calcium and vitamin D metabolism, as well as behavioral factors including nutritional habits and low PA, may alter skeletal status and body composition. Bone mass accrual is highly influenced by mechanical stimulation from skeletal muscles, and the proper muscle-bone interactions during growth are key determinants of skeletal adaptation toward changing loads. [11][12][13]15,16 Low PA, excessive sodium intake, and calcium loss are among the risk factors common not only for osteoporosis but also for PH. 16,17 Because exposure to similar risk factors for both osteoporosis and PH takes place already in childhood, it seems interesting to evaluate the musculoskeletal system at an early stage of PH.The method of choice for the evaluation of both skeletal status and body composition is dual-energy x-ray absorptiometry (DXA). 6 -10,18 -22 DXA offers accurate and precise measurements of total body bone mineral density (TBBMD), total body bone mineral content (TBBMC), lean body mass (LBM; predominantly muscle mass), fat mass (FM), and its fraction of whole body mass. 18 -22 Recently, DXA-derived TBBMC and LBM were implemented as the parameters

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Bone Mass and Body Composition in Children and Adolescents With Primary Hypertension

et al. 2008

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“…Another explanation of this phenomenon includes the increased mechanical factors in obese adolescents. Indeed, as obesity is associated with increased body weight, lever-arm effects increase the muscle forces needed to move that weight around during movement [38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Geometric indices of hip bone strength in obese, overweight, and normal-weight adolescent boys

Hage

2011

Osteoporos Int

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“…Decreased BMD, especially in the spine, is associated with evidence of reduced bone turnover on bone histomorphometry (55). Although spontaneous resolution of symptoms occurs in most children, only partial resolution of LS BMD was recorded (56).…”

Section: Primary Osteoporosismentioning

confidence: 99%

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

Saraff

Högler

2015

European Journal of Endocrinology

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Osteoporosis in children can be primary or secondary due to chronic disease. Awareness among paediatricians is vital to identify patients at risk of developing osteoporosis. Previous fractures and backaches are clinical predictors, and low cortical thickness and low bone density are radiological predictors of fractures. Osteogenesis Imperfecta (OI) is a rare disease and should be managed in tertiary paediatric units with the necessary multidisciplinary expertise. Modern OI management focuses on functional outcomes rather than just improving bone mineral density. While therapy for OI has improved tremendously over the last few decades, this chronic genetic condition has some unpreventable, poorly treatable and disabling complications. In children at risk of secondary osteoporosis, a high degree of suspicion needs to be exercised. In affected children, further weakening of bone should be avoided by minimising exposure to osteotoxic medication and optimising nutrition including calcium and vitamin D. Early intervention is paramount. However, it is important to identify patient groups in whom spontaneous vertebral reshaping and resolution of symptoms occur to avoid unnecessary treatment. Bisphosphonate therapy remains the pharmacological treatment of choice in both primary and secondary osteoporosis in children, despite limited evidence for its use in the latter. The duration and intensity of treatment remain a concern for longterm safety. Various new potent antiresorptive agents are being studied, but more urgently required are studies using anabolic medications that stimulate bone formation. More research is required to bridge the gaps in the evidence for management of paediatric osteoporosis.

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Idiopathic juvenile osteoporosis – an analysis of the muscle-bone relationship

Cited by 29 publications

References 23 publications

Bone Mass and Body Composition in Children and Adolescents With Primary Hypertension

Bone Mass and Body Composition in Children and Adolescents With Primary Hypertension

Geometric indices of hip bone strength in obese, overweight, and normal-weight adolescent boys

ENDOCRINOLOGY AND ADOLESCENCE: Osteoporosis in children: diagnosis and management

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