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This version published online on October 26, 2004
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-1043
A more recent version of this article appeared on January 1, 2005
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Submitted on June 2, 2004
Accepted on October 14, 2004

Interaction between calcium intake and menarcheal age on bone mass gain: an 8-year follow-up study from pre-puberty to post-menarche

Thierry Chevalley*, René Rizzoli, Didier Hans, Serge Ferrari, and Jean-Philippe Bonjour

Service of Bone Diseases [WHO Collaborating Centre for Osteoporosis Prevention], Department of Rehabilitation and Geriatrics, Service of Nuclear Medicine, Department of Radiology, University Hospitals, Geneva, Switzerland

Background: Both late menarcheal age and low calcium intake (Ca intake) during growth are risk factors for osteoporosis, probably by impairing peak bone mass. We investigated whether lasting gain in areal bone mineral density (aBMD) in response to increased Ca intake varies according to menarcheal age and, conversely, whether Ca intake could influence menarcheal age.

Methods: In an initial study, 144 prepubertal girls were randomized in a double-blind controlled trial to receive either a Ca supplement (Ca-suppl.) of 850 mg/day or Placebo from age 7.9 to 8.9 yr. Mean aBMD gain determined by DXA at 6 sites (radius metaphysis, radius diaphysis, femoral neck, trochanter, femoral diaphysis, L2-L4) was significantly (P = 0.004)greater in the Ca-suppl. than in the Placebo group (27 vs. 21 mg/cm2). In 122 girls followed up, menarcheal age was recorded and aBMD determined when aged 16.4 yr.

Findings: Menarcheal age was lower in the Ca-suppl than in the Placebo group (P = 0.048). Menarcheal age and Ca intake were negatively correlated (R0.35, P < 0.001), as were aBMD gains from age 7.9 to 16.4 yr and menarcheal age at all skeletal sites (R range: from -0.41 to -0.22, P < 0.001 to P = 0.016). The positive effect of Ca-suppl. on mean aBMD gain from baseline remained significantly greater in girls below but not in those above the median of menarcheal age (13.0 yr). Early menarcheal age (12.1 ± 0.5): Placebo: 286 ± 36 mg/cm2; Ca-suppl.: 317 ± 46, P = 0.009; Late menarcheal age (13.9 ± 0.5): Placebo: 284 ± 58, Ca-suppl.: 276 ± 50, P > 0.05.

Interpretation: The level of Ca intake during pre-puberty may influence the timing of menarche which, in turn, could influence long-term bone mass gain in response to Ca supplementation. Thus, both determinants of early menarcheal age and high Ca intake may positively interact on bone mineral mass accrual.
Key words: bone growth • calcium-enriched foods • calcium intake • menarcheal age • bone mass gain




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