Osteoporosis International

, Volume 6, Issue 2, pp 141–148

Bone mineral acquisition during adolescence and early adulthood: A study in 574 healthy females 10–24 years of age

  • J. -P. Sabatier
  • G. Guaydier-Souqui`eres
  • D. Laroche
  • A. Benmalek
  • L. Fournier
  • F. Guillon-Metz
  • J. Delavenne
  • A. Y. Denis
Original Article


Low bone mass is known to be associated with an increased risk of fractures. Osteoporosis prevention by maximizing bone mass will be crucial and requires a better knowledge of bone mass acqusition during adolescence. Bone mass was assessed in 574 healthy volunteer females aged 10–24 years. Spine bone mineral density (BMD) in anteroposterior (AP L2–4) and lateral (LAT L3) views was measured using dual-energy X-ray absorptiometry (DXA) and AP bone mineral content (BMC) was calculated. At the same time, spine AP-BMD (L2–4) was evaluated in 333 normal menstruating women, aged 27–47 years. Bone values, osteocalcin and IGF-1 serum concentrations were correlated with chronological age, skeletal age, pubertal stages and time after menarche. In this cross-sectional study, AP- and LAT-BMD and BMC increased dramatically between skeletal ages 10 and 14 or until the first year after menarche. Between 14 and 17 skeletal years of age, AP-BMD and BMC increased moderately, whereas LAT-BMD remained unchanged. After skeletal age 17, or the fourth year after menarche, there was no significant increase in BMD or BMC, and their values did not differ from those of menstruating women. A serum osteocalcin peak was observed at skeletal ages 11–12 or at stage P3, whereas IGF-1 peaked at 13–14 skeletal years of age or at P4 and the first year after menarche. Eighty-six per cent of the adult bone mass of the spine is acquired before skeletal age 14 or the second year after menarche; therefore osteoporosis prevention programs will be particularly effective before that age.


Bone mineral density Females Insulin-like growth factor 1 Osteocalcin Peak bone mass Puberty 


