1. Chapter 44 Osteoporosis: The Early Years

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FIGURE 44.1: Bone mass throughout the life span. The influence of genetics and the environment is greatest during growth..
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FIGURE 44.2: BMD accumulation with age in females. Gains in BMD vary with skeletal site. Almost 95% of adult peak total body BMD occurred by age 15.2 years (A), and the highest BMD of the spine occurs by age 23 years (B), by age 18.5 years for the femoral neck (C), by age 14.2 years for the greater trochanter (D), and by age 15.8 years for Ward’s triangle (E). Reproduced from D. Teegarden, W.R. Proulx, B.R. Martin, J. Zhao, G.P.McCabe, R.M. Lyle, Peak bone mass in young women, J. Bone Miner. Res. 10 (5) (1995), [7]; Y.-C. Lin, R.M. Lyle, C.M. Weaver, L.D McCabe, G.P. McCabe, C.C. Johnston, Peak spine and femoral neck bone mass in young women, Bone 32 (5) (2003), [8].
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FIGURE 44.3: Total body BMD (A) and proximal radius (B) was significantly higher in prepubertal girls randomized to 1 g calcium supplement daily compared to those assigned to placebo from age 10 to 18 years [10].
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FIGURE 44.4: Distal radius fracture incidence for (A) boys and (B) girls from local hospital admissions compared with the total body BMD adjusted for body size aligned by biological age (years from peak height velocity) from the Bailey et al. study [13]. Adapted from R.A. Faulkner, K.S. Davison, D.A. Bailey, R.L. Mirwald, A.D.G. Baxter-Jones, Size-corrected BMD decreases during peak linear growth: implications for fracture incidence during adolescence, J. Bone Miner. Res. 21 (2006) [17] with permission.
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FIGURE 44.5: Childhood forearm fracture incidence in males (A) and females (B) from 1969 to 1971 (lower line) and 1999 to 2001 (upper line) in Rochester, Minnesota. Reproduced from R.P. Heaney, C.M. Weaver, Newer perspectives on calcium and bone quality, J. Am. Coll. Nutr. 24 (6) (2005) 574S581S [18] using data from S. Khosla, I.J. Melton, M.B. Delatoski, Incidence of childhood distal forearm fractures over 30 years, JAMA 290 (2003) [14].
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FIGURE 44.6: Calcium retention as a function of calcium intake in adolescent boys (upper curve) and girls (lower curve) [74].
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FIGURE 44.7: Influence of BMI (as percentiles of BMI-for-age) on calcium retention curve in white 12-year-old girls [77].
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