Home Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study
Article
Licensed
Unlicensed Requires Authentication

Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study

  • Maria A. Papaefthymiou EMAIL logo , Chryssa Bakoula , Aikaterini Sarra , Ioannis Papassotiriou , George P. Chrousos and Flora Bacopoulou
Published/Copyright: April 16, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 27 Issue 7-8

Abstract

Objective: The aim of this study was to assess possible associations between potential risk factors for fractures and their occurrence in otherwise healthy Greek male adolescents.

Subjects: A total of 63 male adolescents participated in the study, 21 males with a history of at least one fracture and 42 healthy male controls.

Methods: Each participant was assessed for physical and pubertal status, hormonal profile, bone mineral density, bone turnover indices, and dietary habits.

Results: The lower bone mineral density-z scores and increasing testosterone and serum collagen type 1 cross-linked C-telopeptide levels were related to fracture risk, whereas increased insulin-like growth factor-1, soluble receptor activator of nuclear factor kappa-B (factor-κB) ligand, and soluble receptor activator of nuclear factors-κB ligand/osteoprotegerin levels were protective for fractures.

Conclusions: The findings indicate a potential ‘added value’ of hormonal parameters and bone markers to bone mineral density for evaluating fracture risk in healthy male adolescents.

Keywords: bone mineral density; bone turnover markers; fracture; male adolescents; testosterone
Corresponding author: Maria A. Papaefthymiou, MD, Center for Adolescent Medicine and UNESCO Chair in Adolescent Medicine and Health Care, First Department of Pediatrics, University of Athens Medical School, Children’s Hospital ‘Aghia Sophia’, Athens, Greece and 4 Dilou Street, Athens 11527, Greece, Phone: +306938900148, 00302167002902, Fax: +302167002902, E-mail:

Acknowledgments

All authors have made substantial contributions to conception, acquisition, and interpretation of data. They have participated in drafting the article and they have approved the content of the manuscript as submitted. Everyone who contributed significantly to this article is listed.

References

1. Khosla S, Melton LJ 3rd, Dekutoski MB, Achenbach SJ, Oberg AL, et al. Incidence of childhood distal forearm fractures over 30 years: a population-based study. JAMA 2003;290:1479–85.10.1001/jama.290.11.1479Search in Google Scholar PubMed

2. Jones IE, Williams SM, Goulding A. Associations of birth weight and length, childhood size, and smoking with bone fractures during growth: evidence from a birth cohort study. Am J Epidemiol 2004;159:343–50.10.1093/aje/kwh052Search in Google Scholar PubMed

3. Darelid A, Ohlsson C, Rudäng R, Kindblom JM, Mellström D, et al. Trabecular volumetric bone mineral density is associated with previous fracture during childhood and adolescence in males: The GOOD Study. J Bone Miner Res 2010;25:537–44.10.1359/jbmr.090824Search in Google Scholar PubMed

4. Carson S, Woolridge DP, Colletti J, Kilgore K. Pediatric upper extremity injuries. Pediatr Clin North Am 2006;53:41–67.10.1016/j.pcl.2005.10.003Search in Google Scholar PubMed

5. Ferrari S, Chevalley T, Bonjour JP, Rizzoli R. Childhood fractures are associated with decreased bone mass gain during puberty: An early marker of persistent bone fragility? J Bone Miner Res 2006;21:501–7.10.1359/jbmr.051215Search in Google Scholar PubMed

6. Wren TA, Shepherd JA, Kalkwarf HJ, Zemel BS, Lappe JM, et al. Racial disparity in fracture risk between white and nonwhite children in the United States. J Pediatr 2012;161:1035–40.10.1016/j.jpeds.2012.07.054Search in Google Scholar PubMed PubMed Central

7. Sarra A, Karantza M, Papaefthymiou M, Soultanakis H, Papaefstathiou A, et al. Influence of developmental and hormonal factors on bone health in adolescent females: a cross-sectional study and review of the literature. J Pediatr Endocrinol Metab 2013;26:239–46.10.1515/jpem-2012-0355Search in Google Scholar PubMed

