Growth and Bone Mineral Accretion During Puberty in Chinese Girls: A Focus on Calcium Retention and the Role of Calcium



The pubertal years are an important period for linear growth and bone mineral accretion. Peak height velocity (PHV) occurs at 3–0 years prior to menarche in Chinese girls, which is similar to the timing for PHV reported in Western girls. However, Chinese girls tend to have a lower peak height velocity (6.0 cm/year) compared to that of American girls (8.3 cm/year) and a longer active growth period. The timing of peak bone mineral accretion in Chinese girls is also similar to that of Western girls, which is 1 year later than PHV and around the age of menarche. As peak bone mineralization occurs 1 year later than peak linear growth, there is a decrease in size-corrected bone mineral density in that year before menarche, which may be related to the increased risk of fracture during the pubertal growth spurt. Chinese girls with low habitual dietary calcium intake have high calcium retention efficiency during puberty. For Chinese girls aged 10–15 years, the calculated apparent calcium retention efficiency is as high as 40.9%. Calcium intake is a significant independent predictor of total body bone mass in Chinese girls during puberty. Ensuring adequate nutrition during this period is important for achieving full potential in linear growth and attaining optimal peak bone mass.


Bone Mass Calcium Intake Dietary Calcium Intake Areal Bone Mineral Density Pubertal Growth Spurt 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Bone area


