REVIEW  BONE HEALTH IN WOMAN’S REPRODUCTIVE LIFE AND POSTMENOPAUSE 

Minerva Obstetrics and Gynecology 2021 December;73(6):662-77

DOI: 10.23736/S2724-606X.20.04713-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Bone health in adolescence

Maria R. AMBROSIO ¹ ✉, Ludovica ALIBERTI ¹, Irene GAGLIARDI ¹, Paola FRANCESCHETTI ², Maria C. ZATELLI ¹

¹ Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; ² Operative Unit of Endocrinology and Metabolic Diseases, Department of Oncology and Specialty Medicine, Ferrara University Hospital, Ferrara, Italy

Adolescence is a fundamental period for the formation of the skeleton, because is the stage in which bones grow more in both size and strength, laying a solid foundation for the future health of the skeleton. Any condition interfering with optimal peak bone mass accrual can increase fracture risk later in life. Up to 80% of peak bone mass is genetically determined while the remaining 20% is modulated by environmental factors that, if deleterious, may result in low bone mineral density (BMD) and an increased risk of fracture. The preferred test to assess bone health is dual-energy x-ray absorptiometry (spine or total body less head) using Z scores instead of T scores, even though in short stature or growth delay, should be used the height Z-score. The correction of risk factors is the first treatment for low BMD in children and adolescents. It’s necessary having a correct lifestyle for preserving bone health: a proper nutrition, an adequate physical weight-bearing activity and avoidance of alcohol intake and tobacco smoke. Bisphosphonates could be used in children who sustained osteoporotic fractures, impairing quality of life, when spontaneous recovery is low for the persistence of osteoporosis risk factors. This clinical review discusses factors affecting bone health during childhood and adolescence and deals with diagnosis and treatment of low bone mass or osteoporosis in this age group.

KEY WORDS: Bone and bones; Adolescent; Bone density; Osteoporosis