8. EUROFIT CoEoSR. Handbook for the EUROFIT Test of Physical Fitness. Strasbourg, 1993.Search in Google Scholar

9. Lewiecki EM, Gordon CM, Baim S, Leonard MB, Bishop NJ, et al. International Society for Clinical Densitometry 2007 Adult and Pediatric Official Positions. Bone 2008;43:1115–21.10.1016/j.bone.2008.08.106Search in Google Scholar PubMed

10. Szulc P, Seeman E, Delmas PD. Biochemical measurements of bone turnover in children and adolescents. Osteoporos Int 2000;11:281–94.10.1007/s001980070116Search in Google Scholar PubMed

11. Konstantynowicz J, Bialokoz-Kalinowska I, Motkowski R, Abramowicz P, Piotrowska-Jastrzebska J, et al. The characteristics of fractures in Polish adolescents aged 16–20 years. Osteoporos Int 2005;16:1397–403.10.1007/s00198-005-1850-3Search in Google Scholar PubMed

12. Chevalley T, Bonjour JP, van Rietbergen B, Ferrari S, Rizzoli R. Fractures during childhood and adolescence in healthy boys: relation with bone mass, microstructure, and strength. J Clin Endocrinol Metab 2011;96:3134–42.10.1210/jc.2011-1445Search in Google Scholar PubMed

13. Ceroni D, Martin X, Delhumeau-Cartier C, Rizzoli R, Kaelin A. Is bone mineral mass truly decreased in teenagers with a first episode of forearm fracture? A prospective longitudinal study. J Pediatr Orthop 2012;32:579–86.10.1097/BPO.0b013e31824b2b1fSearch in Google Scholar PubMed

14. Slemenda CW, Peacock M, Hui S, Zhou L, Johnston CC. Reduced rates of skeletal remodeling are associated with increased bone mineral density during the development of peak skeletal mass. J Bone Miner Res 1997;12:676–82.10.1359/jbmr.1997.12.4.676Search in Google Scholar PubMed

15. Vasikaran S, Eastell R, Bruyère O, Foldes AJ, Garnero P, et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int 2011;22:391–420.10.1007/s00198-010-1501-1Search in Google Scholar PubMed

16. Dimitroulas T, Nikas SN, Trontzas P, Kitas GD. Biologic therapies and systemic bone loss in rheumatoid arthritis. Autoimmun Rev 2013;12:958–66.10.1016/j.autrev.2013.03.015Search in Google Scholar PubMed

17. Moschen AR, Kaser A, Enrich B, Ludwiczek O, Gabriel M, et al. The RANKL/OPG system is activated in inflammatory bowel disease and relates to the state of bone loss. Gut 2005;54: 479–87.10.1136/gut.2004.044370Search in Google Scholar PubMed PubMed Central

18. Trofimov S, Pantsulaia I, Kobyliansky E, Livshits G. Circulating levels of receptor activator of nuclear factor-kappa B ligand/osteoprotegerin/macrophage-colony stimulating factor in a presumably healthy human population. Eur J Endocrinol 2004;150:305–11.10.1530/eje.0.1500305Search in Google Scholar PubMed

19. de Ridder CM, Delemarre-van de Waal HA. Clinical utility of markers of bone turnover in children and adolescents. Curr Opin Pediatr 1998;10:441–8.10.1097/00008480-199808000-00020Search in Google Scholar PubMed

20. Singer FR, Eyre DR. Using biochemical markers of bone turnover in clinical practice. Cleve Clin J Med 2008;75:739–50.10.3949/ccjm.75.10.739Search in Google Scholar PubMed

21. Garnero P, Hausherr E, Chapuy MC, Marcelli C, Grandjean H, et al. Markers of bone resorption predict hip fracture in elderly women: the EPIDOS Prospective Study. J Bone Miner Res 1996;11:1531–8.10.1002/jbmr.5650111021Search in Google Scholar PubMed