Bone mineral content


Bone mineral density


Dual energy X-ray absorptiometry


Peak bone mass


Peak height velocity


Year since menarche


  1. Abbassi V. Growth and normal puberty. Pediatrics. 1998;102(2 Pt 3):507–11.PubMedGoogle Scholar
  2. Bailey DA, Wedge JH, McCulloch RG, Martin AD, Bernhardson SC. J Bone Joint Surg Am. 1989;71:1225–31.PubMedGoogle Scholar
  3. Bailey DA, Martin AD, McKay HA, Whiting S, Mirwald R. Calcium accretion in girls and boys during puberty: a longitudinal analysis. J Bone Miner Res. 2000;15:2245–50.PubMedCrossRefGoogle Scholar
  4. Bailey DA, Faulkner RA, Mirwald RL, Sherar L, Baxter-Jones AGD. Bone mineral accrual over 15 years from per-adolescence into adulthood. J Bone Miner Res. 2006;21:S30.Google Scholar
  5. Braun M, Palacios C, Wigertz K, Jackman LA, Bryant RJ, McCabe LD, Martin BR, McCabe GP, Peacock M, Weaver CM. Racial differences in skeletal calcium retention in adolescent girls with varied controlled calcium intakes. Am J Clin Nutr. 2007;85:1657–63.PubMedGoogle Scholar
  6. Cheng JC, Maffulli N, Leung SS, Lee WT, Lau JT, Chan KM. Axial and peripheral bone mineral acquisition: a 3-year longitudinal study in Chinese adolescents. Eur J Pediatr. 1999;158:506–12.PubMedCrossRefGoogle Scholar
  7. Ellis KJ, Shypailo RJ, Hergenroeder A, Perez M, Abrams S. Total body calcium and bone mineral content: comparison of dual-energy X-ray absorptiometry with neutron activation analysis. J Bone Miner Res. 1996;11:843–8.PubMedCrossRefGoogle Scholar
  8. Faulkner RA, Davison KS, Bailey DA, Mirwald RL, Baxter-Jones AD. Size-corrected BMD decreases during peak linear growth: implications for fracture incidence during adolescence. J Bone Miner Res. 2006;21:1864–70.PubMedCrossRefGoogle Scholar
  9. Grimston SK, Willows ND, Hanley DA. Mechanical loading regime and its relationship to bone mineral density in children. Med Sci Sports Exerc. 1993;25:1203–10.PubMedGoogle Scholar
  10. Heaney RP. The bone-remodeling transient: implications for the interpretation of clinical studies of bone mass change. J Bone Miner Res. 1994;9:1515–23.PubMedCrossRefGoogle Scholar
  11. Jones G, Dwyer T. Bone mass in prepubertal children: gender differences and the role of physical activity and sunlight exposure. J Clin Endocrinol Metab. 1998;83:4274–9.PubMedCrossRefGoogle Scholar
  12. Kroger H, Kotaniemi A, Kroger L, Alhava E. Development of bone mass and bone density of the spine and femoral neck–a prospective study of 65 children and adolescents. Bone Miner. 1993;23:171–82.PubMedCrossRefGoogle Scholar
  13. Lee WT, Cheng JC, Jiang J, Hu P, Hu X, Roberts DC. Calcium absorption measured by stable calcium isotopes ((42)Ca & (44)Ca) among Northern Chinese adolescents with low vitamin D status. J Orthop Surg (Hong Kong). 2002;10:61–6.Google Scholar
  14. Martin AD, Bailey DA, McKay HA, Whiting S. Bone mineral and calcium accretion during puberty. Am J Clin Nutr. 1997;66:611–5.PubMedGoogle Scholar
  15. Matkovic V, Goel PK, Badenhop-Stevens NE, Landoll JD, Li B, Ilich JZ, Skugor M, Nagode LA, Mobley SL, Ha EJ, Hangartner TN, Clairmont A. Calcium supplementation and bone mineral density in females from childhood to young adulthood: a randomized controlled trial. Am J Clin Nutr. 2005;81:175–88.Google Scholar
  16. O’Brien KO, Abrams SA, Liang LK, Ellis KJ, Gagel RF. Increased efficiency of calcium absorption during short periods of inadequate calcium intake in girls. Am J Clin Nutr. 1996;63:579–83.Google Scholar
  17. Theintz G, Buchs B, Rizzoli R, Slosman D, Clavien H, Sizonenko PC, Bonjour JP. 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.PubMedCrossRefGoogle Scholar
  18. Uusi-Rasi K, Haapasalo H, Kannus P, Pasanen M, Sievanen H, Oja P, Vuori I. Determinants of bone mineralization in 8 to 20 year old Finnish females. Eur J Clin Nutr. 1997;51:54–9.PubMedCrossRefGoogle Scholar
  19. Vatanparast H, Baxter-Jones A, Faulkner RA, Bailey DA, Whiting SJ. Positive effects of vegetable and fruit consumption and calcium intake on bone mineral accrual in boys during growth from childhood to adolescence: the University of Saskatchewan Pediatric Bone Mineral Accrual Study. Am J Clin Nutr. 2005;82:700–6.PubMedGoogle Scholar
  20. Whiting SJ, Vatanparast H, Baxter-Jones A, Faulkner RA, Mirwald R, Bailey DA. Factors that affect bone mineral accrual in the adolescent growth spurt. J Nutr. 2004;134:696S–700S.PubMedGoogle Scholar
  21. Yin J, Zhang Q, Du WJ, Wang XY, Hu XQ, Ma GS. Study on calcium metabolism among 12–17 years old adolescents. ACTA Nutrimenta Sinica. 2007;29:113–7.Google Scholar
  22. Zhang LW. Normal references of growth and development for children and adolescents in Beijing area. PhD thesis. Beijing, China CDC. 2003.Google Scholar
  23. Zhu K, Du X, Greenfield H, Zhang Q, Ma G, Hu X, Fraser DR. Bone mass in Chinese premenarcheal girls: the roles of body composition, calcium intake and physical activity. Br J Nutr. 2004;92:985–93.PubMedCrossRefGoogle Scholar
  24. Zhu K, Greenfield H, Zhang Q, Du X, Ma G, Foo LH, Cowell CT, Fraser DR. Growth and bone mineral accretion during puberty in chinese girls: a five-year longitudinal study. J Bone Miner Res. 2008;23:167–72.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Endocrinology and DiabetesSir Charles Gairdner HospitalNedlandsAustralia
  2. 2.School of Medicine and PharmacologyUniversity of Western AustraliaPerthAustralia

Personalised recommendations