ORIGINAL RESEARCH article

Front. Endocrinol.

Sec. Bone Research

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1587985

This article is part of the Research TopicBone Health and Development in Children and Adolescents: Volume IIView all 8 articles

RISK FACTORS ASSOCIATED WITH LOW BONE MINERAL DENSITY AND CHILDHOOD OSTEOPOROSIS IN A POPULATION UNDERGOING SKELETAL GROWTH: A CROSS-SECTIONAL ANALYTIC STUDY

Provisionally accepted
Berta  Magallares-LópezBerta Magallares-López1,2,3*Dacia  CerdàDacia Cerdà4Jocelyn  BetancourtJocelyn Betancourt3,5Gloria  FragaGloria Fraga3,5Hye Sang  ParkHye Sang Park1,3Helena  Codes-MéndezHelena Codes-Méndez1,3*Estefanía  Quesada-MasachsEstefanía Quesada-Masachs2,6Mireia  López-CorbetoMireia López-Corbeto6Montserrat  TorrentMontserrat Torrent5Ana  MarínAna Marín7Silvia  HerreraSilvia Herrera3,7Ignasi  GichIgnasi Gich3,8,9Susana  BoronatSusana Boronat3,5Jordi  CasademontJordi Casademont10Hector  CorominasHector Corominas1,3Jorge  MaloufJorge Malouf7
  • 1Department of rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
  • 2Department of rheumatology, Hospital Universitari Dexeus-Grupo Quirón Salud, Barcelona, Balearic Islands, Spain
  • 3Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Balearic Islands, Spain
  • 4Department of Rheumatology, Hospital Sant Joan Despí Moisès Broggi, Barcelona, Balearic Islands, Spain
  • 5Department of Pediatrics, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
  • 6Department of Pediatric Rheumatology, Vall d'Hebrón Barcelona Hospital Campus, Barcelona, Balearic Islands, Spain
  • 7Department of Mineral Metabolism Unit - Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Balearic Islands, Spain
  • 8Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Madrid Community, Spain
  • 9Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Barcelona, Balearic Islands, Spain
  • 10Department of Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Balearic Islands, Spain

The final, formatted version of the article will be published soon.

Background:Early identification of risk factors for low bone mass for chronological age (LBMca) and childhood osteoporosis (cOP) in patients undergoing skeletal growth is essential to mitigate long-term skeletal complications. cOP is diagnosed when LBMca (BMD Z-score ≤2) is accompanied by a clinically significant fracture history, or when vertebral fragility fractures are present.Methods:Patients under 21 years of age with at least one risk factor for LBMca (malabsorption syndrome, chronic inflammatory diseases, hematological diseases, endocrinopathies, drugs that affect bone metabolism, or insufficient calcium intake) were included. Data on fractures history and physical activity levels were collected. Spine and whole-body dual-energy x-ray absorptiometry (DXA) and vertebral morphometry were performed. Age-adjusted linear regression analysis evaluated associations between bone mineral density (BMD) and risk factors.Results:A total of 103 patients were included (mean age 9.8 years; 52.4% female), and 96.1% had more than two risk factors. The prevalence of LBMca was 10.5% and the prevalence of cOP was 4.8%. Vertebral BMD was positively associated with male sex. Whole body BMD was negatively associated with sedentary lifestyle and fracture history. Total body less head BMD showed negative associations with current steroid treatment, sedentary lifestyle, and history of fractures.Conclusions:Pediatric populations at risk of LBMca or cOP often have multiple risk factors, notably modifying ones such as physical inactivity. Up to 10.5% of children with risk factors present LBMca and 4.8% have an undiagnosed or unknown cOP. Longitudinal studies are warranted to understand the long-term impact of the identified risk factors, including age, sex, sedentary lifestyle, ethnicity and vitamin D status, on bone health.

Keywords: Low Bone Mass for Chronological Age, childhood osteoporosis, Bone fragility, bone mineral density, DXA (Dual-energy X-ray Absorptiometry)

Received: 05 Mar 2025; Accepted: 28 Apr 2025.

Copyright: © 2025 Magallares-López, Cerdà, Betancourt, Fraga, Park, Codes-Méndez, Quesada-Masachs, López-Corbeto, Torrent, Marín, Herrera, Gich, Boronat, Casademont, Corominas and Malouf. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Berta Magallares-López, Department of rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
Helena Codes-Méndez, Department of rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain

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