22. Hofbauer L, Hicok K, Chen D, Khosla S. Regulation of osteoprotegerin production by androgens and anti-androgens in human osteoblastic lineage cells. Eur J Endocrinol 2002;147:269–73.10.1530/eje.0.1470269Search in Google Scholar PubMed

23. Rivara FP, Bergman AB, Logerfo JP, Weiss NS. Epidemiology of childhood injuries. II. Sex differences in injury rates. Am J Dis Child 1982;136:502–6.10.1001/archpedi.1982.03970420026004Search in Google Scholar PubMed

24. Slemenda CW, Millet JZ, Hui SL, Reister TK, Johnston CC. Role of physical activity in the development of skeletal mass in children. J Bone Miner Res 1991;11:1227–33.10.1002/jbmr.5650061113Search in Google Scholar PubMed

25. Valerio G, Gallè F, Mancusi C, Di Onofrio V, Colapietro M, et al. Pattern of fractures across pediatric age groups: analysis of individual and lifestyle factors. BMC Public Health 2010;10:656.10.1186/1471-2458-10-656Search in Google Scholar PubMed PubMed Central

26. Padova G, Borzì G, Incorvaia L, Siciliano G, Migliorino V, et al. Prevalence of osteoporosis and vertebral fractures in acromegalic patients. Clin Cases Miner Bone Metab 2011;8:37–43.Search in Google Scholar

27. Ohlsson C, Mellström D, Carlzon D, Orwoll E, Ljunggren O, et al. Older men with low serum IGF-1 have an increased risk of incident fractures: the MrOS Sweden study. J Bone Miner Res 2011;26:865–72.10.1002/jbmr.281Search in Google Scholar PubMed

28. Paccou J, Dewailly J, Cortet B. Reduced levels of serum IGF-1 is related to the presence of osteoporotic fractures in male idiopathic osteoporosis. Joint Bone Spine 2012;79:78–82.10.1016/j.jbspin.2011.06.002Search in Google Scholar PubMed

29. Loud KJ, Micheli LJ, Bristol S, Austin SB, Gordon CM. Family history predicts stress fracture in active female adolescents. Pediatrics 2007;120:364–72.10.1542/peds.2006-2145Search in Google Scholar PubMed PubMed Central

30. Pekkinen M, Viljakainen H, Saarnio E, Lamberg-Allardt C, Mäkitie O. Vitamin D is a major determinant of bone mineral density at school age. PLoS One 2012;7:e40090.10.1371/journal.pone.0040090Search in Google Scholar PubMed PubMed Central

31. Ryan LM, Teach SJ, Singer SA, Wood R, Freishtat R, et al. Bone mineral density and vitamin D status among African American children with forearm fractures. Pediatrics 2012;130:e553–60.10.1542/peds.2012-0134Search in Google Scholar PubMed PubMed Central

32. Heaney RP, Holick MF. Why the IOM recommendations for vitamin D are deficient. J Bone Miner Res 2011;26:455–7.10.1002/jbmr.328Search in Google Scholar PubMed

33. James JR, Massey PA, Hollister AM, Greber EM. Prevalence of hypovitaminosis among children with upper extremity fractures. J Pediatr Orthop 2013;33:159–62.10.1097/BPO.0b013e3182770bf7Search in Google Scholar PubMed

34. Chevalley T, Bonjour JP, Ferrari S, Hans D, Rizzoli R. Skeletal site selectivity in the effects of calcium supplementation on areal bone mineral density gain: a randomized, double-blind, placebo-controlled trial in prepubertal boys. J Clin Endocrinol Metab 2005;90:3342–9.10.1210/jc.2004-1455Search in Google Scholar PubMed

35. Afghani A, Abbott AV, Wiswell RA, Jaque SV, Gleckner C, et al. Bone mineral density in Hispanic women: role of aerobic capacity, fat-free mass, and adiposity. Int J Sports Med 2004;25:384–90.10.1055/s-2004-815839Search in Google Scholar PubMed

Article note: The authors are responsible for the choice and presentation of views contained in this article and for opinions expressed therein, which are not necessarily those of UNESCO and do not commit the Organization.