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  1. 1.
    Pocock NA, Eisman JA, Hopper JL, Yeates MG, Sambrook PN, Eberl S. Genetic determinants of bone mass in adult. J Clin Invest 1987;80:706–10.Google Scholar
  2. 2.
    Slemenda CW, Christian JC, Williams CJ, Norton JA, Johnston CC. Genetic determinants of bone mass in adult women: a reevaluation of the twin model and the potential importance of gene interaction on heritability estimates. J Bone Miner Res 1991;6:561–7.Google Scholar
  3. 3.
    Ross PD, Orimo H, Wasnich RD, et al. Methodological issues in comparing genetic and environmental influences on bone mass. Bone Miner 1989;7:67–77.Google Scholar
  4. 4.
    Slemenda CW, Miller JZ, Hui SL, Reister TK, Johnston CC. Role of physical activity in the development of skeletal mass in children. J Bone Miner Res 1991;6:1227–33.Google Scholar
  5. 5.
    Johnson CC, Miller JZ, Slemenda CW, et al. Calcium supplementation and increases in bone mineral density in children. N Engl J Med 1992;327:82–7.Google Scholar
  6. 6.
    Matkovic V, Heaney RP. Calcium balance during human growth: evidence for threshold behavior. Am J Clin Nutr 1992;55:992–6.Google Scholar
  7. 7.
    Fehily AM, Coles RJ, Evans WD, Elwood PC. Factors affecting bone density in young adults. Am J Clin Nutr 1992;56:579–86.Google Scholar
  8. 8.
    Tylavsky FA, Anderson JJB, Talmage RV, Taft TN. Are caclium intakes and physical activity patterns during adolescence related to radial bone mass of white college-age females? Osteoporosis Int 1992;2:232–40.Google Scholar
  9. 9.
    Krall EA, Dawson-Hughes B. Heritable and life-style determinants of bone mineral density. J Bone Miner Res 1993;8:1–9.Google Scholar
  10. 10.
    Anderson JJB, Tylavsky FA, Halioua J, Metz JA. Determinants of peak bone mass in young adult women: a review. Osteoporosis Int 1993;Suppl 1:S32–6.Google Scholar
  11. 11.
    Glastre C, Braillon P, David L, Cochat P, Meunier PJ, Delmas PD. Measurement of bone mineral content of the lumbar spine by dual energy X-ray absorptiometry in normal children: correlations with growth parameters. J Clin Endocrinol Metab 1990;70:1330–3.Google Scholar
  12. 12.
    De Schepper J, Derde MP, Van den Broeck M, Piepsz A, Jonckheer MH. Normative data for lumbar spine bone mineral content in children: influence of age, height, weight, and pubertal stage. J Nucl Med 1991;32:216–20.Google Scholar
  13. 13.
    Bonjour JP, Theintz G, Buchs B, Slosman D, Rizzoli R. Critical years and stages of puberty for spinal and femoral bone mass accumulation during adolescence. J Clin Endocrinol Metab 1991;73:555–63.Google Scholar
  14. 14.
    Katzman DK, Bachrach LK, Carter DR, Marcus R. Clinical and anthropometric correlates of bone mineral acquisition in healthy adolescent girls. J Clin Endocrinol Metab 1991;73:1332–9.Google Scholar
  15. 15.
    Geusens P, Cantatore F, Nijs J, Proesmans W, Emma F, Dequeker J. Heterogeneity of growth of bone in children at the spine, radius and total skeleton. Growth Dev Aging 1991;55:249–56.Google Scholar
  16. 16.
    Gordon CL, Halton JM, Atkinson SA, Webber CE. The contributions of growth and puberty to peak bone mass. Growth Dev Aging 1991;55:257–62.Google Scholar
  17. 17.
    Thomas KE, Cook SD, Benett JT, Whitecloud TS, Rice JC. Femoral neck and lumbar spine bone mineral densities in a normal population 3–20 years of age. J Pediatr Orthop 1991;11:48–58.Google Scholar
  18. 18.
    Grimston SK, Morrison K, Harder JA, Hanley DA. Bone mineral density during puberty in Western Canadian children. Bone Miner 1992;19:85–96.Google Scholar
  19. 19.
    Kröger H, Kotaniemi A, Vainio P, Alhava E. Bone densitometry of the spine and femur in children by dual-energy x-ray absorptiometry. Bone Miner 1992;17:75–85.Google Scholar
  20. 20.
    Matkovic V, Jelic T, Wardlaw GM, et al. Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. J Clin Invest 1994;93:799–808.Google Scholar
  21. 21.
    Gilsanz V, Gibbens DT, Roe TF, et al. Vertebral bone density in children: effect of puberty. Radiology 1988;166:847–50.Google Scholar
  22. 22.
    Mora S, Goodman WG, Loro ML, Roe TF, Sayre J, Gilsanz V. Age-related changes in cortical and cancellous vertebral bone density in girls: assessment with quantitative CT. AJR 1994;162:405–9.Google Scholar
  23. 23.
    Bonjour JP, Theintz G, Law F, Slosman D, Rizzoli R. Peak bone mass. Osteoporosis Int 1994;Suppl 1:S7–13.Google Scholar
  24. 24.
    Johansen JS, Giwercman A, Hartwell D, et al. Serum bone Glaprotein as a marker of bone growth in children and adolescents: correlation with age, height, serum insulin-like growth factor I, and serum testosterone. J Clin Endocrinol Metab 1988;67:273–8.Google Scholar
