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Peak Bone Mass, Size Appear Almost Fully Attained by Late Adolescence

Most of peak bone mass and size are acquired by late adolescence and followed by consolidation at some skeletal sites, according to a new report.

Peak bone mineral content (peak BMC) and subsequent bone loss are important determinants for the risk of osteoporotic fracture in later life. However, previous studies of the age at which peak bone values are reached have produced varying results.

Seeking to further investigate the timing of peak BMC, Dr. Yvette M. Henry and colleagues of Northern General Hospital, Sheffield, United Kingdom, studied bone size and volumetric bone mass density (vBMD) in 266 healthy Caucasian subjects.

Within the study population, 132 subjects were children (63 boys and 69 girls, ages 11-19 years) and 134 were adults (66 men and 68 women, ages 20-50 years).

The researchers used dual-energy x-ray absorptiometry at the anterior-posterior (AP) and lateral lumbar spine (LS) femoral neck (FN) and ultradistal radius (UDR) to measure BMC and estimate vBMD and bone size.

Data sets from both age groups were combined to assess the timing of peak values and changes in BMC, bone size, and vBMD with age.

Analysis showed that LS BMC increased steeply with age into young adulthood in both sexes. Boys and girls at 16 years of age were similar in the percentage of both peak BMC attained (82% and 79%, respectively) and bone size achieved (83% and 85%, respectively).

LS peak vBMD was reached earlier in men than in women (22 years vs. 29 years, respectively), but the percentage of peak vBMD achieved was comparable in both sexes (97% and 94%, respectively).

Increases in FN and UDR BMC with age were similar in women and men (23 and 21 years, respectively). Bone size in the FN increased with age in both sexes, and the highest values for vBMD occurred at 12 years or earlier. In contrast, UDR bone size increased with age only in men, and vBMD increased during growth in girls more than boys.

Noting increase in bone size with little increase in vBMD during consolidation, the researchers speculate that BMC increases in young adulthood may primarily be due to a continued increase in bone size.

"It is important to understand the time course for attaining peak bone density if preventative lifestyle changes for osteoporosis are to be adequately implemented," they said," and to understand how the origins of osteoporosis may begin during childhood and young adulthood."

Osteoporos Int 2004 Apr;15:4:263-73. Epub 2004 Feb 24. "Attainment of peak bone mass at the lumbar spine, femoral neck and radius in men and women: relative contributions of bone size and volumetric bone mineral density"

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