Received: 2013-10-19
Accepted: 2014-2-28
Published Online: 2014-4-16
Published in Print: 2014-7-1

©2014 by Walter de Gruyter Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Welcome to Assistant Editors at JPEM
  4. Review article
  5. Common approach to childhood obesity in Japan
  6. Images in pediatric endocrinology
  7. Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood
  8. Original articles
  9. Prevalence of vitamin D deficiency among Iranian adolescents
  10. Analysis of body composition among children and adolescents – a cross-sectional study of the Polish population and comparison of body fat measurement methods
  11. Association of rs8066560 variant in the sterol regulatory element-binding protein 1 (SREBP-1) and miR-33b genes with hyperglycemia and insulin resistance
  12. Differences in anxiety and depression between male and female caregivers of children with a disorder of sex development
  13. Fasting and postprandial levels of a novel anorexigenic peptide nesfatin in childhood obesity
  14. The effect of growth hormone treatment on height in children with idiopathic short stature
  15. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: secular trend towards earlier age of onset
  16. Relationships of gamma-glutamyltransferase and beta 2-microglobulin on high sensitivity C-reactive protein among Japanese elementary school children
  17. Evaluation of insulin resistance and metabolic syndrome in a group of obese Czech children
  18. Circulating intact parathyroid hormone is suppressed at 25-hydroxyvitamin D concentrations >25 nmol/L in children
  19. Association between vitamin D level and cardiovascular risk in obese children and adolescents
  20. Serum paraoxonase activity and oxidative stress and their relationship with obesity-related metabolic syndrome and non-alcoholic fatty liver disease in obese children and adolescents
  21. Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves’ disease compared with adolescent patients
  22. Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study
  23. Evaluation of lipid and glucose metabolism and cortisol and thyroid hormone levels in obese appropriate for gestational age (AGA) born and non-obese small for gestational age (SGA) born prepubertal Slovak children
  24. Chitotriosidase as a possible marker of clinically evidenced atherosclerosis in dyslipidemic children
  25. Exhaled carbon monoxide in adolescents with diabetic cardiovascular autonomic neuropathy
  26. Gut hormone profiles in preterm and term infants during the first 2 months of life
  27. Outcome analysis of aromatase inhibitor therapy to increase adult height in males with predicted short adult stature and/or rapid pubertal progress: a retrospective chart review
  28. A deletion including exon 2 of the TSHR gene is associated with thyroid dysgenesis and severe congenital hypothyroidism
  29. Steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) in childhood
  30. Patient Reports
  31. Neonatal diabetes in an infant of diabetic mother: same novel INS missense mutation in the mother and her offspring
  32. Atypical neurologic presentations of new onset type 1 diabetes mellitus in pediatric age group: a report of five unusual cases and review of the literature
  33. Importance of dietary calcium and vitamin D in the treatment of hypercalcaemia in Williams-Beuren syndrome
  34. Vitamin D intoxication in two brothers: be careful with dietary supplements
  35. Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing
  36. A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status
  37. Holoprosencephaly: ZIC2 mutation in a case with panhypopituitarism
  38. An association of hypochondroplasia and immune deficiency
  39. Hypophosphatemic rickets caused by a novel PHEX gene mutation in an Indian girl
  40. Psoriasis vulgaris and autoimmune polyendocrine syndrome type I: a case report
  41. Identification of a combined missense/splice-site mutation in FAH causing tyrosinemia type 1
  42. Letter to the Editor
  43. Vitamin D intake and premature infants with intraventricular hemorrhage: how advisable is it?
https://doi.org/10.1515/jpem-2013-0407
Keywords for this article
bone mineral density; bone turnover markers; fracture; male adolescents; testosterone

