This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Wang, Q. Search for Related Content PubMed PubMed Citation Articles by Wang, Q. Related Collections Pediatric Endocrinology Calcium and Bone Metabolism Female Endocrinology

Bone’s Structural Diversity in Adult Females Is Established before Puberty

Austin Health (Q.W., E.S.), University of Melbourne, Heidelberg 3081, Melbourne, Australia; Department of Health Sciences (S.C.), University of Jyväskylä, 40351 Jyväskylä, Finland; and Department of Medical Rehabilitation (M.A.), Oulu University Hospital and Institute of Health Sciences, University of Oulu, 90221 Oulu, Finland

Address all correspondence and requests for reprints to: Dr. Seeman, Department of Endocrinology, Austin Health, Centaur Building, Repatriation Campus, Heidelberg 3081, Melbourne, Australia. E-mail: egos{at}unimelb.edu.au.

Introduction: Bone must be rigid for leverage yet light for mobility. We studied how bone modeling and remodeling fashioned differences in bone size, shape, and mass during growth to achieve these properties in adulthood.

Methods: We measured the structural features of a tibial cross-section using quantitative computed tomography and markers of remodeling in 258 10- to 13-yr-old girls during 2 yr and in 108 of their mothers.

Results: Tibia total cross-sectional area and mass correlated between daughters and their mothers (r = 0.34 and 0.44, respectively, both P < 0.01). The location of a daughter’s tibial total cross-sectional area, medullar area, and bone mass in the lower, middle, or upper part of the sample distribution was established before puberty and tracked during 2 yr (r = 0.84–0.94 first vs. last measurements’ ranking). Tibial cross-sectional area correlated with medullar area (r = 0.69). Both areas correlated inversely with volumetric bone mineral density (r = –0.32 and –0.67, respectively; all P < 0.001), so larger cross-sections had a lower volumetric bone mineral density. The amount of bone deposited on the anterior and posterior periosteal surface during 2 yr was twice that deposited medially and laterally (P < 0.001), increasing strength more in the former than in the latter principal axis.

Conclusion: Differences in skeletal size, shape, and mass in adulthood are likely to be largely established before puberty. We infer that bone fragility in advanced age has its structural antecedents partly established in early life.