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The Journal of Clinical Endocrinology & Metabolism Vol. 82, No. 1 57-62
Copyright © 1997 by The Endocrine Society


Pediatric Endocrinology

Bone Mineral Density in Children and Adolescents: Relation to Puberty, Calcium Intake, and Physical Activity1

Annemieke M. Boot, Maria A. J. de Ridder, Huibert A. P. Pols, Eric P. Krenning and Sabine M. P. F. de Muinck Keizer-Schrama

Department of Pediatrics, Division of Endocrinology, Sophia Children’s Hospital (A.B., S.M.K.S.), and the Department of Epidemiology and Biostatistics (M.R.), Department of Internal Medicine, Division of Endocrinology (H.P.), and Department of Nuclear Medicine (E.K.), Erasmus University, Rotterdam, The Netherlands

Address all correspondence and requests for reprints to: Dr. A. M. Boot, Sophia Children’s Hospital, Division of Endocrinology, dr. Molewaterplein 60, 3015 GJ Rotterdam, the Netherlands.

The association of height, weight, pubertal stage, calcium intake, and physical activity with bone mineral density (BMD) was evaluated in 500 children and adolescents (205 boys and 295 girls), aged 4–20 yr. The BMD (grams per cm2) of lumbar spine and total body was measured with dual energy x-ray absorptiometry. Lumbar spine volumetric BMD was calculated to correct for bone size. BMD and volumetric BMD increased with age. During puberty, the age-dependent increment was higher. After adjustment for age, the Tanner stage was significantly associated with all three BMD variables in girls and with spinal BMD in boys. In boys, positive correlations were found between BMD and both calcium intake and physical activity after adjustment for age. Stepwise regression analysis with weight, height, Tanner stage, calcium intake, and physical activity as determinants with adjustment for age resulted in a model with Tanner stage in girls and weight in boys for all three BMD variables. The major independent determinant of BMD was the Tanner stage in girls and weight in boys.




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