Bone mineral density and body composition of children and adolescents in health and disease

Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to enhanced bone fragility and a consequent increase in fracture risk. Osteoporosis is a major public health problem involving postmenopausal women and aging individuals. The lifetime risk of osteoporotic fractures of the vertebral bodies (symptomatic), hip, and distal radius is about 40 % for white women and 13 % for white men. At present, the best possibility to assess the fracture risk of an individual is the measurement of bone mass (g) or bone mineral density (BMD, glcm). Studies in postmenopausal women showed that for each standard deviation decrease in BMD there was a 2-3 fold increase in fracture risk. Bone mass later in life is determined by the peak bone mass acquired during adolescence and the subsequent rate of bone loss. Low peak bone mass results in a higher risk of osteoporosis. A high peak bone mass provides a larger reserve later in life. BMD increases during childhood until the peak bone mass is achieved, around the age of 18 to 20 years. Thereafter, bone mass stabilizes and then decreases progressively in both sexes after 35 to 40 years of age with a steeper decline in women after the menopause.

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