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Welcome to Assistant Editors at JPEM
  4. Review article
  5. Common approach to childhood obesity in Japan
  6. Images in pediatric endocrinology
  7. Aromatase deficiency in an adolescent girl misdiagnosed as congenital adrenal hyperplasia in infancy and childhood
  8. Original articles
  9. Prevalence of vitamin D deficiency among Iranian adolescents
  10. Analysis of body composition among children and adolescents – a cross-sectional study of the Polish population and comparison of body fat measurement methods
  11. Association of rs8066560 variant in the sterol regulatory element-binding protein 1 (SREBP-1) and miR-33b genes with hyperglycemia and insulin resistance
  12. Differences in anxiety and depression between male and female caregivers of children with a disorder of sex development
  13. Fasting and postprandial levels of a novel anorexigenic peptide nesfatin in childhood obesity
  14. The effect of growth hormone treatment on height in children with idiopathic short stature
  15. Clinical characteristics of type 1 diabetes over a 40 year period in Turkey: secular trend towards earlier age of onset
  16. Relationships of gamma-glutamyltransferase and beta 2-microglobulin on high sensitivity C-reactive protein among Japanese elementary school children
  17. Evaluation of insulin resistance and metabolic syndrome in a group of obese Czech children
  18. Circulating intact parathyroid hormone is suppressed at 25-hydroxyvitamin D concentrations >25 nmol/L in children
  19. Association between vitamin D level and cardiovascular risk in obese children and adolescents
  20. Serum paraoxonase activity and oxidative stress and their relationship with obesity-related metabolic syndrome and non-alcoholic fatty liver disease in obese children and adolescents
  21. Clinical features at diagnosis and responses to antithyroid drugs in younger children with Graves’ disease compared with adolescent patients
  22. Influence of hormonal parameters, bone mineral density and bone turnover on fracture risk in healthy male adolescents: a case control study
  23. Evaluation of lipid and glucose metabolism and cortisol and thyroid hormone levels in obese appropriate for gestational age (AGA) born and non-obese small for gestational age (SGA) born prepubertal Slovak children
  24. Chitotriosidase as a possible marker of clinically evidenced atherosclerosis in dyslipidemic children
  25. Exhaled carbon monoxide in adolescents with diabetic cardiovascular autonomic neuropathy
  26. Gut hormone profiles in preterm and term infants during the first 2 months of life
  27. Outcome analysis of aromatase inhibitor therapy to increase adult height in males with predicted short adult stature and/or rapid pubertal progress: a retrospective chart review
  28. A deletion including exon 2 of the TSHR gene is associated with thyroid dysgenesis and severe congenital hypothyroidism
  29. Steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT) in childhood
  30. Patient Reports
  31. Neonatal diabetes in an infant of diabetic mother: same novel INS missense mutation in the mother and her offspring
  32. Atypical neurologic presentations of new onset type 1 diabetes mellitus in pediatric age group: a report of five unusual cases and review of the literature
  33. Importance of dietary calcium and vitamin D in the treatment of hypercalcaemia in Williams-Beuren syndrome
  34. Vitamin D intoxication in two brothers: be careful with dietary supplements
  35. Transient diabetes insipidus in a preterm neonate and the challenge of desmopressin dosing
  36. A rare case of hypoglycaemia due to insulinoma in an adolescent with acutely altered mental status
  37. Holoprosencephaly: ZIC2 mutation in a case with panhypopituitarism
  38. An association of hypochondroplasia and immune deficiency
  39. Hypophosphatemic rickets caused by a novel PHEX gene mutation in an Indian girl
  40. Psoriasis vulgaris and autoimmune polyendocrine syndrome type I: a case report
  41. Identification of a combined missense/splice-site mutation in FAH causing tyrosinemia type 1
  42. Letter to the Editor
  43. Vitamin D intake and premature infants with intraventricular hemorrhage: how advisable is it?
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 20.11.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2013-0407/pdf
Scroll to top button