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      Bone Mineral Density in Healthy Female Adolescents According to Age, Bone Age and Pubertal Breast Stage


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          This study was designed to evaluate bone mineral density (BMD) in healthy female Brazilian adolescents in five groups looking at chronological age, bone age, and pubertal breast stage, and determining BMD behavior for each classification.


          Seventy-two healthy female adolescents aged between 10 to 20 incomplete years were divided into five groups and evaluated for calcium intake, weight, height, body mass index (BMI), pubertal breast stage, bone age, and BMD. Bone mass was measured by bone densitometry (DXA) in lumbar spine and proximal femur regions, and the total body. BMI was estimated by Quetelet index. Breast development was assessed by Tanner’s criteria and skeletal maturity by bone age. BMD comparison according to chronologic and bone age, and breast development were analyzed by Anova, with Scheffe’s test used to find significant differences between groups at P≤0.05.


          BMD (g·cm -2) increased in all studied regions as age advanced, indicating differences from the ages of 13 to 14 years. This group differed to the 10 and 11 to 12 years old groups for lumbar spine BMD (0.865±0.127 vs 0.672±0.082 and 0.689±0.083, respectively) and in girls at pubertal development stage B3, lumbar spine BMD differed from B5 (0.709±0.073 vs 0.936±0.130) and whole body BMD differed from B4 and B5 (0.867±0.056 vs 0.977±0.086 and 1.040±0.080, respectively).


          Bone mineralization increased in the B3 breast maturity group, and the critical years for bone mass acquisition were between 13 and 14 years of age for all sites evaluated by densitometry.

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          Physical growth: National Center for Health Statistics percentiles.

          Anthropometry is an effective and frequently performed child health and nutrition screening procedure. The value of physical growth data depends on their accuracy and reliability, how they are recorded and interpreted, and what follow-up efforts are made after identification of growth abnormality. The new National Center for Health Statistics percentiles can be used to improve identification of potential health and nutritional problems and to facilitate the epidemological comparison of one group of children with others.
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            The bone mineral density in childhood study: bone mineral content and density according to age, sex, and race.

            Low bone mass may increase risk of fracture. Several chronic medical conditions, medications, and lifestyle factors affect bone mineral accrual. Appropriate reference values are essential for identification of children with bone deficits. Our objective was to establish reference curves for bone mineral content (BMC) and density (BMD) in children. The Bone Mineral Density in Childhood Study is an ongoing longitudinal study in which measurements are obtained annually at five clinical centers in the United States. Participants included 1554 healthy children (761 male, 793 female), ages 6-16 yr, of all ethnicities. Scans of the whole body, lumbar spine, hip, and forearm were obtained using dual-energy x-ray absorptiometry. Percentile curves based on three annual measurements were generated using the LMS statistical procedure. BMC of the whole body and lumbar spine and BMD of the whole body, lumbar spine, total hip, femoral neck, and forearm are given for specific percentiles by sex, age, and race (Black vs. non-Black). BMC and BMD were higher for Blacks at all skeletal sites (P < 0.0001). BMC and BMD increased with age, and a plateau was not evident by age 16 (girls) or age 17 (boys). The variation in BMC and BMD also increased with age. Age-, race-, and sex-specific reference curves can be used to help identify children with bone deficits and for monitoring changes in bone in response to chronic diseases or therapies.
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              Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes.

              The role of caffeine as a risk factor for bone loss is controversial. Our goals were 1) to compare in both a cross-sectional study and a 3-y longitudinal study the bone mineral density (BMD) of postmenopausal women consuming high or low amounts of caffeine and 2) to study the interaction between caffeine intake, vitamin D receptor (VDR) polymorphism, and BMD in the longitudinal study. The results are derived from cross-sectional measurements of BMD in 489 elderly women (aged 65-77 y) and from longitudinal measurements made in 96 of these women who were treated with a placebo for 3 y. Changes in BMD were adjusted for confounding factors and were compared between groups with either low ( 300 mg/d) caffeine intakes and between the VDR genotype subgroups of the low- and high-caffeine groups. Women with high caffeine intakes had significantly higher rates of bone loss at the spine than did those with low intakes (-1.90 +/- 0.97% compared with 1.19 +/- 1.08%; P = 0.038). When the data were analyzed according to VDR genotype and caffeine intake, women with the tt genotype had significantly (P = 0.054) higher rates of bone loss at the spine (-8.14 +/- 2.62%) than did women with the TT genotype (-0.34 +/- 1.42%) when their caffeine intake was >300 mg/d. Intakes of caffeine in amounts >300 mg/d ( approximately 514 g, or 18 oz, brewed coffee) accelerate bone loss at the spine in elderly postmenopausal women. Furthermore, women with the tt genetic variant of VDR appear to be at a greater risk for this deleterious effect of caffeine on bone.

                Author and article information

                Open Orthop J
                The Open Orthopaedics Journal
                Bentham Open
                12 September 2011
                : 5
                : 324-330
                [1 ]Clinical and Experimental Pediatrics Research Centre, Department of Pediatrics, Botucatu School of Medicine – UNESP, São Paulo State University, Brazil
                [2 ]Department of Physical Education, University of North Paraná – UENP, Brazil
                [3 ]Tropical Diseases and Image Diagnosis Department, Botucatu School of Medicine – UNESP, São Paulo State University, Brazil
                [4 ]Department of Applied Mathematics, State University of Londrina – UEL, Brazil
                [5 ]Department of Pediatrics, Adolescent Medicine Discipline, Post graduation Program in Gynecology, Obstetrics, and Mastology, Botucatu School of Medicine – UNESP, São Paulo State University, Brazil
                Author notes
                [* ]Address correspondence to this author at the Departamento de Pediatria, Disciplina de Medicina do Adolescente, Faculdade de Medicina de Botucatu, UNESP., CEP: 18607-918, Botucatu, SP, Brazil; Tel: +55 (14) 3811-6274/3811-6083; E-mail: tamara@ 123456fmb.unesp.br
                © Moretto et al.; Licensee Bentham Open.

                This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

                : 10 May 2011
                : 11 July 2011
                : 12 July 2011

                female,pubertal events.,bone mineral density,adolescents,breast development
                female, pubertal events., bone mineral density, adolescents, breast development


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