Poor bone health in children increases the risk for fracture and possibly bone deformity. Conditions that impact the structural framework of bone and its mineralization may also lead to deformed bones. The childhood and adolescent years are a critical period for bone accrual with 50% of peak bone mass being achieved during the adolescent years, and more than 80% being achieved by 18 years of age. Because peak bone mass is a key determinant of future bone health, impaired rates of bone accrual during childhood and adolescence may increase the long-term risk of fracture. Non-modifiable determinants of bone accrual include genetic factors and diseases, whereas modifiable determinants include nutritional status, mechanical loading, hormones, chronic systemic diseases and chronic use of certain medications. In order to optimize bone health in a pediatric population and reduce both immediate and future fracture risk as well as the risk for longstanding bone deformity, it is essential to manage pediatric bone disorders in a timely and effective manner.
Management of conditions impacting bone health in children can be complex and challenging, and is often multifaceted. When the cause is modifiable, the first step of management may involve nutritional recommendations, attention to mechanical loading of bones, optimizing pubertal status, and addressing any underlying chronic disease/s. In recent times, data have also emerged regarding pharmacological interventions to optimize bone health in some of these conditions, and particularly in children with genetic conditions resulting in impaired bone health, those receiving chronic glucocorticoid therapy, and children with hematological malignancies. This Research Topic of Frontiers in Endocrinology covers the management of children suffering from some of these conditions. Each review is covered by an expert in this field.
We expect that this Topic will become an important resource for professionals managing children and adolescents with bone disorders.
Sub-themes of the current issue include, but are not limited to, management of:
-Primary bone disorders such as osteogenesis imperfecta and fibrous dysplasia
-Disorders of muscle such as Duchenne’s muscular dystrophy and spinal muscular atrophy
-Immobilization osteoporosis
-Conditions of low energy availability (eating disorders and oligo-amenorrheic athletes)
-Chronic systemic diseases (cystic fibrosis, inflammatory bowel disorders)
-Malignancy (leukemia, brain tumors)
-Chronic glucocorticoid use; other medications
-Rickets
This collection is the second volume of
'Management of Bone Disorders in Children'