A Longitudinal Study of Bone Gain in Pubertal Girls: Anthropometric and Biochemical Correlates

Authors

  • Joanna Cadogan,

    1. Centre for Human Nutrition, University of Sheffield, Sheffield, United Kingdom
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  • Aubrey Blumsohn,

    1. Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, Sheffield, United Kingdom
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  • Margo E. Barker,

    1. Centre for Human Nutrition, University of Sheffield, Sheffield, United Kingdom
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  • Richard Eastell

    Corresponding author
    1. Department of Human Metabolism and Clinical Biochemistry, University of Sheffield, Sheffield, United Kingdom
    • Address reprint requests to: Prof. Richard Eastell, Division of Clinical Sciences (NGHT), Section of Medicine, Bone Metabolism Group, University of Sheffield, Northern General Hospital, Herries Road, Sheffield S5 7AU, U.K.
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Abstract

The aim of this longitudinal study was to investigate the factors associated with bone mineral acquisition in pubertal girls. Subjects were 37 healthy, Caucasian girls aged 12.1 years (SD 0.3). Measurements were made at 6-month intervals over a period of 18 months and included total body bone mineral content (TBBMC), total body bone mineral density (TBBMD), lean mass, and fat mass by dual-energy X-ray absorptiometry, anthropometry, lifestyle factors, four biochemical markers of bone turnover, hormonal status, and fractional calcium absorption. In multiple regression analysis, correlates of relative gain in TBBMC were gain in lean mass (p < 0.001) and estradiol (p = 0.008). For TBBMD, correlates were gain in lean (p < 0.001) and fat mass (p = 0.003), estradiol (p < 0.001), dietary energy intake (p = 0.003), and parathyroid hormone (p = 0.023). Statural growth and gain in bone mass were unrelated; both height velocity and bone turnover peaked ∼20 months prior to menarche, whereas gain in bone mass peaked at menarche. Bone turnover markers correlated with height velocity (0.40 < r < 0.62), but not with bone gain. Estradiol was independently and negatively associated with all markers of bone turnover (−0.67 < r < −0.80). We conclude that estradiol is an important determinant of bone mineral gain in pubertal girls and is probably responsible for the reduction in bone turnover in late puberty; lean mass was the body composition parameter most closely associated with bone gain; height gain and bone gain are dissociated during the period of rapid growth at puberty; and bone turnover markers are modestly related to height gain, but are not predictive of bone gain.

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