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Calcium Absorption, Bone Mass Accumulation, and Kinetics Increase during Early Pubertal Development in Girls¹

U.S. Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center (S.A.A., K.J.E.), Section of Endocrinology (K.C.C., S.K.G.), Department of Pediatrics (S.A.A., K.J.E.), Baylor College of Medicine, and Texas Children’s Hospital (S.A.A., K.J.E.), Houston, Texas 77030; Department of Clinical Science, A. I. duPont Hospital for Children (K.O.K.), Wilmington, Delaware 19899; and Department of Orthopedics and Rehabilitation, Yale University School of Medicine (C.M.G.), New Haven, Connecticut 06510

Address all correspondence and requests for reprints to: Steven A. Abrams, M.D., U.S. Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center, 1100 Bates Street, Houston, Texas 77030. E-mail: sabrams{at}bcm.tmc.edu

To evaluate the changes in calcium and bone mineral metabolism associated with early pubertal development, we performed longitudinal measurements of calcium absorption, calcium kinetics, bone mineral content, and hormonal markers related to puberty in a multiethnic group of girls beginning when they were 7 or 8 yr old. Girls were Tanner stage 1 (breast) at the start of the study. They were placed on a 1200 mg/day dietary calcium intake and studied at approximately 6-month intervals until they reached Tanner stage 2 (breast). Results at that time point (PUB) were compared to values obtained approximately 1 yr earlier (LatePRE) and those 1 yr before that (EarlyPRE). We found an increase in calcium absorption comparing PUB to LatePRE (n = 34; 36.6 ± 8.7% vs. 30.7 ± 9.9%; P = 0.002). Using whole body, dual energy, x-ray absorptiometry scanning, we found an increase in calcium gain during the LatePRE to PUB period compared with that during the EarlyPRE to LatePRE period (135 ± 53 vs. 110 ± 45 mg/day; P = 0.04). Calcium kinetic studies showed a significant increase in the bone calcium deposition rate (V_o+) during the PUB compared to the LatePRE period. Hormonal and biochemical markers of bone development were also significantly increased at PUB compared to LatePRE. Hormonal activity, as evidenced by the unstimulated LH level, was significantly correlated with calcium gain between the LatePRE and PUB studies and the bone calcium deposition rate in the PUB study. These data demonstrate, using multiple independent methods, an increase in calcium utilization associated with the earliest physical signs of puberty.

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