  25. 25.
    Delmas PD, Chatelain P, Malaval L, Bonne G. Serum bone GLA-protein in growth hormone deficient children. J Bone Miner Res 1986;1:333–8.Google Scholar
  26. 26.
    Argente J, Barrios V, Pozo J, et al. Normative data for insulin-like growth factors (IGFs), IGF-binding proteins, and growth hormone-binding protein in a healthy Spanish pediatric population: age- and sex-related changes. J Clin Endocrinol Metab 1993;77:1522–28.Google Scholar
  27. 27.
    Tanner JM. Growth at adolescence, 2nd ed. Oxford: Blackwell, 1962.Google Scholar
  28. 28.
    Fisher M, Kempers B. Phantom studies in osteoporosis. Eur J Nucl Med 1993;20:434–9.Google Scholar
  29. 29.
    Duboeuf F, Pommet R, Meunier PJ, Delmas PD, Dual-energy X-ray absorptiometry of the spine in anteroposterior and lateral projections. Osteoporosis Int 1994;4:110–6.Google Scholar
  30. 30.
    Breier BH, Gallaher BW, Gluckman PD. Radioimmunoassay for insulin-like growth factor-I: solutions to some potential problems and pitfalls. J Endocrinol 1991;128:347–57.Google Scholar
  31. 31.
    Rodin A, Murby B, Smith MA, et al. Premenopausal bone loss in the lumbar spine and neck of femur: a study of 225 Caucasian women. Bone 1990;11:1–5.Google Scholar
  32. 32.
    Laitinen K, Välimäki M, Keto P. Density measured by dual X-ray absorptiometry in healthy Finnish women. Calcif Tissue Int 1991;48:224–31.Google Scholar
  33. 33.
    Recker RR, Davies KM, Hinders SM, Heaney RP, Stegman MR, Kimmel DB. Bone gain in young adult women. JAMA 1992;268:2403–8.Google Scholar
  34. 34.
    Ortolani S, Trevisan C, Bianchi ML, Gandolini G, Cherubini R, Polli EE. Influence of body parameters on female peak bone mass and bone loss. Osteoporosis Int 1993;Suppl 1:S61–6.Google Scholar
  35. 35.
    Theintz G, Buchs B, Rizzoli R, et al. Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab 1992;75:1060–5.Google Scholar
  36. 36.
    Mazess RB, Barden HS. Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth-control pills. Am J Clin Nutr 1991;53:132–42.Google Scholar
  37. 37.
    Ortolani S, Cherubini R, Bianchi ML, et al. Spontaneous changes of vertebral bone density before menopause in healthy women: a longitudinal study. Bone Miner 1994;25(Suppl 2):27S.Google Scholar
  38. 38.
    Rosenthal DI, Mayo-Smith W, Hayes CW, et al. Age and bone mass in premenopausal women. J Bone Miner Res 1989;4:533–8.Google Scholar
  39. 39.
    Anderson M, Hwang SG, Green WT. Growth of the normal trunk in boys and girls during the second decade of life. J Bone Joint Surg [Am] 1965;47:1554–64.Google Scholar
  40. 40.
    Tupman GS. A study of bone growth in normal children and its relationship to skeletal maturation. J Bone Joint Surg [Br] 1962:44:42–67.Google Scholar
  41. 41.
    Schmorl G, Junghans H. The human spine in health and disease, 2nd edn. New York: Grune & Stratton, 1971.Google Scholar
  42. 42.
    Young HB, Zoli A, Gallagher JR. Events of puberty in 111 Florentine girls. Am J Dis Child 1963;106:568–72.Google Scholar
  43. 43.
    Slemenda CW, Reister TK, Hui SL, Miller JZ, Christian JC, Johnston CC. Influences on skeletal mineralization in children and adolescents: evidence for varying effects of sexual maturation and physical activity. J Pediatr 1994;125:201–7.Google Scholar
  44. 44.
    Brown JP, Malaval L, Chapuy MC, Delmas PD, Edouard C, Meunier PJ. Serum bone gla-protein: a specific marker for bone formation in postmenopausal osteoporosis. Lancet 1984;1:1081–93.Google Scholar
  45. 45.
    Juul A, Bang P, Hertel NT, et al. Serum insulin-like growth factor-1 in 1030 healthy children, adolescents, and adults: relation to age, sex, stage of puberty, testicular size and body mass index. J Clin Endocrinol Metab 1994;78:744–52.Google Scholar
  46. 46.
    Johansson AG, Forslund A, Hambraeus L, Blum WF, Ljunghall S. Growth hormone-dependent insulin-like growth factor binding protein is a major determinant of bone mineral density in healthy men. J Bone Miner Res 1994;9:915–21.Google Scholar

Copyright information

© European Foundation for Osteoporosis 1996

Authors and Affiliations

  • J. -P. Sabatier
    • 1
  • G. Guaydier-Souqui`eres
    • 1
  • D. Laroche
    • 1
  • A. Benmalek
    • 1
  • L. Fournier
    • 1
  • F. Guillon-Metz
    • 1
  • J. Delavenne
    • 1
  • A. Y. Denis
    • 1
  1. 1.Groupe Régional d'Etude et de Recherche sur l'Os (GRERO), Services de Rhumatologie et de Médecine NucléaireCentre Hospitalier UniversitaireCaenFrance

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